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            <SupplierCode>GQ</SupplierCode>
            <SupplierName>BIG GREEN SURGICAL COMPANY PTY LIMITED</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>GT</SupplierCode>
            <SupplierName>W L Gore &amp; Associates</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NAA</SupplierCode>
            <SupplierName>NSW HEALTH SERVICE - SOUTH EASTERN SYDNEY LOCAL HEALTH DISTRICT</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>GW</SupplierCode>
            <SupplierName>EQUINOX MEDICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>GX</SupplierCode>
            <SupplierName>GETINGE AUSTRALIA PTY. LTD.</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>GZ</SupplierCode>
            <SupplierName>AUSTRALIAN CRANIOFACIAL IMPLANTS PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HB</SupplierCode>
            <SupplierName>HORTEN MEDICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HC</SupplierCode>
            <SupplierName>Health Care Surgical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HD</SupplierCode>
            <SupplierName>Henry Schein-Halas Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HG</SupplierCode>
            <SupplierName>HEALTHSCOPE OPERATIONS PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HI</SupplierCode>
            <SupplierName>DIGITAL DENTAL NETWORK PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HJ</SupplierCode>
            <SupplierName>AVANT-GARDE SURGICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HK</SupplierCode>
            <SupplierName>Heraeus Medical Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>YA</SupplierCode>
            <SupplierName>YPSOMED AUSTRALIA PTY LIMITED</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HQ</SupplierCode>
            <SupplierName>BioMeDent Pty Limited</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HR</SupplierCode>
            <SupplierName>GVPD PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HT</SupplierCode>
            <SupplierName>ADLER ORTHO AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HU</SupplierCode>
            <SupplierName>ARTHREX AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HV</SupplierCode>
            <SupplierName>ELITE SURGICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NBB</SupplierCode>
            <SupplierName>New South Wales Bone Bank</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>HW</SupplierCode>
            <SupplierName>Stryker Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IB</SupplierCode>
            <SupplierName>Implament</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IC</SupplierCode>
            <SupplierName>Southern Implants Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IF</SupplierCode>
            <SupplierName>Implant Direct Oceania Pty Limited</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IG</SupplierCode>
            <SupplierName>Integra Neurosciences Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>II</SupplierCode>
            <SupplierName>INSULET AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IJ</SupplierCode>
            <SupplierName>INNOVATIVE MEDCARE TECHNOLOGY PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>ZA</SupplierCode>
            <SupplierName>Zimmer Biomet Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IQ</SupplierCode>
            <SupplierName>IQ Medical</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IT</SupplierCode>
            <SupplierName>Integrant Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MAA</SupplierCode>
            <SupplierName>Medtronic Australasia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NCA</SupplierCode>
            <SupplierName>NSW HEALTH SERVICE - SOUTH EASTERN SYDNEY LOCAL HEALTH DISTRICT</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IW</SupplierCode>
            <SupplierName>Beaver-Visitec International Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MAB</SupplierCode>
            <SupplierName>Queensland Tissue Bank</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NCC</SupplierCode>
            <SupplierName>NSW HEALTH SERVICE - SOUTH EASTERN SYDNEY LOCAL HEALTH DISTRICT</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>ZI</SupplierCode>
            <SupplierName>Zimmer Biomet Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IY</SupplierCode>
            <SupplierName>EVOLUTION SURGICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>IZ</SupplierCode>
            <SupplierName>Inovanz (PTY) LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JA</SupplierCode>
            <SupplierName>JOY SURGICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JC</SupplierCode>
            <SupplierName>JELLICOE SURGICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JD</SupplierCode>
            <SupplierName>JOI ORTHOPAEDICS PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JF</SupplierCode>
            <SupplierName>ARIA HEALTHCARE PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>ZW</SupplierCode>
            <SupplierName>Surgical Supplies Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JG</SupplierCode>
            <SupplierName>ADDITIVE SURGICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JI</SupplierCode>
            <SupplierName>INTERVENE MEDICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>ZZ</SupplierCode>
            <SupplierName>AA-Med Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JJ</SupplierCode>
            <SupplierName>Johnson &amp; Johnson Medical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JK</SupplierCode>
            <SupplierName>ALLIED SCIENTIFIC PRODUCTS PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JN</SupplierCode>
            <SupplierName>DENTAL DEVICES PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JP</SupplierCode>
            <SupplierName>CENTINEL SPINE AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JS</SupplierCode>
            <SupplierName>CORCYM AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JT</SupplierCode>
            <SupplierName>J T Medical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JV</SupplierCode>
            <SupplierName>Stryker Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JW</SupplierCode>
            <SupplierName>CORDIS AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JY</SupplierCode>
            <SupplierName>CRYOLIFE MEDICAL (AUSTRALIA) COMPANY PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>KB</SupplierCode>
            <SupplierName>KINETIX LIFESCIENCES PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>KF</SupplierCode>
            <SupplierName>KSJ GROUP PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>KG</SupplierCode>
            <SupplierName>Kevin Grundy (IBD) Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>KH</SupplierCode>
            <SupplierName>KH NXGEN (AUS) Pty Limited</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>KI</SupplierCode>
            <SupplierName>Avanos Medical Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>KT</SupplierCode>
            <SupplierName>KLS Martin Australia Pty Limited</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LB</SupplierCode>
            <SupplierName>Globus Medical Australia</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LC</SupplierCode>
            <SupplierName>Lima Orthopaedics Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LE</SupplierCode>
            <SupplierName>LTR MEDICAL PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LH</SupplierCode>
            <SupplierName>Lifehealthcare Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LI</SupplierCode>
            <SupplierName>Amplitude Australia</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LM</SupplierCode>
            <SupplierName>LMT Surgical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LN</SupplierCode>
            <SupplierName>Lumos Medical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LO</SupplierCode>
            <SupplierName>Link Orthopaedics  Australia</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>RNB</SupplierCode>
            <SupplierName>Hunter New England Bone Bank</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LV</SupplierCode>
            <SupplierName>ConMed Linvatec Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MA</SupplierCode>
            <SupplierName>Mathys Orthopaedics Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MB</SupplierCode>
            <SupplierName>MD Solutions Australasia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MC</SupplierCode>
            <SupplierName>Medtronic Australasia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>ME</SupplierCode>
            <SupplierName>Getz Healthcare Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MH</SupplierCode>
            <SupplierName>Applied Medical Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MI</SupplierCode>
            <SupplierName>Medtronic Australasia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MJ</SupplierCode>
            <SupplierName>MatOrtho Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MN</SupplierCode>
            <SupplierName>Johnson &amp; Johnson Medical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>CAA</SupplierCode>
            <SupplierName>ConMed Linvatec Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MO</SupplierCode>
            <SupplierName>Medical &amp; Optical Instruments Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MS</SupplierCode>
            <SupplierName>Medical Specialties Australasia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MU</SupplierCode>
            <SupplierName>Medacta Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>TBV</SupplierCode>
            <SupplierName>Donor Tissue Bank of Victoria</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MV</SupplierCode>
            <SupplierName>More Group Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MZ</SupplierCode>
            <SupplierName>Medigroup Australia</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>SAC</SupplierCode>
            <SupplierName>Sydney Local Health District</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>SAB</SupplierCode>
            <SupplierName>Smith &amp; Nephew Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>SAE</SupplierCode>
            <SupplierName>The Eye Bank of South Australia</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NF</SupplierCode>
            <SupplierName>Nutricia Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NJ</SupplierCode>
            <SupplierName>Neoss Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NR</SupplierCode>
            <SupplierName>Nobel Biocare Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NV</SupplierCode>
            <SupplierName>Nuvasive Australia and NZ  Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NW</SupplierCode>
            <SupplierName>Biomet 3i Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>MVS</SupplierCode>
            <SupplierName>Institute of Medical &amp; Veterinary Science T/A South Australian Tissue Bank</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>NY</SupplierCode>
            <SupplierName>NeoSurgical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OB</SupplierCode>
            <SupplierName>Optimed Technologies</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OG</SupplierCode>
            <SupplierName>Maxoniq</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OH</SupplierCode>
            <SupplierName>Orthotech Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OI</SupplierCode>
            <SupplierName>Audmet Australia Pty Ltd trading as Oticon Medical</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OK</SupplierCode>
            <SupplierName>MY BIOLOGICS PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OL</SupplierCode>
            <SupplierName>Olympus Australia</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OW</SupplierCode>
            <SupplierName>MERIT MEDICAL AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OX</SupplierCode>
            <SupplierName>MERIL AUSTRALIA PTY LTD</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>OY</SupplierCode>
            <SupplierName>Osseointegration Holdings Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>JAA</SupplierCode>
            <SupplierName>Johnson &amp; Johnson Medical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>PB</SupplierCode>
            <SupplierName>Australian Pacific Medical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>PC</SupplierCode>
            <SupplierName>Precision Surgical Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LEM</SupplierCode>
            <SupplierName>Lions Eye Donation Service</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>PF</SupplierCode>
            <SupplierName>Perios Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>PJ</SupplierCode>
            <SupplierName>PurePlay Orthopaedics</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>PN</SupplierCode>
            <SupplierName>Penumbra Neuro Australia Pty Ltd</SupplierName>
        </Supplier>
        <Supplier>
            <SupplierCode>LEW</SupplierCode>
            <SupplierName>Lions Eye Bank of Western Australia</SupplierName>
        </Supplier>
    </Suppliers>
    <Categories>
        <Category>
            <CategoryID>1</CategoryID>
            <CategoryDescription>01 - Ophthalmic</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>3</CategoryID>
            <CategoryDescription>03 - Orthopaedic</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>6</CategoryID>
            <CategoryDescription>01 - Cardio-thoracic</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>41</CategoryID>
            <CategoryDescription>02 - Ophthalmic</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>13</CategoryID>
            <CategoryDescription>06 - Specialist Orthopaedic</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>17</CategoryID>
            <CategoryDescription>12 - Knee</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>18</CategoryID>
            <CategoryDescription>11 - Hip</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>19</CategoryID>
            <CategoryDescription>13 - Spinal</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>20</CategoryID>
            <CategoryDescription>09 - Cardiothoracic</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>21</CategoryID>
            <CategoryDescription>03 - General Miscellaneous</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>22</CategoryID>
            <CategoryDescription>02 - Ear, Nose &amp; Throat</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>23</CategoryID>
            <CategoryDescription>07 - Plastic and Reconstructive</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>24</CategoryID>
            <CategoryDescription>10 - Vascular</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>25</CategoryID>
            <CategoryDescription>04 - Neurosurgical</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>26</CategoryID>
            <CategoryDescription>05 - Urogenital</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>27</CategoryID>
            <CategoryDescription>08 - Cardiac</CategoryDescription>
        </Category>
        <Category>
            <CategoryID>28</CategoryID>
            <CategoryDescription>04 - Dermatologic</CategoryDescription>
        </Category>
    </Categories>
    <SubCategories>
        <SubCategory>
            <SubCategoryID>256</SubCategoryID>
            <SubCategoryDescription>05.03 - Voiding Dysfunction Prostheses</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>257</SubCategoryID>
            <SubCategoryDescription>08.15 - Stents For Treatment Of Coarctation Of The Aorta</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>259</SubCategoryID>
            <SubCategoryDescription>09.11 - Implant Ventricular Assist System</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>261</SubCategoryID>
            <SubCategoryDescription>13.14 - Sacroiliac Joint Fixation</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>262</SubCategoryID>
            <SubCategoryDescription>01.10 - Artificial Iris</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>263</SubCategoryID>
            <SubCategoryDescription>13.15 - Annular closure/reconstruction</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>264</SubCategoryID>
            <SubCategoryDescription>09.12 - Pectus Bar</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>265</SubCategoryID>
            <SubCategoryDescription>09.13 - Chordal Replacement Devices, fixed and adjustable</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>266</SubCategoryID>
            <SubCategoryDescription>08.16 - Remote Monitoring System</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>267</SubCategoryID>
            <SubCategoryDescription>08.17 - Catheter Delivery</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>290</SubCategoryID>
            <SubCategoryDescription>08.18 - Cardiac Ablation</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>291</SubCategoryID>
            <SubCategoryDescription>09.14 - Surgical cardiac ablation</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>293</SubCategoryID>
            <SubCategoryDescription>08.14 - Implantable Cardiac Event Recorders</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>294</SubCategoryID>
            <SubCategoryDescription>03.10 - Electronic Controlling Devices (Insulin)</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>123</SubCategoryID>
            <SubCategoryDescription>06.03 - SKELETAL RECONSTRUCTION</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>124</SubCategoryID>
            <SubCategoryDescription>06.01 - ANKLE AND FOOT</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>131</SubCategoryID>
            <SubCategoryDescription>06.02 - UPPER LIMB</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>140</SubCategoryID>
            <SubCategoryDescription>01.01 - ANTERIOR CHAMBER INTRAOCULAR LENSES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>141</SubCategoryID>
            <SubCategoryDescription>01.02 - POSTERIOR CHAMBER INTRAOCULAR LENSES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>142</SubCategoryID>
            <SubCategoryDescription>01.03 - INTRAOCULAR FLUIDS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>143</SubCategoryID>
            <SubCategoryDescription>01.04 - CAPSULAR TENSION RINGS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>144</SubCategoryID>
            <SubCategoryDescription>01.05 - GLAUCOMA DRAINAGE</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>145</SubCategoryID>
            <SubCategoryDescription>01.06 - EYELID PROSTHESES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>146</SubCategoryID>
            <SubCategoryDescription>01.07 - LACRIMAL DUCT DRAINAGE PROSTHESES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>147</SubCategoryID>
            <SubCategoryDescription>01.08 - ORBITAL PROSTHESES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>148</SubCategoryID>
            <SubCategoryDescription>01.09 - RETINAL DETACHMENT PROSTHESES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>149</SubCategoryID>
            <SubCategoryDescription>12.01 - FEMORAL COMPONENT: TOTAL KNEE ARTHROPLASTY</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>150</SubCategoryID>
            <SubCategoryDescription>12.02 - FEMORAL COMPONENT: UNI-COMPARTMENTAL KNEE ARTHROPLASTY</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>151</SubCategoryID>
            <SubCategoryDescription>12.03 - TIBIAL TRAY COMPONENT - TOTAL KNEE ARTHROPLASTY</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>152</SubCategoryID>
            <SubCategoryDescription>12.04 - TIBIAL TRAY COMPONENT: UNI-COMPARTMENTAL KNEE ARTHROPLASTY</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>153</SubCategoryID>
            <SubCategoryDescription>12.05 - TIBIAL INSERT: TOTAL KNEE ARTHROPLASTY</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>154</SubCategoryID>
            <SubCategoryDescription>12.06 - TIBIAL INSERT: UNI-COMPARTMENTAL ARTHROPLASTY</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>155</SubCategoryID>
            <SubCategoryDescription>12.07 - PATELLO FEMORAL REPLACEMENT - FEMORAL COMPONENT</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>156</SubCategoryID>
            <SubCategoryDescription>12.08 - PATELLAR COMPONENT</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>157</SubCategoryID>
            <SubCategoryDescription>12.09 - TUMOUR PRODUCTS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>159</SubCategoryID>
            <SubCategoryDescription>12.11 - KNEE ACCESSORIES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>161</SubCategoryID>
            <SubCategoryDescription>11.01 - FEMORAL COMPONENTS - PRIMARY AND REVISION</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>162</SubCategoryID>
            <SubCategoryDescription>11.02 - FEMORAL HEADS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>163</SubCategoryID>
            <SubCategoryDescription>11.03 - ACETABULAR COMPONENTS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>164</SubCategoryID>
            <SubCategoryDescription>11.04 - ACCESSORIES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>165</SubCategoryID>
            <SubCategoryDescription>13.01 - Bone Screws</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>166</SubCategoryID>
            <SubCategoryDescription>13.02 - Accessories for bone screws and connector components</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>167</SubCategoryID>
            <SubCategoryDescription>13.03 - Connector</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>168</SubCategoryID>
            <SubCategoryDescription>13.04 - Hook</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>169</SubCategoryID>
            <SubCategoryDescription>13.05 - Plate</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>170</SubCategoryID>
            <SubCategoryDescription>13.06 - Rod</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>171</SubCategoryID>
            <SubCategoryDescription>13.07 - Plate-Rod</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>172</SubCategoryID>
            <SubCategoryDescription>13.08 - Washer/Staple</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>173</SubCategoryID>
            <SubCategoryDescription>13.09 - C-Ring</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>174</SubCategoryID>
            <SubCategoryDescription>13.10 - Fusion Cage</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>175</SubCategoryID>
            <SubCategoryDescription>13.11 - Disc Replacement</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>176</SubCategoryID>
            <SubCategoryDescription>13.12 - Vertebral Body Replacement</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>177</SubCategoryID>
            <SubCategoryDescription>13.13 - Interspinous Fixation</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>178</SubCategoryID>
            <SubCategoryDescription>09.01 - Mechanical Valves</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>179</SubCategoryID>
            <SubCategoryDescription>09.02 - Tissue Valves</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>180</SubCategoryID>
            <SubCategoryDescription>09.03 - Valve Conduits</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>181</SubCategoryID>
            <SubCategoryDescription>09.04 - Atrio-Ventricular Rings and Bands</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>182</SubCategoryID>
            <SubCategoryDescription>09.05 - Patches</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>183</SubCategoryID>
            <SubCategoryDescription>09.06 - Membranes</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>186</SubCategoryID>
            <SubCategoryDescription>09.09 - Aorta and Side Branch Grafts</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>187</SubCategoryID>
            <SubCategoryDescription>03.01 - BRACHYTHERAPY</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>188</SubCategoryID>
            <SubCategoryDescription>03.02 - DRUG DELIVERY DEVICES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>189</SubCategoryID>
            <SubCategoryDescription>03.03 - ENTERAL TUBES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>190</SubCategoryID>
            <SubCategoryDescription>03.04 - GASTRIC BANDS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>191</SubCategoryID>
            <SubCategoryDescription>03.05 - HAEMOSTATIC DEVICES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>192</SubCategoryID>
            <SubCategoryDescription>03.06 - LUMINAL STENTS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>193</SubCategoryID>
            <SubCategoryDescription>03.07 - PULMONARY/PERITONEAL DEVICES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>194</SubCategoryID>
            <SubCategoryDescription>03.08 - CLOSURE DEVICES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>196</SubCategoryID>
            <SubCategoryDescription>02.01 - EAR</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>197</SubCategoryID>
            <SubCategoryDescription>02.02 - NOSE</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>198</SubCategoryID>
            <SubCategoryDescription>02.03 - THROAT</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>199</SubCategoryID>
            <SubCategoryDescription>07.01 - CRANIOMAXILLOFACIAL RECONSTRUCTION &amp; FIXATION</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>200</SubCategoryID>
            <SubCategoryDescription>07.02 - CRANIOMAXILLOFACIAL IMPLANTS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>201</SubCategoryID>
            <SubCategoryDescription>07.03 - DENTAL IMPLANTS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>202</SubCategoryID>
            <SubCategoryDescription>07.04 - DISTRACTOR SYSTEMS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>203</SubCategoryID>
            <SubCategoryDescription>07.05 - SOFT TISSUE &amp; TISSUE EXPANDERS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>204</SubCategoryID>
            <SubCategoryDescription>07.06 - MAMMARY IMPLANTS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>206</SubCategoryID>
            <SubCategoryDescription>10.01 - Vascular Stents</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>207</SubCategoryID>
            <SubCategoryDescription>10.02 - Stent Grafts</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>208</SubCategoryID>
            <SubCategoryDescription>10.03 - Grafts</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>209</SubCategoryID>
            <SubCategoryDescription>10.04 - Vascular Patches</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>210</SubCategoryID>
            <SubCategoryDescription>10.05 - Vessel Bands</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>211</SubCategoryID>
            <SubCategoryDescription>10.06 - Embolic Protection Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>212</SubCategoryID>
            <SubCategoryDescription>10.07 - Arterial Closure Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>213</SubCategoryID>
            <SubCategoryDescription>10.08 - Occlusion Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>214</SubCategoryID>
            <SubCategoryDescription>10.09 - Long Term Vascular Access Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>215</SubCategoryID>
            <SubCategoryDescription>10.10 - Peritoneal Dialysis, Long Term Implantable Catheters</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>218</SubCategoryID>
            <SubCategoryDescription>04.01 - ANEURYSM CLIPS</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>219</SubCategoryID>
            <SubCategoryDescription>04.02 - DURA DEFECT REPAIR</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>220</SubCategoryID>
            <SubCategoryDescription>04.03 - HYDROCEPHALUS DEVICES</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>221</SubCategoryID>
            <SubCategoryDescription>04.04 - DEEP BRAIN STIMULATION (DBS)</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>222</SubCategoryID>
            <SubCategoryDescription>04.05 - NEUROSTIMULATION THERAPIES FOR PAIN MANAGEMENT</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>223</SubCategoryID>
            <SubCategoryDescription>04.06 - INTRATHECAL DRUG DELIVERY SYSTEM</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>224</SubCategoryID>
            <SubCategoryDescription>04.07 - NEUROSTIMULATION THERAPIES FOR SEIZURE CONTROL</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>225</SubCategoryID>
            <SubCategoryDescription>04.08 - NEURO INTERVENTION</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>226</SubCategoryID>
            <SubCategoryDescription>05.01 - Incontinence Prostheses</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>227</SubCategoryID>
            <SubCategoryDescription>05.02 - Ureteric Stents</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>230</SubCategoryID>
            <SubCategoryDescription>05.05 - Penile Prostheses</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>231</SubCategoryID>
            <SubCategoryDescription>05.06 - Testicular Prostheses</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>232</SubCategoryID>
            <SubCategoryDescription>05.07 - Sacral Neuromodulation</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>233</SubCategoryID>
            <SubCategoryDescription>05.08 - Tubal Obstruction Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>234</SubCategoryID>
            <SubCategoryDescription>05.09 - Nephrostomy Catheters</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>235</SubCategoryID>
            <SubCategoryDescription>05.10 - Vesicoureteral Reflux Prostheses</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>236</SubCategoryID>
            <SubCategoryDescription>08.01 - Single Chamber ICDs</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>237</SubCategoryID>
            <SubCategoryDescription>08.02 - Dual Chamber ICDs</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>238</SubCategoryID>
            <SubCategoryDescription>08.03 - ICDs with CRT</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>239</SubCategoryID>
            <SubCategoryDescription>08.04 - Single Chamber Pacemakers</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>240</SubCategoryID>
            <SubCategoryDescription>08.05 - Dual Chamber Pacemakers</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>241</SubCategoryID>
            <SubCategoryDescription>08.06 - CRT Pacemakers</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>242</SubCategoryID>
            <SubCategoryDescription>08.07 - ICD Leads</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>243</SubCategoryID>
            <SubCategoryDescription>08.08 - Pacemaker Leads</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>244</SubCategoryID>
            <SubCategoryDescription>08.09 - Pacemaker/ICD Adaptors</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>245</SubCategoryID>
            <SubCategoryDescription>08.10 - Pacemaker/ICD Extenders</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>246</SubCategoryID>
            <SubCategoryDescription>08.11 - Pacemaker/Lead Accessories</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>247</SubCategoryID>
            <SubCategoryDescription>08.12 - Coronary Stents</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>248</SubCategoryID>
            <SubCategoryDescription>08.13 - Special Purpose Percutaneous Cardiovascular Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>249</SubCategoryID>
            <SubCategoryDescription>08.14 - Implantable Cardiac Event Recorders</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>251</SubCategoryID>
            <SubCategoryDescription>09.08 - Cardiac Assisted Fixation Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>252</SubCategoryID>
            <SubCategoryDescription>09.10 - Skeletal Fixation Devices</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>253</SubCategoryID>
            <SubCategoryDescription>04.09 - Intracranial Pressure (ICP) Monitoring</SubCategoryDescription>
        </SubCategory>
        <SubCategory>
            <SubCategoryID>255</SubCategoryID>
            <SubCategoryDescription>04.10 - Cerebrospinal Fluid (CSF) Diversion</SubCategoryDescription>
        </SubCategory>
    </SubCategories>
    <Groups>
        <Group>
            <GroupID>2181</GroupID>
            <GroupDescription>08.13.03 - Left Atrial Appendage Closure</GroupDescription>
        </Group>
        <Group>
            <GroupID>1219</GroupID>
            <GroupDescription>06.01.02 - Sinus Tarsi Implant</GroupDescription>
        </Group>
        <Group>
            <GroupID>1228</GroupID>
            <GroupDescription>06.03.01 - Intramedullary Nails</GroupDescription>
        </Group>
        <Group>
            <GroupID>1229</GroupID>
            <GroupDescription>06.03.02 - Intramedullary Nail Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1231</GroupID>
            <GroupDescription>06.03.04 - Screws</GroupDescription>
        </Group>
        <Group>
            <GroupID>1237</GroupID>
            <GroupDescription>06.03.11 - External Fixateurs</GroupDescription>
        </Group>
        <Group>
            <GroupID>1241</GroupID>
            <GroupDescription>06.03.15 - Bone Graft Substitute</GroupDescription>
        </Group>
        <Group>
            <GroupID>1269</GroupID>
            <GroupDescription>06.01.01 - Ankle joint component</GroupDescription>
        </Group>
        <Group>
            <GroupID>1273</GroupID>
            <GroupDescription>06.02.01 - Wrist</GroupDescription>
        </Group>
        <Group>
            <GroupID>1274</GroupID>
            <GroupDescription>06.02.02 - Finger Joint Articulations</GroupDescription>
        </Group>
        <Group>
            <GroupID>1275</GroupID>
            <GroupDescription>06.02.03 - Elbow</GroupDescription>
        </Group>
        <Group>
            <GroupID>1276</GroupID>
            <GroupDescription>06.02.04 - Shoulder - Humeral</GroupDescription>
        </Group>
        <Group>
            <GroupID>1277</GroupID>
            <GroupDescription>06.02.05 - Shoulder - Glenoid</GroupDescription>
        </Group>
        <Group>
            <GroupID>1278</GroupID>
            <GroupDescription>06.02.06 - Shoulder - Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1279</GroupID>
            <GroupDescription>06.03.14 - Bone Cement</GroupDescription>
        </Group>
        <Group>
            <GroupID>1324</GroupID>
            <GroupDescription>01.01.01 - Aphakic</GroupDescription>
        </Group>
        <Group>
            <GroupID>1325</GroupID>
            <GroupDescription>01.01.02 - Phakic</GroupDescription>
        </Group>
        <Group>
            <GroupID>1326</GroupID>
            <GroupDescription>01.02.01 - Rigid</GroupDescription>
        </Group>
        <Group>
            <GroupID>1327</GroupID>
            <GroupDescription>01.02.02 - Foldable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1328</GroupID>
            <GroupDescription>01.02.03 - Pseudo-phakic, piggy-back</GroupDescription>
        </Group>
        <Group>
            <GroupID>1329</GroupID>
            <GroupDescription>01.03.01 - Viscoelastic</GroupDescription>
        </Group>
        <Group>
            <GroupID>1330</GroupID>
            <GroupDescription>01.03.02 - Non Viscous</GroupDescription>
        </Group>
        <Group>
            <GroupID>1331</GroupID>
            <GroupDescription>01.04.01 - Simple</GroupDescription>
        </Group>
        <Group>
            <GroupID>1332</GroupID>
            <GroupDescription>01.04.02 - Complex</GroupDescription>
        </Group>
        <Group>
            <GroupID>1333</GroupID>
            <GroupDescription>01.05.01 - Ab Externo Long Tube /Reservoir</GroupDescription>
        </Group>
        <Group>
            <GroupID>1334</GroupID>
            <GroupDescription>01.05.02 - Ab Externo</GroupDescription>
        </Group>
        <Group>
            <GroupID>1335</GroupID>
            <GroupDescription>01.06.01 - Spacers</GroupDescription>
        </Group>
        <Group>
            <GroupID>1336</GroupID>
            <GroupDescription>01.06.02 - Weights</GroupDescription>
        </Group>
        <Group>
            <GroupID>1337</GroupID>
            <GroupDescription>01.07.01 - Intracanalicular</GroupDescription>
        </Group>
        <Group>
            <GroupID>1339</GroupID>
            <GroupDescription>01.08.01 - Intrascleral</GroupDescription>
        </Group>
        <Group>
            <GroupID>1340</GroupID>
            <GroupDescription>01.08.02 - Extrascleral</GroupDescription>
        </Group>
        <Group>
            <GroupID>1341</GroupID>
            <GroupDescription>01.08.03 - Fascial - solid and permeable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1342</GroupID>
            <GroupDescription>01.09.01 - Buckles, bands, tyres and sponges</GroupDescription>
        </Group>
        <Group>
            <GroupID>1344</GroupID>
            <GroupDescription>01.09.03 - Sleeves</GroupDescription>
        </Group>
        <Group>
            <GroupID>1345</GroupID>
            <GroupDescription>01.09.04 - Intraocular Gases</GroupDescription>
        </Group>
        <Group>
            <GroupID>1346</GroupID>
            <GroupDescription>01.09.05 - Intraocular Heavy Liquids</GroupDescription>
        </Group>
        <Group>
            <GroupID>1347</GroupID>
            <GroupDescription>01.09.06 - Intraocular Silicone Oils</GroupDescription>
        </Group>
        <Group>
            <GroupID>1348</GroupID>
            <GroupDescription>12.01.01 - Cemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1349</GroupID>
            <GroupDescription>12.01.02 - Cemented, Alloy, PMMA Coating</GroupDescription>
        </Group>
        <Group>
            <GroupID>1350</GroupID>
            <GroupDescription>12.01.03 - Cemented, Non-Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1351</GroupID>
            <GroupDescription>12.01.04 - Uncemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1352</GroupID>
            <GroupDescription>12.01.05 - Uncemented, Alloy, HA Coating</GroupDescription>
        </Group>
        <Group>
            <GroupID>1353</GroupID>
            <GroupDescription>12.02.01 - Cemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1354</GroupID>
            <GroupDescription>12.02.02 - Cemented, Non-Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1355</GroupID>
            <GroupDescription>12.02.03 - Uncemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1356</GroupID>
            <GroupDescription>12.03.01 - Cemented, All polyethylene</GroupDescription>
        </Group>
        <Group>
            <GroupID>1357</GroupID>
            <GroupDescription>12.03.02 - Cemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1359</GroupID>
            <GroupDescription>12.03.04 - Cemented, Alloy, for Mobile Insert</GroupDescription>
        </Group>
        <Group>
            <GroupID>1360</GroupID>
            <GroupDescription>12.03.05 - Uncemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1361</GroupID>
            <GroupDescription>12.03.06 - Uncemented, Alloy, Moulded Polyethylene</GroupDescription>
        </Group>
        <Group>
            <GroupID>1362</GroupID>
            <GroupDescription>12.03.07 - Uncemented, Alloy, for Mobile Insert</GroupDescription>
        </Group>
        <Group>
            <GroupID>1363</GroupID>
            <GroupDescription>12.04.01 - Cemented, Alloy Polyethylene</GroupDescription>
        </Group>
        <Group>
            <GroupID>1364</GroupID>
            <GroupDescription>12.04.02 - Cemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1365</GroupID>
            <GroupDescription>12.04.03 - Cemented, Alloy, Moulded Polyethylene</GroupDescription>
        </Group>
        <Group>
            <GroupID>1366</GroupID>
            <GroupDescription>12.04.04 - Cemented, Alloy, for Mobile Insert</GroupDescription>
        </Group>
        <Group>
            <GroupID>1367</GroupID>
            <GroupDescription>12.04.05 - Uncemented, Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1368</GroupID>
            <GroupDescription>12.04.06 - Uncemented, Alloy, for Mobile Insert</GroupDescription>
        </Group>
        <Group>
            <GroupID>1369</GroupID>
            <GroupDescription>12.05.01 - Minimally Stabilised</GroupDescription>
        </Group>
        <Group>
            <GroupID>1370</GroupID>
            <GroupDescription>12.05.02 - Posterior Stabilised</GroupDescription>
        </Group>
        <Group>
            <GroupID>1371</GroupID>
            <GroupDescription>12.05.03 - Totally Constrained</GroupDescription>
        </Group>
        <Group>
            <GroupID>1372</GroupID>
            <GroupDescription>12.06.01 - Tibial Insert: Uni-Compartmental Arthroplasty</GroupDescription>
        </Group>
        <Group>
            <GroupID>1374</GroupID>
            <GroupDescription>12.07.01 - Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1375</GroupID>
            <GroupDescription>12.07.02 - Non-Alloy</GroupDescription>
        </Group>
        <Group>
            <GroupID>1376</GroupID>
            <GroupDescription>12.08.01 - Cemented, All Polyethylene</GroupDescription>
        </Group>
        <Group>
            <GroupID>1377</GroupID>
            <GroupDescription>12.08.02 - Cemented, Polyethylene, Metal Backed</GroupDescription>
        </Group>
        <Group>
            <GroupID>1378</GroupID>
            <GroupDescription>12.08.03 - Uncemented, Polyethylene, Metal Backed</GroupDescription>
        </Group>
        <Group>
            <GroupID>1379</GroupID>
            <GroupDescription>12.08.04 - Polyethylene Insert for Mobile Patella</GroupDescription>
        </Group>
        <Group>
            <GroupID>1380</GroupID>
            <GroupDescription>12.09.01 - Distal Femur</GroupDescription>
        </Group>
        <Group>
            <GroupID>1381</GroupID>
            <GroupDescription>12.09.02 - Proximal Tibia</GroupDescription>
        </Group>
        <Group>
            <GroupID>1382</GroupID>
            <GroupDescription>12.09.03 - Diaphyseal Extension Piece (Femoral or Tibial)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1383</GroupID>
            <GroupDescription>12.09.04 - Bone Anchorage Piece</GroupDescription>
        </Group>
        <Group>
            <GroupID>1384</GroupID>
            <GroupDescription>12.09.05 - Tibial Inserts</GroupDescription>
        </Group>
        <Group>
            <GroupID>1385</GroupID>
            <GroupDescription>12.09.06 - Augments</GroupDescription>
        </Group>
        <Group>
            <GroupID>1386</GroupID>
            <GroupDescription>12.09.07 - Stems</GroupDescription>
        </Group>
        <Group>
            <GroupID>1387</GroupID>
            <GroupDescription>12.09.08 - Couplers or adaptors, incorporating stem extenders, sleeves and other couplings</GroupDescription>
        </Group>
        <Group>
            <GroupID>1390</GroupID>
            <GroupDescription>12.11.01 - Augments</GroupDescription>
        </Group>
        <Group>
            <GroupID>1391</GroupID>
            <GroupDescription>12.11.02 - Axles for hinged prostheses</GroupDescription>
        </Group>
        <Group>
            <GroupID>1392</GroupID>
            <GroupDescription>12.11.03 - Bolts</GroupDescription>
        </Group>
        <Group>
            <GroupID>1393</GroupID>
            <GroupDescription>12.11.04 - Connectors for hinged prostheses</GroupDescription>
        </Group>
        <Group>
            <GroupID>1395</GroupID>
            <GroupDescription>12.11.06 - End caps</GroupDescription>
        </Group>
        <Group>
            <GroupID>1396</GroupID>
            <GroupDescription>12.11.07 - Offset couplers/adaptors</GroupDescription>
        </Group>
        <Group>
            <GroupID>1397</GroupID>
            <GroupDescription>12.11.08 - Pegs, lugs, etc</GroupDescription>
        </Group>
        <Group>
            <GroupID>1398</GroupID>
            <GroupDescription>12.11.09 - Screws</GroupDescription>
        </Group>
        <Group>
            <GroupID>1399</GroupID>
            <GroupDescription>12.11.10 - Stems - straight or offset</GroupDescription>
        </Group>
        <Group>
            <GroupID>1400</GroupID>
            <GroupDescription>12.11.11 - Stem Extenders, Sleeves and other couplings</GroupDescription>
        </Group>
        <Group>
            <GroupID>1401</GroupID>
            <GroupDescription>12.11.12 - Temporary Spacers</GroupDescription>
        </Group>
        <Group>
            <GroupID>1404</GroupID>
            <GroupDescription>11.01.01 - Cemented</GroupDescription>
        </Group>
        <Group>
            <GroupID>1405</GroupID>
            <GroupDescription>11.01.02 - Cemented, Long Lengths (≥200mm)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1406</GroupID>
            <GroupDescription>11.01.03 - Uncemented</GroupDescription>
        </Group>
        <Group>
            <GroupID>1407</GroupID>
            <GroupDescription>11.01.04 - Uncemented, HA Coated</GroupDescription>
        </Group>
        <Group>
            <GroupID>1408</GroupID>
            <GroupDescription>11.01.05 - Uncemented, Long Lengths (≥200mm)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1409</GroupID>
            <GroupDescription>11.01.06 - Uncemented, Long Lengths, HA Coated (≤200mm)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1410</GroupID>
            <GroupDescription>11.01.07 - Uncemented, Modular</GroupDescription>
        </Group>
        <Group>
            <GroupID>1411</GroupID>
            <GroupDescription>11.01.08 - Uncemented, Modular, HA Coated</GroupDescription>
        </Group>
        <Group>
            <GroupID>1412</GroupID>
            <GroupDescription>11.01.09 - Uncemented, Modular, Long Lengths (Stem ≥200mm;  Body ≥75mm;  Cone ≥70mm;  Spacer/Sleeve ≥50mm)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1413</GroupID>
            <GroupDescription>11.01.10 - Uncemented, Modular, HA Coated, Long Lengths (Stem ≥200mm;  Body ≥75mm;  Cone ≥70mm;  Spacer/Sleeve ≥50mm)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1416</GroupID>
            <GroupDescription>11.01.13 - Monoblock Hemis</GroupDescription>
        </Group>
        <Group>
            <GroupID>1417</GroupID>
            <GroupDescription>11.01.14 - Femoral Neck</GroupDescription>
        </Group>
        <Group>
            <GroupID>1419</GroupID>
            <GroupDescription>11.02.01 - Conventional Femoral Heads, ≤32mm</GroupDescription>
        </Group>
        <Group>
            <GroupID>1420</GroupID>
            <GroupDescription>11.02.02 - Conventional Femoral Heads, &gt;32mm</GroupDescription>
        </Group>
        <Group>
            <GroupID>1422</GroupID>
            <GroupDescription>11.02.04 - Resurfacing, Cemented</GroupDescription>
        </Group>
        <Group>
            <GroupID>1424</GroupID>
            <GroupDescription>11.02.06 - Bipolar/Multipolar</GroupDescription>
        </Group>
        <Group>
            <GroupID>1425</GroupID>
            <GroupDescription>11.03.01 - Cups, Cemented</GroupDescription>
        </Group>
        <Group>
            <GroupID>1426</GroupID>
            <GroupDescription>11.03.02 - Shells, Uncemented</GroupDescription>
        </Group>
        <Group>
            <GroupID>1427</GroupID>
            <GroupDescription>11.03.03 - Shells, Uncemented, HA</GroupDescription>
        </Group>
        <Group>
            <GroupID>1428</GroupID>
            <GroupDescription>11.03.04 - Insert/Liner</GroupDescription>
        </Group>
        <Group>
            <GroupID>1429</GroupID>
            <GroupDescription>11.03.05 - Bonded Shell/Liner</GroupDescription>
        </Group>
        <Group>
            <GroupID>1431</GroupID>
            <GroupDescription>11.03.07 - Resurfacing Cup</GroupDescription>
        </Group>
        <Group>
            <GroupID>1432</GroupID>
            <GroupDescription>11.03.08 - Acetabular Reconstruction Devices</GroupDescription>
        </Group>
        <Group>
            <GroupID>1433</GroupID>
            <GroupDescription>11.04.01 - Augment</GroupDescription>
        </Group>
        <Group>
            <GroupID>1434</GroupID>
            <GroupDescription>11.04.02 - Bolt</GroupDescription>
        </Group>
        <Group>
            <GroupID>1435</GroupID>
            <GroupDescription>11.04.03 - Bone Screw</GroupDescription>
        </Group>
        <Group>
            <GroupID>1436</GroupID>
            <GroupDescription>11.04.04 - Calcar Block</GroupDescription>
        </Group>
        <Group>
            <GroupID>1437</GroupID>
            <GroupDescription>11.04.05 - Cement Restrictor</GroupDescription>
        </Group>
        <Group>
            <GroupID>1438</GroupID>
            <GroupDescription>11.04.06 - Centraliser</GroupDescription>
        </Group>
        <Group>
            <GroupID>1439</GroupID>
            <GroupDescription>11.04.07 - Claw</GroupDescription>
        </Group>
        <Group>
            <GroupID>1440</GroupID>
            <GroupDescription>11.04.08 - Connector</GroupDescription>
        </Group>
        <Group>
            <GroupID>1441</GroupID>
            <GroupDescription>11.04.09 - Dome Plug</GroupDescription>
        </Group>
        <Group>
            <GroupID>1442</GroupID>
            <GroupDescription>11.04.10 - Head Taper Insert</GroupDescription>
        </Group>
        <Group>
            <GroupID>1443</GroupID>
            <GroupDescription>11.04.11 - Neck Adapter</GroupDescription>
        </Group>
        <Group>
            <GroupID>1444</GroupID>
            <GroupDescription>11.04.12 - Nut</GroupDescription>
        </Group>
        <Group>
            <GroupID>1445</GroupID>
            <GroupDescription>11.04.13 - Pin</GroupDescription>
        </Group>
        <Group>
            <GroupID>1446</GroupID>
            <GroupDescription>11.04.14 - Plug - Including Dome Plug</GroupDescription>
        </Group>
        <Group>
            <GroupID>1447</GroupID>
            <GroupDescription>11.04.15 - Plug and Hood</GroupDescription>
        </Group>
        <Group>
            <GroupID>1449</GroupID>
            <GroupDescription>11.04.17 - Ring</GroupDescription>
        </Group>
        <Group>
            <GroupID>1450</GroupID>
            <GroupDescription>11.04.18 - Screw</GroupDescription>
        </Group>
        <Group>
            <GroupID>1451</GroupID>
            <GroupDescription>11.04.19 - Sleeve</GroupDescription>
        </Group>
        <Group>
            <GroupID>1452</GroupID>
            <GroupDescription>11.04.20 - Spacer- Unique</GroupDescription>
        </Group>
        <Group>
            <GroupID>1454</GroupID>
            <GroupDescription>11.04.22 - Trochanter Plate</GroupDescription>
        </Group>
        <Group>
            <GroupID>1455</GroupID>
            <GroupDescription>11.04.23 - Trochanteric Replacement</GroupDescription>
        </Group>
        <Group>
            <GroupID>1456</GroupID>
            <GroupDescription>11.04.24 - Washer</GroupDescription>
        </Group>
        <Group>
            <GroupID>1457</GroupID>
            <GroupDescription>11.04.25 - Wire - Cobalt Chrome</GroupDescription>
        </Group>
        <Group>
            <GroupID>1458</GroupID>
            <GroupDescription>11.04.26 - Wire - Stainless Steel</GroupDescription>
        </Group>
        <Group>
            <GroupID>1460</GroupID>
            <GroupDescription>06.01.03 - Ankle joint</GroupDescription>
        </Group>
        <Group>
            <GroupID>1461</GroupID>
            <GroupDescription>06.01.04 - Replacement of other joints of the foot including articulations</GroupDescription>
        </Group>
        <Group>
            <GroupID>1462</GroupID>
            <GroupDescription>13.01.01 - Pedicle, Monoaxial</GroupDescription>
        </Group>
        <Group>
            <GroupID>1463</GroupID>
            <GroupDescription>13.01.02 - Pedicle, Polyaxial</GroupDescription>
        </Group>
        <Group>
            <GroupID>1464</GroupID>
            <GroupDescription>13.01.03 - Standard</GroupDescription>
        </Group>
        <Group>
            <GroupID>1465</GroupID>
            <GroupDescription>13.02.01 - Nut/Set Screw/Locking Screw</GroupDescription>
        </Group>
        <Group>
            <GroupID>1466</GroupID>
            <GroupDescription>13.02.02 - Collar/Sleeve</GroupDescription>
        </Group>
        <Group>
            <GroupID>1467</GroupID>
            <GroupDescription>13.02.03 - Cap/Cover Plate</GroupDescription>
        </Group>
        <Group>
            <GroupID>1468</GroupID>
            <GroupDescription>13.02.04 - Cap/Cover Plate, Complex</GroupDescription>
        </Group>
        <Group>
            <GroupID>1469</GroupID>
            <GroupDescription>13.02.05 - Block/Screw head</GroupDescription>
        </Group>
        <Group>
            <GroupID>1470</GroupID>
            <GroupDescription>13.02.06 - Cross Link Rod</GroupDescription>
        </Group>
        <Group>
            <GroupID>1471</GroupID>
            <GroupDescription>13.02.07 - Hook/Clamp/Plate</GroupDescription>
        </Group>
        <Group>
            <GroupID>1472</GroupID>
            <GroupDescription>13.03.01 - In-Line</GroupDescription>
        </Group>
        <Group>
            <GroupID>1473</GroupID>
            <GroupDescription>13.03.02 - Offset</GroupDescription>
        </Group>
        <Group>
            <GroupID>1474</GroupID>
            <GroupDescription>13.03.03 - Transverse (Rod-to-Rod)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1475</GroupID>
            <GroupDescription>13.04.01 - Hook</GroupDescription>
        </Group>
        <Group>
            <GroupID>1476</GroupID>
            <GroupDescription>13.05.01 - Integral Fixation</GroupDescription>
        </Group>
        <Group>
            <GroupID>1477</GroupID>
            <GroupDescription>13.05.02 - No Integral Fixation</GroupDescription>
        </Group>
        <Group>
            <GroupID>1478</GroupID>
            <GroupDescription>13.06.01 - Standard</GroupDescription>
        </Group>
        <Group>
            <GroupID>1479</GroupID>
            <GroupDescription>13.06.02 - Telescoping</GroupDescription>
        </Group>
        <Group>
            <GroupID>1480</GroupID>
            <GroupDescription>13.06.03 - Dual Unit</GroupDescription>
        </Group>
        <Group>
            <GroupID>1481</GroupID>
            <GroupDescription>13.07.01 - Plate Rod</GroupDescription>
        </Group>
        <Group>
            <GroupID>1482</GroupID>
            <GroupDescription>13.08.01 - Washer</GroupDescription>
        </Group>
        <Group>
            <GroupID>1483</GroupID>
            <GroupDescription>13.08.02 - Staple</GroupDescription>
        </Group>
        <Group>
            <GroupID>1484</GroupID>
            <GroupDescription>13.09.01 - C-Ring</GroupDescription>
        </Group>
        <Group>
            <GroupID>1485</GroupID>
            <GroupDescription>13.10.01 - Interbody, Integral Fixation</GroupDescription>
        </Group>
        <Group>
            <GroupID>1486</GroupID>
            <GroupDescription>13.10.02 - Interbody, No Integral Fixation</GroupDescription>
        </Group>
        <Group>
            <GroupID>1487</GroupID>
            <GroupDescription>13.10.03 - Facet Joint</GroupDescription>
        </Group>
        <Group>
            <GroupID>1488</GroupID>
            <GroupDescription>13.11.01 - System</GroupDescription>
        </Group>
        <Group>
            <GroupID>1489</GroupID>
            <GroupDescription>13.11.02 - End Plate</GroupDescription>
        </Group>
        <Group>
            <GroupID>1490</GroupID>
            <GroupDescription>13.11.03 - Core</GroupDescription>
        </Group>
        <Group>
            <GroupID>1492</GroupID>
            <GroupDescription>13.12.01 - Telescoping Cage</GroupDescription>
        </Group>
        <Group>
            <GroupID>1493</GroupID>
            <GroupDescription>13.12.02 - Stackable Cage</GroupDescription>
        </Group>
        <Group>
            <GroupID>1494</GroupID>
            <GroupDescription>13.12.03 - Mesh</GroupDescription>
        </Group>
        <Group>
            <GroupID>1495</GroupID>
            <GroupDescription>13.12.04 - Mesh, End Plate</GroupDescription>
        </Group>
        <Group>
            <GroupID>1496</GroupID>
            <GroupDescription>13.13.01 - Interspinous Fixation Device</GroupDescription>
        </Group>
        <Group>
            <GroupID>2521</GroupID>
            <GroupDescription>02.01.08 - Tympanic Membrane Grafts</GroupDescription>
        </Group>
        <Group>
            <GroupID>1497</GroupID>
            <GroupDescription>09.01.01 - Bi-Leaflet, rotatable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1499</GroupID>
            <GroupDescription>09.02.01 - Stented, anatomical</GroupDescription>
        </Group>
        <Group>
            <GroupID>1500</GroupID>
            <GroupDescription>09.02.02 - Stented, non anatomical</GroupDescription>
        </Group>
        <Group>
            <GroupID>1501</GroupID>
            <GroupDescription>09.02.03 - Non-Stented</GroupDescription>
        </Group>
        <Group>
            <GroupID>1502</GroupID>
            <GroupDescription>09.03.01 - Mechanical Valve</GroupDescription>
        </Group>
        <Group>
            <GroupID>1503</GroupID>
            <GroupDescription>09.03.02 - Tissue Valve, stented anatomical</GroupDescription>
        </Group>
        <Group>
            <GroupID>1507</GroupID>
            <GroupDescription>09.05.01 - Tissue</GroupDescription>
        </Group>
        <Group>
            <GroupID>1508</GroupID>
            <GroupDescription>09.05.02 - Synthetic</GroupDescription>
        </Group>
        <Group>
            <GroupID>1509</GroupID>
            <GroupDescription>09.06.01 - Non-cardiovascular &lt; 100cm²</GroupDescription>
        </Group>
        <Group>
            <GroupID>1510</GroupID>
            <GroupDescription>09.06.02 - Non-cardiovascular ≥100cm² and &lt;200cm²</GroupDescription>
        </Group>
        <Group>
            <GroupID>1511</GroupID>
            <GroupDescription>09.06.03 - Non-cardiovascular  ≥200cm²</GroupDescription>
        </Group>
        <Group>
            <GroupID>1517</GroupID>
            <GroupDescription>09.09.01 - Modified Tube (end modified eg valsalva)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1518</GroupID>
            <GroupDescription>09.09.02 - Tube with one side branch</GroupDescription>
        </Group>
        <Group>
            <GroupID>1519</GroupID>
            <GroupDescription>09.09.03 - Tube with multiple side branches (more than 1)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1520</GroupID>
            <GroupDescription>03.01.01 - Hepatic, Yttrium 90, Standard Dose</GroupDescription>
        </Group>
        <Group>
            <GroupID>1521</GroupID>
            <GroupDescription>03.01.02 - Prostatic I-125</GroupDescription>
        </Group>
        <Group>
            <GroupID>1522</GroupID>
            <GroupDescription>03.02.01 - Infusion Ports</GroupDescription>
        </Group>
        <Group>
            <GroupID>1524</GroupID>
            <GroupDescription>03.02.02 - Infusion Pumps, Balloon Based</GroupDescription>
        </Group>
        <Group>
            <GroupID>1525</GroupID>
            <GroupDescription>03.02.03 - Infusion Pumps, Battery Powered</GroupDescription>
        </Group>
        <Group>
            <GroupID>1526</GroupID>
            <GroupDescription>02.01.01 - Cochlear Implants</GroupDescription>
        </Group>
        <Group>
            <GroupID>1528</GroupID>
            <GroupDescription>02.01.02 - Speech Processors</GroupDescription>
        </Group>
        <Group>
            <GroupID>1540</GroupID>
            <GroupDescription>03.02.04 - Infusion Pumps, Spring Powered</GroupDescription>
        </Group>
        <Group>
            <GroupID>1541</GroupID>
            <GroupDescription>03.02.05 - Infusion Pump Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1542</GroupID>
            <GroupDescription>03.02.06 - Pharmaceutical Beads</GroupDescription>
        </Group>
        <Group>
            <GroupID>1544</GroupID>
            <GroupDescription>03.03.01 - Feeding Tubes</GroupDescription>
        </Group>
        <Group>
            <GroupID>1545</GroupID>
            <GroupDescription>03.03.02 - Gastrostomy Tubes</GroupDescription>
        </Group>
        <Group>
            <GroupID>1546</GroupID>
            <GroupDescription>03.03.03 - Jejunostomy Tubes</GroupDescription>
        </Group>
        <Group>
            <GroupID>1547</GroupID>
            <GroupDescription>03.03.04 - Caecostomy Tubes</GroupDescription>
        </Group>
        <Group>
            <GroupID>1548</GroupID>
            <GroupDescription>03.04.01 - Adjustable Gastric Band with Port</GroupDescription>
        </Group>
        <Group>
            <GroupID>1551</GroupID>
            <GroupDescription>03.05.01 - Occluder Pin</GroupDescription>
        </Group>
        <Group>
            <GroupID>1552</GroupID>
            <GroupDescription>03.05.02 - Powder</GroupDescription>
        </Group>
        <Group>
            <GroupID>1553</GroupID>
            <GroupDescription>03.05.03 - Sponges</GroupDescription>
        </Group>
        <Group>
            <GroupID>1554</GroupID>
            <GroupDescription>03.05.04 - Pliable Patches</GroupDescription>
        </Group>
        <Group>
            <GroupID>1555</GroupID>
            <GroupDescription>03.05.05 - Matrix</GroupDescription>
        </Group>
        <Group>
            <GroupID>1556</GroupID>
            <GroupDescription>03.06.01 - Biliary Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1557</GroupID>
            <GroupDescription>03.06.02 - Colonic Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1558</GroupID>
            <GroupDescription>03.06.03 - Oesophageal Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1560</GroupID>
            <GroupDescription>02.01.04 - Implantable Bone Conduction Hearing System</GroupDescription>
        </Group>
        <Group>
            <GroupID>1561</GroupID>
            <GroupDescription>03.06.04 - Pancreatic Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1562</GroupID>
            <GroupDescription>03.06.05 - Enteral Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1563</GroupID>
            <GroupDescription>03.06.06 - Tracheobronchial Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1564</GroupID>
            <GroupDescription>03.06.07 - Nerve Repair Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1565</GroupID>
            <GroupDescription>02.01.05 - Ossicle/Middle Ear Prosthesis</GroupDescription>
        </Group>
        <Group>
            <GroupID>1566</GroupID>
            <GroupDescription>02.01.06 - Ventilation Tube/Grommet</GroupDescription>
        </Group>
        <Group>
            <GroupID>1568</GroupID>
            <GroupDescription>02.02.01 - Septal Button</GroupDescription>
        </Group>
        <Group>
            <GroupID>1569</GroupID>
            <GroupDescription>02.03.01 - Tracheal Speaking Valve</GroupDescription>
        </Group>
        <Group>
            <GroupID>1570</GroupID>
            <GroupDescription>02.03.02 - Vocal Chord Medialisation Implant</GroupDescription>
        </Group>
        <Group>
            <GroupID>1571</GroupID>
            <GroupDescription>02.03.03 - Tracheal Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1573</GroupID>
            <GroupDescription>02.03.04 - Thyroplasty</GroupDescription>
        </Group>
        <Group>
            <GroupID>1574</GroupID>
            <GroupDescription>02.03.05 - Cannula</GroupDescription>
        </Group>
        <Group>
            <GroupID>1576</GroupID>
            <GroupDescription>02.03.06 - Injectable Material for Vocal Fold Augmentation / Laryngeal Reconstruction</GroupDescription>
        </Group>
        <Group>
            <GroupID>1577</GroupID>
            <GroupDescription>03.07.01 - Drainage Catheters</GroupDescription>
        </Group>
        <Group>
            <GroupID>2601</GroupID>
            <GroupDescription>09.09.05 - Hybrid stent graft (Branched)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1578</GroupID>
            <GroupDescription>03.07.02 - Endobronchial Valve</GroupDescription>
        </Group>
        <Group>
            <GroupID>1579</GroupID>
            <GroupDescription>03.08.01 - Adhesion Barriers</GroupDescription>
        </Group>
        <Group>
            <GroupID>1580</GroupID>
            <GroupDescription>03.08.02 - Internal Adhesives</GroupDescription>
        </Group>
        <Group>
            <GroupID>1581</GroupID>
            <GroupDescription>03.08.03 - Ligating Devices</GroupDescription>
        </Group>
        <Group>
            <GroupID>1582</GroupID>
            <GroupDescription>03.08.04 - Staples &amp; Tackers</GroupDescription>
        </Group>
        <Group>
            <GroupID>1585</GroupID>
            <GroupDescription>07.01.01 - Mesh - Metal</GroupDescription>
        </Group>
        <Group>
            <GroupID>1586</GroupID>
            <GroupDescription>07.01.02 - Mesh - Non-metal</GroupDescription>
        </Group>
        <Group>
            <GroupID>1587</GroupID>
            <GroupDescription>07.01.03 - Mesh - Composite</GroupDescription>
        </Group>
        <Group>
            <GroupID>1588</GroupID>
            <GroupDescription>07.01.04 - Non-mesh</GroupDescription>
        </Group>
        <Group>
            <GroupID>1589</GroupID>
            <GroupDescription>07.01.05 - Fracture or Reconstruction Plates</GroupDescription>
        </Group>
        <Group>
            <GroupID>1590</GroupID>
            <GroupDescription>07.01.06 - Screws</GroupDescription>
        </Group>
        <Group>
            <GroupID>1591</GroupID>
            <GroupDescription>07.01.07 - Ancillary Components</GroupDescription>
        </Group>
        <Group>
            <GroupID>1592</GroupID>
            <GroupDescription>07.02.01 - Chin</GroupDescription>
        </Group>
        <Group>
            <GroupID>1593</GroupID>
            <GroupDescription>07.02.02 - Cranium</GroupDescription>
        </Group>
        <Group>
            <GroupID>1594</GroupID>
            <GroupDescription>07.02.03 - Ear</GroupDescription>
        </Group>
        <Group>
            <GroupID>1595</GroupID>
            <GroupDescription>07.02.04 - Malar</GroupDescription>
        </Group>
        <Group>
            <GroupID>1596</GroupID>
            <GroupDescription>07.02.05 - Mandible, Maxilla and Temperomandibular Joint (TMJ)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1597</GroupID>
            <GroupDescription>07.02.06 - Nose and Zygoma</GroupDescription>
        </Group>
        <Group>
            <GroupID>1598</GroupID>
            <GroupDescription>07.02.07 - Orbit</GroupDescription>
        </Group>
        <Group>
            <GroupID>1599</GroupID>
            <GroupDescription>07.02.08 - External Prostheses, Bone Attachment</GroupDescription>
        </Group>
        <Group>
            <GroupID>1600</GroupID>
            <GroupDescription>07.03.01 - Abutment</GroupDescription>
        </Group>
        <Group>
            <GroupID>1601</GroupID>
            <GroupDescription>07.03.02 - Zygomatic Bone Implant</GroupDescription>
        </Group>
        <Group>
            <GroupID>1602</GroupID>
            <GroupDescription>07.03.03 - Endosseous Implant</GroupDescription>
        </Group>
        <Group>
            <GroupID>1603</GroupID>
            <GroupDescription>07.04.01 - Complete</GroupDescription>
        </Group>
        <Group>
            <GroupID>1604</GroupID>
            <GroupDescription>07.04.02 - Component</GroupDescription>
        </Group>
        <Group>
            <GroupID>1605</GroupID>
            <GroupDescription>07.05.01 - Muscular</GroupDescription>
        </Group>
        <Group>
            <GroupID>1606</GroupID>
            <GroupDescription>07.05.02 - Tissue Expanders</GroupDescription>
        </Group>
        <Group>
            <GroupID>1607</GroupID>
            <GroupDescription>07.05.03 - Skin, Artificial</GroupDescription>
        </Group>
        <Group>
            <GroupID>1608</GroupID>
            <GroupDescription>07.05.04 - Coupler</GroupDescription>
        </Group>
        <Group>
            <GroupID>1609</GroupID>
            <GroupDescription>07.06.01 - Saline Filled</GroupDescription>
        </Group>
        <Group>
            <GroupID>1610</GroupID>
            <GroupDescription>07.06.02 - Gel Filled</GroupDescription>
        </Group>
        <Group>
            <GroupID>2641</GroupID>
            <GroupDescription>08.17.01 - Transcatheter Aortic Valve Implantation</GroupDescription>
        </Group>
        <Group>
            <GroupID>1622</GroupID>
            <GroupDescription>10.01.01 - Bare Metal Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1624</GroupID>
            <GroupDescription>10.01.02 - Drug Eluting Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1625</GroupID>
            <GroupDescription>10.02.01 - Tube (Thoracic Aorta)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1626</GroupID>
            <GroupDescription>10.02.02 - Tube (Abdominal Aorta)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1627</GroupID>
            <GroupDescription>10.02.03 - Tube (Aorto-uni-iliac)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1628</GroupID>
            <GroupDescription>10.02.04 - Bifurcated</GroupDescription>
        </Group>
        <Group>
            <GroupID>1629</GroupID>
            <GroupDescription>10.02.05 - Branched</GroupDescription>
        </Group>
        <Group>
            <GroupID>1630</GroupID>
            <GroupDescription>10.02.06 - Fenestrated</GroupDescription>
        </Group>
        <Group>
            <GroupID>1631</GroupID>
            <GroupDescription>10.02.07 - Accessory Component (Aortic)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1632</GroupID>
            <GroupDescription>10.02.08 - Accessory Component (Other including iliac limb and extension)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1633</GroupID>
            <GroupDescription>10.02.09 - Iliac Graft Plug</GroupDescription>
        </Group>
        <Group>
            <GroupID>1634</GroupID>
            <GroupDescription>10.02.10 - Tube, Peripheral, Balloon Expandable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1635</GroupID>
            <GroupDescription>10.02.11 - Tube, Peripheral, Self Expandable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1636</GroupID>
            <GroupDescription>10.03.01 - Tube</GroupDescription>
        </Group>
        <Group>
            <GroupID>1637</GroupID>
            <GroupDescription>10.03.02 - Bifurcated</GroupDescription>
        </Group>
        <Group>
            <GroupID>1638</GroupID>
            <GroupDescription>10.03.03 - Branched or Fenestrated</GroupDescription>
        </Group>
        <Group>
            <GroupID>1639</GroupID>
            <GroupDescription>10.03.04 - Tapered or End-modified</GroupDescription>
        </Group>
        <Group>
            <GroupID>1640</GroupID>
            <GroupDescription>10.04.01 - Vascular Patches</GroupDescription>
        </Group>
        <Group>
            <GroupID>1641</GroupID>
            <GroupDescription>10.05.01 - Vessel Bands</GroupDescription>
        </Group>
        <Group>
            <GroupID>1642</GroupID>
            <GroupDescription>10.06.01 - Venous</GroupDescription>
        </Group>
        <Group>
            <GroupID>1643</GroupID>
            <GroupDescription>10.06.02 - Arterial</GroupDescription>
        </Group>
        <Group>
            <GroupID>1644</GroupID>
            <GroupDescription>10.07.01 - Arterial Closure Devices</GroupDescription>
        </Group>
        <Group>
            <GroupID>1645</GroupID>
            <GroupDescription>10.08.01 - Particle</GroupDescription>
        </Group>
        <Group>
            <GroupID>1646</GroupID>
            <GroupDescription>10.08.02 - Coil, Peripheral</GroupDescription>
        </Group>
        <Group>
            <GroupID>1647</GroupID>
            <GroupDescription>10.08.03 - Polymer</GroupDescription>
        </Group>
        <Group>
            <GroupID>1648</GroupID>
            <GroupDescription>10.08.04 - Complex Occlusion Devices, including detachable balloon, sphere or umbrella</GroupDescription>
        </Group>
        <Group>
            <GroupID>1649</GroupID>
            <GroupDescription>10.09.01 - Percutaneous Catheters, Single Lumen</GroupDescription>
        </Group>
        <Group>
            <GroupID>1650</GroupID>
            <GroupDescription>10.09.02 - Percutaneous Catheters, Multiple Lumen</GroupDescription>
        </Group>
        <Group>
            <GroupID>1651</GroupID>
            <GroupDescription>10.09.03 - Percutaneous Catheters, Multiple Lumen for Haemodialysis</GroupDescription>
        </Group>
        <Group>
            <GroupID>1652</GroupID>
            <GroupDescription>10.09.04 - Infuser Ports, Single Chamber</GroupDescription>
        </Group>
        <Group>
            <GroupID>1653</GroupID>
            <GroupDescription>10.09.05 - Infuser Ports, Multiple Chamber</GroupDescription>
        </Group>
        <Group>
            <GroupID>1654</GroupID>
            <GroupDescription>10.10.01 - Peritoneal Dialysis, Long Term Implantable Catheters</GroupDescription>
        </Group>
        <Group>
            <GroupID>1655</GroupID>
            <GroupDescription>04.01.01 - Aneurysm Clip</GroupDescription>
        </Group>
        <Group>
            <GroupID>1656</GroupID>
            <GroupDescription>04.01.02 - AVM Clip</GroupDescription>
        </Group>
        <Group>
            <GroupID>1657</GroupID>
            <GroupDescription>04.02.01 - Repair, Graft, Small (≤10cm²)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1658</GroupID>
            <GroupDescription>04.02.02 - Repair, Graft, Medium (&gt;10 to 50cm²)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1659</GroupID>
            <GroupDescription>04.02.03 - Repair, Graft, Large (&gt;50 to 100cm²)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1660</GroupID>
            <GroupDescription>04.02.04 - Repair, Graft, Extra Large (&gt;100cm²)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1661</GroupID>
            <GroupDescription>04.02.05 - Repair, Liquid Sealant (0 to 3ml)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1662</GroupID>
            <GroupDescription>04.02.06 - Repair, Liquid Sealant (&gt;3 to 6ml)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1663</GroupID>
            <GroupDescription>04.02.07 - Repair, Self-Adhesive Membrane Sealant, Small (≤10cm²)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1664</GroupID>
            <GroupDescription>04.02.08 - Repair, Self-Adhesive Membrane Sealant, Medium (&gt;10 to 50cm²)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1666</GroupID>
            <GroupDescription>04.03.01 - Valves</GroupDescription>
        </Group>
        <Group>
            <GroupID>1667</GroupID>
            <GroupDescription>04.03.02 - Unitised shunt assembly, with proximal/distal catheter</GroupDescription>
        </Group>
        <Group>
            <GroupID>1668</GroupID>
            <GroupDescription>04.03.03 - Catheter</GroupDescription>
        </Group>
        <Group>
            <GroupID>1669</GroupID>
            <GroupDescription>04.03.04 - Antisyphon Device</GroupDescription>
        </Group>
        <Group>
            <GroupID>1670</GroupID>
            <GroupDescription>04.03.05 - Reservoir/Priming Device</GroupDescription>
        </Group>
        <Group>
            <GroupID>1671</GroupID>
            <GroupDescription>04.03.06 - Shunt Attachment</GroupDescription>
        </Group>
        <Group>
            <GroupID>1672</GroupID>
            <GroupDescription>04.04.01 - Implantable Pulse Generator</GroupDescription>
        </Group>
        <Group>
            <GroupID>1673</GroupID>
            <GroupDescription>04.04.02 - External Components</GroupDescription>
        </Group>
        <Group>
            <GroupID>1674</GroupID>
            <GroupDescription>04.04.03 - Leads</GroupDescription>
        </Group>
        <Group>
            <GroupID>1675</GroupID>
            <GroupDescription>04.04.04 - Microtargetting Electrodes</GroupDescription>
        </Group>
        <Group>
            <GroupID>1676</GroupID>
            <GroupDescription>04.04.05 - Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1677</GroupID>
            <GroupDescription>04.05.01 - Pulse Generators</GroupDescription>
        </Group>
        <Group>
            <GroupID>1678</GroupID>
            <GroupDescription>04.05.02 - External Components</GroupDescription>
        </Group>
        <Group>
            <GroupID>1679</GroupID>
            <GroupDescription>04.05.03 - Leads</GroupDescription>
        </Group>
        <Group>
            <GroupID>1680</GroupID>
            <GroupDescription>04.05.04 - Lead Extension</GroupDescription>
        </Group>
        <Group>
            <GroupID>1681</GroupID>
            <GroupDescription>04.06.01 - Implantable Infusion Pump </GroupDescription>
        </Group>
        <Group>
            <GroupID>1682</GroupID>
            <GroupDescription>04.06.02 - Patient Programmer</GroupDescription>
        </Group>
        <Group>
            <GroupID>1683</GroupID>
            <GroupDescription>04.06.03 - Intrathecal Catheter</GroupDescription>
        </Group>
        <Group>
            <GroupID>1684</GroupID>
            <GroupDescription>04.06.04 - Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1685</GroupID>
            <GroupDescription>04.07.01 - Vagal nerve stimulators</GroupDescription>
        </Group>
        <Group>
            <GroupID>1687</GroupID>
            <GroupDescription>04.08.01 - Stent</GroupDescription>
        </Group>
        <Group>
            <GroupID>1688</GroupID>
            <GroupDescription>04.08.02 - Coils</GroupDescription>
        </Group>
        <Group>
            <GroupID>1689</GroupID>
            <GroupDescription>04.08.03 - Assist Devices</GroupDescription>
        </Group>
        <Group>
            <GroupID>1690</GroupID>
            <GroupDescription>04.05.05 - Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1691</GroupID>
            <GroupDescription>03.08.09 - Plugs</GroupDescription>
        </Group>
        <Group>
            <GroupID>1692</GroupID>
            <GroupDescription>10.08.05 - Liquid</GroupDescription>
        </Group>
        <Group>
            <GroupID>1693</GroupID>
            <GroupDescription>10.08.06 - Delivery Device For Occlusion Media</GroupDescription>
        </Group>
        <Group>
            <GroupID>1694</GroupID>
            <GroupDescription>06.03.03 - Plates</GroupDescription>
        </Group>
        <Group>
            <GroupID>1695</GroupID>
            <GroupDescription>04.02.09 - Repair, Self-Adhesive Membrane Sealant, Large (&gt;50 to 100cm²)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1696</GroupID>
            <GroupDescription>05.01.01 - Inflatable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1698</GroupID>
            <GroupDescription>05.01.03 - Sling</GroupDescription>
        </Group>
        <Group>
            <GroupID>1699</GroupID>
            <GroupDescription>05.01.04 - Injectable, Synthetic</GroupDescription>
        </Group>
        <Group>
            <GroupID>1701</GroupID>
            <GroupDescription>05.02.01 - Fixed length</GroupDescription>
        </Group>
        <Group>
            <GroupID>1702</GroupID>
            <GroupDescription>05.02.02 - Multi-length</GroupDescription>
        </Group>
        <Group>
            <GroupID>1703</GroupID>
            <GroupDescription>05.02.03 - Urinary diversion</GroupDescription>
        </Group>
        <Group>
            <GroupID>1709</GroupID>
            <GroupDescription>05.05.02 - Inflatable - Two component</GroupDescription>
        </Group>
        <Group>
            <GroupID>1710</GroupID>
            <GroupDescription>05.05.03 - Inflatable - Three component</GroupDescription>
        </Group>
        <Group>
            <GroupID>1711</GroupID>
            <GroupDescription>05.06.01 - Testicular prostheses</GroupDescription>
        </Group>
        <Group>
            <GroupID>1712</GroupID>
            <GroupDescription>05.07.01 - Primary Cell Pulse Generator (non-rechargeable)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1713</GroupID>
            <GroupDescription>05.07.02 - External Components</GroupDescription>
        </Group>
        <Group>
            <GroupID>1714</GroupID>
            <GroupDescription>05.07.03 - Lead</GroupDescription>
        </Group>
        <Group>
            <GroupID>1715</GroupID>
            <GroupDescription>05.07.04 - Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1716</GroupID>
            <GroupDescription>05.08.01 - Extraluminal</GroupDescription>
        </Group>
        <Group>
            <GroupID>1718</GroupID>
            <GroupDescription>05.09.01 - Nephrostomy Catheters</GroupDescription>
        </Group>
        <Group>
            <GroupID>1719</GroupID>
            <GroupDescription>05.10.01 - Vesicoureteral Reflux Prostheses</GroupDescription>
        </Group>
        <Group>
            <GroupID>1721</GroupID>
            <GroupDescription>05.05.01 - Malleable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1723</GroupID>
            <GroupDescription>08.01.02 - Features of 8.1.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis</GroupDescription>
        </Group>
        <Group>
            <GroupID>1725</GroupID>
            <GroupDescription>08.02.02 - Features of 8.2.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis</GroupDescription>
        </Group>
        <Group>
            <GroupID>1727</GroupID>
            <GroupDescription>08.03.02 - Features of 8.3.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis</GroupDescription>
        </Group>
        <Group>
            <GroupID>1730</GroupID>
            <GroupDescription>08.04.03 - SSIR with small/compact size, multi-programmability &amp; longevity, &amp; four or more advanced features</GroupDescription>
        </Group>
        <Group>
            <GroupID>1732</GroupID>
            <GroupDescription>08.05.02 - DDDR/VDDR including rate responsive feature</GroupDescription>
        </Group>
        <Group>
            <GroupID>1734</GroupID>
            <GroupDescription>08.05.04 - DDDR with continuous threshold monitoring in atrium + ventricle with ability to adapt pacing outputs accordingly, &amp; with four or more advanced features</GroupDescription>
        </Group>
        <Group>
            <GroupID>1736</GroupID>
            <GroupDescription>08.06.02 - Features of 8.6.1 plus continuous threshold monitoring in atrium &amp; ventricle with ability to adapt pacing outputs accordingly</GroupDescription>
        </Group>
        <Group>
            <GroupID>1737</GroupID>
            <GroupDescription>08.07.01 - Coronary Sinus</GroupDescription>
        </Group>
        <Group>
            <GroupID>1738</GroupID>
            <GroupDescription>08.07.02 - Subcutaneous</GroupDescription>
        </Group>
        <Group>
            <GroupID>1741</GroupID>
            <GroupDescription>08.07.05 - Transvenous/Steroid/Passive</GroupDescription>
        </Group>
        <Group>
            <GroupID>1743</GroupID>
            <GroupDescription>08.07.06 - Transvenous/Steroid/Active</GroupDescription>
        </Group>
        <Group>
            <GroupID>1745</GroupID>
            <GroupDescription>08.07.07 - Epicardial Patches</GroupDescription>
        </Group>
        <Group>
            <GroupID>1746</GroupID>
            <GroupDescription>08.08.01 - Non-transvenous, Bi-Polar, Steroid</GroupDescription>
        </Group>
        <Group>
            <GroupID>1747</GroupID>
            <GroupDescription>08.08.02 - Non-transvenous, Uni-Polar, Steroid</GroupDescription>
        </Group>
        <Group>
            <GroupID>1748</GroupID>
            <GroupDescription>08.08.03 - Non-transvenous, Uni-Polar, Non-Steroid</GroupDescription>
        </Group>
        <Group>
            <GroupID>1751</GroupID>
            <GroupDescription>08.08.06 - Transvenous, Uni-Polar, Passive, Steroid, Left Ventricular</GroupDescription>
        </Group>
        <Group>
            <GroupID>1753</GroupID>
            <GroupDescription>08.08.08 - Transvenous, Bi-Polar, Passive, Steroid, Right Ventricular/Atrial</GroupDescription>
        </Group>
        <Group>
            <GroupID>1756</GroupID>
            <GroupDescription>08.08.09 - Transvenous, Bi-Polar, Active, Steroid, Right Ventricular/Atrial</GroupDescription>
        </Group>
        <Group>
            <GroupID>1759</GroupID>
            <GroupDescription>08.08.11 - Transvenous, Multi-Polar, Passive, Steroid, Left Ventricular</GroupDescription>
        </Group>
        <Group>
            <GroupID>1763</GroupID>
            <GroupDescription>08.09.01 - Pacemaker/ICD Adaptors</GroupDescription>
        </Group>
        <Group>
            <GroupID>1764</GroupID>
            <GroupDescription>08.10.01 - Pacemaker/ICD Adaptors</GroupDescription>
        </Group>
        <Group>
            <GroupID>1765</GroupID>
            <GroupDescription>08.11.01 - Pacemaker/Lead Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1766</GroupID>
            <GroupDescription>08.12.01 - Drug Eluting</GroupDescription>
        </Group>
        <Group>
            <GroupID>1767</GroupID>
            <GroupDescription>08.12.02 - Bare Metal</GroupDescription>
        </Group>
        <Group>
            <GroupID>1768</GroupID>
            <GroupDescription>08.13.01 - Cardiac Defect Occluders</GroupDescription>
        </Group>
        <Group>
            <GroupID>1770</GroupID>
            <GroupDescription>08.14.01 - Implantable Cardiac Event Recorders</GroupDescription>
        </Group>
        <Group>
            <GroupID>1771</GroupID>
            <GroupDescription>03.08.10 - Anastomosis Clip</GroupDescription>
        </Group>
        <Group>
            <GroupID>1772</GroupID>
            <GroupDescription>06.03.05 - Surgical Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1773</GroupID>
            <GroupDescription>06.03.06 - Staples</GroupDescription>
        </Group>
        <Group>
            <GroupID>1774</GroupID>
            <GroupDescription>06.03.07 - Soft Tissue Fixation Devices</GroupDescription>
        </Group>
        <Group>
            <GroupID>1776</GroupID>
            <GroupDescription>06.03.08 - Soft Tissue Substitute</GroupDescription>
        </Group>
        <Group>
            <GroupID>1777</GroupID>
            <GroupDescription>06.03.16 - Meshes</GroupDescription>
        </Group>
        <Group>
            <GroupID>1778</GroupID>
            <GroupDescription>06.03.17 - Tumour / Limb Deficiency</GroupDescription>
        </Group>
        <Group>
            <GroupID>1779</GroupID>
            <GroupDescription>03.04.03 - Replacement Injection Ports</GroupDescription>
        </Group>
        <Group>
            <GroupID>1781</GroupID>
            <GroupDescription>03.04.02 - Gastric Band without Port</GroupDescription>
        </Group>
        <Group>
            <GroupID>1782</GroupID>
            <GroupDescription>03.08.05 - Polypropylene/Polyester Mesh</GroupDescription>
        </Group>
        <Group>
            <GroupID>1783</GroupID>
            <GroupDescription>03.08.06 - Composite Mesh</GroupDescription>
        </Group>
        <Group>
            <GroupID>1785</GroupID>
            <GroupDescription>03.08.08 - PTFE/ePTFE Mesh</GroupDescription>
        </Group>
        <Group>
            <GroupID>1786</GroupID>
            <GroupDescription>05.01.02 - Permanently Adjustable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1790</GroupID>
            <GroupDescription>09.08.02 - Surgical closure devices (atrial appendage)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1791</GroupID>
            <GroupDescription>09.10.01 - Skeletal fixation, sternum</GroupDescription>
        </Group>
        <Group>
            <GroupID>1792</GroupID>
            <GroupDescription>03.01.03 - Tissue Expander/Separator</GroupDescription>
        </Group>
        <Group>
            <GroupID>1793</GroupID>
            <GroupDescription>03.07.03 - Drainage Shunts, Peritineovenous</GroupDescription>
        </Group>
        <Group>
            <GroupID>1794</GroupID>
            <GroupDescription>04.09.01 - Transducer</GroupDescription>
        </Group>
        <Group>
            <GroupID>1796</GroupID>
            <GroupDescription>04.10.01 - External Ventricular Drain</GroupDescription>
        </Group>
        <Group>
            <GroupID>1797</GroupID>
            <GroupDescription>03.05.06 - Foam</GroupDescription>
        </Group>
        <Group>
            <GroupID>1798</GroupID>
            <GroupDescription>03.08.07 - Complete Biomaterial Mesh</GroupDescription>
        </Group>
        <Group>
            <GroupID>1799</GroupID>
            <GroupDescription>03.08.11 - Dynamic Wound Closure Devices</GroupDescription>
        </Group>
        <Group>
            <GroupID>1800</GroupID>
            <GroupDescription>05.03.01 - Urethral Stents</GroupDescription>
        </Group>
        <Group>
            <GroupID>1801</GroupID>
            <GroupDescription>05.03.02 - Prostatic Retractor</GroupDescription>
        </Group>
        <Group>
            <GroupID>1802</GroupID>
            <GroupDescription>01.05.03 - Ab Interno Glaucoma Drainage Device</GroupDescription>
        </Group>
        <Group>
            <GroupID>1803</GroupID>
            <GroupDescription>01.07.03 - Balloon Dilatation Catheters</GroupDescription>
        </Group>
        <Group>
            <GroupID>1804</GroupID>
            <GroupDescription>08.15.01 - Uncovered</GroupDescription>
        </Group>
        <Group>
            <GroupID>1805</GroupID>
            <GroupDescription>08.15.02 - Covered</GroupDescription>
        </Group>
        <Group>
            <GroupID>1806</GroupID>
            <GroupDescription>11.04.27 - Insert Orientation Spacer Ring</GroupDescription>
        </Group>
        <Group>
            <GroupID>1807</GroupID>
            <GroupDescription>07.02.09 - Anatomical Biomodel</GroupDescription>
        </Group>
        <Group>
            <GroupID>1811</GroupID>
            <GroupDescription>09.09.04 - Hybrid stent graft (unbranched)</GroupDescription>
        </Group>
        <Group>
            <GroupID>1812</GroupID>
            <GroupDescription>08.01.03 - Single Chamber, Subcutaneous</GroupDescription>
        </Group>
        <Group>
            <GroupID>1814</GroupID>
            <GroupDescription>13.12.05 - Non Stackable Cage, other</GroupDescription>
        </Group>
        <Group>
            <GroupID>1815</GroupID>
            <GroupDescription>09.02.04 - Rapid deployment aortic valve with dedicated single use tools</GroupDescription>
        </Group>
        <Group>
            <GroupID>1816</GroupID>
            <GroupDescription>13.02.08 - Sublaminar Cable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1817</GroupID>
            <GroupDescription>02.02.02 - Nasal Valve Stent</GroupDescription>
        </Group>
        <Group>
            <GroupID>1819</GroupID>
            <GroupDescription>09.11.01 - Ventricular Assist System</GroupDescription>
        </Group>
        <Group>
            <GroupID>1820</GroupID>
            <GroupDescription>11.04.28 - Acetabular Stem or equivalent</GroupDescription>
        </Group>
        <Group>
            <GroupID>1821</GroupID>
            <GroupDescription>13.14.01 - Sacroiliac Joint Fixation Device</GroupDescription>
        </Group>
        <Group>
            <GroupID>1822</GroupID>
            <GroupDescription>01.10.01 - Foldable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1823</GroupID>
            <GroupDescription>13.15.01 - Annular closure/reconstruction device</GroupDescription>
        </Group>
        <Group>
            <GroupID>1824</GroupID>
            <GroupDescription>09.12.01 - Pectus Bar</GroupDescription>
        </Group>
        <Group>
            <GroupID>1825</GroupID>
            <GroupDescription>09.12.02 - Stabilisers</GroupDescription>
        </Group>
        <Group>
            <GroupID>1826</GroupID>
            <GroupDescription>13.06.05 - Rod, Percutaneous Controlled Expansion</GroupDescription>
        </Group>
        <Group>
            <GroupID>1828</GroupID>
            <GroupDescription>09.13.01 - Chordal Replacement Devices, fixed and adjustable</GroupDescription>
        </Group>
        <Group>
            <GroupID>1829</GroupID>
            <GroupDescription>08.11.02 - Antibacterial Envelope</GroupDescription>
        </Group>
        <Group>
            <GroupID>1830</GroupID>
            <GroupDescription>09.11.02 - External Components</GroupDescription>
        </Group>
        <Group>
            <GroupID>1831</GroupID>
            <GroupDescription>09.11.03 - Patient Mobility Accessories</GroupDescription>
        </Group>
        <Group>
            <GroupID>1832</GroupID>
            <GroupDescription>08.16.01 - Remote Monitoring System</GroupDescription>
        </Group>
        <Group>
            <GroupID>1841</GroupID>
            <GroupDescription>09.04.04 - Atrio-Ventricular Ring or Band, Standard</GroupDescription>
        </Group>
        <Group>
            <GroupID>1842</GroupID>
            <GroupDescription>09.04.05 - Atrio-Ventricular Ring or Band, Modified</GroupDescription>
        </Group>
        <Group>
            <GroupID>1901</GroupID>
            <GroupDescription>07.01.08 - Non-mesh, non-resorbable</GroupDescription>
        </Group>
        <Group>
            <GroupID>2945</GroupID>
            <GroupDescription>06.03.12 - Internal Fixator</GroupDescription>
        </Group>
        <Group>
            <GroupID>2946</GroupID>
            <GroupDescription>08.18.01 - Radio frequency (RF) Ablation</GroupDescription>
        </Group>
        <Group>
            <GroupID>2947</GroupID>
            <GroupDescription>08.18.02 - Cryoablation</GroupDescription>
        </Group>
        <Group>
            <GroupID>2948</GroupID>
            <GroupDescription>09.14.01 - RF Ablation</GroupDescription>
        </Group>
        <Group>
            <GroupID>2949</GroupID>
            <GroupDescription>09.14.02 - Cryoablation</GroupDescription>
        </Group>
        <Group>
            <GroupID>2950</GroupID>
            <GroupDescription>05.07.05 - Rechargeable Pulse Generator</GroupDescription>
        </Group>
        <Group>
            <GroupID>2952</GroupID>
            <GroupDescription>08.17.02 - Mitral Valve Repair</GroupDescription>
        </Group>
        <Group>
            <GroupID>2957</GroupID>
            <GroupDescription>09.09.06 - Straight Tube</GroupDescription>
        </Group>
        <Group>
            <GroupID>2958</GroupID>
            <GroupDescription>05.03.04 - Temporary Implant</GroupDescription>
        </Group>
        <Group>
            <GroupID>2960</GroupID>
            <GroupDescription>02.01.09 - Implantable Piezoelectric Bone Conduction Hearing System (all components)</GroupDescription>
        </Group>
        <Group>
            <GroupID>2962</GroupID>
            <GroupDescription>08.14.01 - Implantable Cardiac Event Recorders</GroupDescription>
        </Group>
        <Group>
            <GroupID>2963</GroupID>
            <GroupDescription>03.08.01 - Adhesion Barriers</GroupDescription>
        </Group>
        <Group>
            <GroupID>2964</GroupID>
            <GroupDescription>03.10.01 - Personal Diabetes Manager</GroupDescription>
        </Group>
    </Groups>
    <SubGroups>
        <SubGroup>
            <SubGroupID>6144</SubGroupID>
            <SubGroupDescription>06.02.02.11 - Finger, interphalangeal - proximal component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6145</SubGroupID>
            <SubGroupDescription>06.02.02.12 - Finger, interphalangeal - distal component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6146</SubGroupID>
            <SubGroupDescription>06.02.02.13 - Interpositional Devices</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4111</SubGroupID>
            <SubGroupDescription>06.03.15.06 - Demineralised Bone Matrix, 2 – 5cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4112</SubGroupID>
            <SubGroupDescription>06.03.15.07 - Demineralised Bone Matrix, &gt;5cc - 10cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4113</SubGroupID>
            <SubGroupDescription>06.03.15.08 - Demineralised Bone Matrix, &gt;10cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4114</SubGroupID>
            <SubGroupDescription>06.03.15.09 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), 0 - 5cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4115</SubGroupID>
            <SubGroupDescription>06.03.15.10 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), &gt;5cc - 10cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4116</SubGroupID>
            <SubGroupDescription>06.03.15.11 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), &gt;10cc - 20cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4117</SubGroupID>
            <SubGroupDescription>06.03.15.12 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), &gt;20cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4122</SubGroupID>
            <SubGroupDescription>06.03.15.17 - Metal Scaffold</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4123</SubGroupID>
            <SubGroupDescription>13.03.03.01 - Fixed</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4124</SubGroupID>
            <SubGroupDescription>13.03.03.02 - Adjustable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4125</SubGroupID>
            <SubGroupDescription>13.05.01.01 - Cervical</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4126</SubGroupID>
            <SubGroupDescription>13.05.01.02 - ThoracoLumbar / Lumbar / Lumbosacral</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4127</SubGroupID>
            <SubGroupDescription>13.05.02.01 - Cervical</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4128</SubGroupID>
            <SubGroupDescription>13.05.02.02 - ThoracoLumbar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4129</SubGroupID>
            <SubGroupDescription>13.05.02.03 - Occipital</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4131</SubGroupID>
            <SubGroupDescription>13.05.02.05 - Laminoplasty Plate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4132</SubGroupID>
            <SubGroupDescription>13.06.03.01 - Thoracolumbar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6181</SubGroupID>
            <SubGroupDescription>06.03.05.13 - Chest Wall Reconstruction Plate Accessories</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4133</SubGroupID>
            <SubGroupDescription>13.06.03.02 - Occipital</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4134</SubGroupID>
            <SubGroupDescription>13.10.02.01 - Cervical</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4135</SubGroupID>
            <SubGroupDescription>13.10.02.02 - ThoracoLumbar / Lumbar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4136</SubGroupID>
            <SubGroupDescription>13.12.01.01 - Integral Fixation</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4137</SubGroupID>
            <SubGroupDescription>13.12.01.02 - No Integral Fixation</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4138</SubGroupID>
            <SubGroupDescription>13.12.01.03 - End Plate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4141</SubGroupID>
            <SubGroupDescription>09.05.02.01 - Cardiovascular &lt; 75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4142</SubGroupID>
            <SubGroupDescription>09.05.02.02 - Cardiovascular ≥ 75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4145</SubGroupID>
            <SubGroupDescription>02.01.02.01 - Initial</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4147</SubGroupID>
            <SubGroupDescription>02.01.02.02 - Replacement</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7221</SubGroupID>
            <SubGroupDescription>06.03.08.03 - Non-biological cartilage substitute</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4150</SubGroupID>
            <SubGroupDescription>02.01.04.01 - Sound Processor</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4151</SubGroupID>
            <SubGroupDescription>02.01.04.02 - Osseointegration</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4152</SubGroupID>
            <SubGroupDescription>02.01.04.03 - Cover Screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6201</SubGroupID>
            <SubGroupDescription>07.01.08.01 - &lt;6cm2</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4154</SubGroupID>
            <SubGroupDescription>02.01.05.01 - Stapes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6202</SubGroupID>
            <SubGroupDescription>07.01.08.02 - &gt;6cm2 - &lt;8cm2</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4155</SubGroupID>
            <SubGroupDescription>02.01.05.02 - Malleus</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6203</SubGroupID>
            <SubGroupDescription>07.01.08.03 - &gt;8cm2</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4156</SubGroupID>
            <SubGroupDescription>02.01.05.03 - Partial Ossicle Replacement (one or two)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4157</SubGroupID>
            <SubGroupDescription>02.01.05.04 - Total Ossicle Replacement (three)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4162</SubGroupID>
            <SubGroupDescription>03.01.02.01 - Standard Dose</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4163</SubGroupID>
            <SubGroupDescription>03.01.02.02 - Single Seed or Partial Dose</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4164</SubGroupID>
            <SubGroupDescription>03.02.01.01 - Single Lumen</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4183</SubGroupID>
            <SubGroupDescription>03.02.03.02 - Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and active insulin</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4185</SubGroupID>
            <SubGroupDescription>03.02.03.04 - Other Pharmacology</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4186</SubGroupID>
            <SubGroupDescription>03.02.03.05 - Programmable/Reprogrammable Flow Rate and Bolus</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4187</SubGroupID>
            <SubGroupDescription>03.02.03.03 - Device has capability to automatically adjust the insulin delivery based on continuous glucose monitoring data</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4188</SubGroupID>
            <SubGroupDescription>03.02.04.01 - Fixed Flow Rate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4190</SubGroupID>
            <SubGroupDescription>03.02.05.01 - Kit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4191</SubGroupID>
            <SubGroupDescription>03.02.05.02 - Administration Cassette</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4192</SubGroupID>
            <SubGroupDescription>03.02.05.03 - Administration Reservoir</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4193</SubGroupID>
            <SubGroupDescription>03.02.05.04 - Administration Set</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4194</SubGroupID>
            <SubGroupDescription>03.02.05.05 - Other</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4195</SubGroupID>
            <SubGroupDescription>03.02.06.01 - Single Units</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4197</SubGroupID>
            <SubGroupDescription>03.03.02.01 - Initial</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4198</SubGroupID>
            <SubGroupDescription>03.03.02.02 - Subsequent</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4199</SubGroupID>
            <SubGroupDescription>03.05.03.01 - Absorbable ≤75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4200</SubGroupID>
            <SubGroupDescription>03.05.03.02 - Absorbable &gt;75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4201</SubGroupID>
            <SubGroupDescription>07.01.01.01 - &lt;0.2mm thick, 1-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4202</SubGroupID>
            <SubGroupDescription>07.01.01.02 - &lt;0.2mm thick, 51-100cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4203</SubGroupID>
            <SubGroupDescription>07.01.01.03 - 0.2-0.49mm thick, 1-10cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4204</SubGroupID>
            <SubGroupDescription>07.01.01.04 - 0.2-0.49mm thick, 11-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4205</SubGroupID>
            <SubGroupDescription>07.01.01.05 - 0.2-0.49mm thick, 51-200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4206</SubGroupID>
            <SubGroupDescription>07.01.01.06 - 0.2-0.49mm thick, &gt;200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4207</SubGroupID>
            <SubGroupDescription>07.01.01.07 - 0.5-0.8mm thick, 1-10cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4208</SubGroupID>
            <SubGroupDescription>07.01.01.08 - 0.5-0.8mm thick, 11-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4209</SubGroupID>
            <SubGroupDescription>07.01.01.09 - 0.5-0.8mm thick, 51-200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4210</SubGroupID>
            <SubGroupDescription>07.01.01.10 - 0.5-0.8mm thick, &gt;200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4213</SubGroupID>
            <SubGroupDescription>03.05.05.01 - Liquid ≤6ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4214</SubGroupID>
            <SubGroupDescription>03.05.05.02 - Liquid &gt;6ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4215</SubGroupID>
            <SubGroupDescription>03.05.05.03 - Non-liquid ≤50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4216</SubGroupID>
            <SubGroupDescription>03.05.05.04 - Non-liquid &gt;50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4217</SubGroupID>
            <SubGroupDescription>03.05.05.05 - Accessory Extender</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4218</SubGroupID>
            <SubGroupDescription>03.06.01.01 - Non-reinforced Wall</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4220</SubGroupID>
            <SubGroupDescription>07.01.02.02 - &lt;0.2mm thick, 11-25cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4221</SubGroupID>
            <SubGroupDescription>07.01.02.03 - 0.2-0.49mm thick, 1-10cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4222</SubGroupID>
            <SubGroupDescription>07.01.02.04 - 0.2-0.49mm thick, 11-25cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4223</SubGroupID>
            <SubGroupDescription>07.01.02.05 - 0.2-0.49mm thick, 26-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4225</SubGroupID>
            <SubGroupDescription>07.01.02.07 - 0.5-0.8mm thick, 1-10cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4226</SubGroupID>
            <SubGroupDescription>07.01.02.08 - 0.5-0.8mm thick, 11-25cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4227</SubGroupID>
            <SubGroupDescription>07.01.02.09 - 0.5-0.8mm thick, 26-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4228</SubGroupID>
            <SubGroupDescription>07.01.02.10 - 0.5-0.8mm thick, 51-100cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4229</SubGroupID>
            <SubGroupDescription>07.01.02.11 - 0.5-0.8mm thick, 101-200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4230</SubGroupID>
            <SubGroupDescription>07.01.02.12 - &gt;0.8mm thick, 1-10cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5255</SubGroupID>
            <SubGroupDescription>06.03.03.01 - Standard (screw size ≥4.5mm)(including blade) ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4231</SubGroupID>
            <SubGroupDescription>07.01.02.13 - &gt;0.8mm thick, 11-25cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5256</SubGroupID>
            <SubGroupDescription>06.03.03.02 - Standard (screw size ≥4.5mm)(including blade) ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4232</SubGroupID>
            <SubGroupDescription>07.01.02.14 - &gt;0.8mm thick, 26-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6281</SubGroupID>
            <SubGroupDescription>03.01.03.02 - Gel 10mL or Balloon</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5257</SubGroupID>
            <SubGroupDescription>06.03.03.03 - Standard (screw size ≥4.5mm)(including blade) ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4233</SubGroupID>
            <SubGroupDescription>07.01.02.15 - &gt;0.8mm thick, 51-100cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4234</SubGroupID>
            <SubGroupDescription>03.06.01.02 - Reinforced Wall, Uncovered/Bare Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5258</SubGroupID>
            <SubGroupDescription>06.03.03.04 - Small (screw size 2.71mm – 4.49mm)(including blade) ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4235</SubGroupID>
            <SubGroupDescription>03.06.01.03 - Reinforced Wall, Covered</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5259</SubGroupID>
            <SubGroupDescription>06.03.03.05 - Small (screw size 2.71mm – 4.49mm)(including blade) ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5260</SubGroupID>
            <SubGroupDescription>06.03.03.06 - Small (screw size 2.71mm – 4.49mm)(including blade) ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4237</SubGroupID>
            <SubGroupDescription>03.06.03.02 - Reinforced Wall, Uncovered/Bare Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5261</SubGroupID>
            <SubGroupDescription>06.03.03.07 - Mini (screw size ≤2.7mm)(including blade) ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4238</SubGroupID>
            <SubGroupDescription>03.06.03.03 - Reinforced Wall, Covered</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5262</SubGroupID>
            <SubGroupDescription>06.03.03.08 - Mini (screw size ≤2.7mm)(including blade) ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5263</SubGroupID>
            <SubGroupDescription>06.03.03.09 - Mini (screw size ≤2.7mm)(including blade) ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4239</SubGroupID>
            <SubGroupDescription>07.01.03.01 - 0.5-0.8mm thick, 1-25cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5264</SubGroupID>
            <SubGroupDescription>06.03.03.10 - Dynamic - Hip ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4240</SubGroupID>
            <SubGroupDescription>07.01.03.02 - 0.5-0.8mm thick, 26-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5265</SubGroupID>
            <SubGroupDescription>06.03.03.11 - Dynamic - Hip ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4241</SubGroupID>
            <SubGroupDescription>07.01.03.03 - &gt;0.8mm thick 26-50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4242</SubGroupID>
            <SubGroupDescription>03.07.01.01 - Pleural</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5266</SubGroupID>
            <SubGroupDescription>06.03.03.12 - Dynamic - Hip ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4243</SubGroupID>
            <SubGroupDescription>03.07.01.02 - Intraperitoneal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5267</SubGroupID>
            <SubGroupDescription>06.03.03.13 - Dynamic - supracondylar ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5268</SubGroupID>
            <SubGroupDescription>06.03.03.14 - Dynamic - supracondylar ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5269</SubGroupID>
            <SubGroupDescription>06.03.03.15 - Dynamic - supracondylar ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5270</SubGroupID>
            <SubGroupDescription>06.03.03.16 - Periarticular anatomic - Clavicle plate ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4246</SubGroupID>
            <SubGroupDescription>03.08.01.03 - Spray</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5271</SubGroupID>
            <SubGroupDescription>06.03.03.17 - Periarticular anatomic - Clavicle plate ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4247</SubGroupID>
            <SubGroupDescription>03.08.02.01 - Adhesive ≤2ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5272</SubGroupID>
            <SubGroupDescription>06.03.03.18 - Periarticular anatomic - Clavicle plate ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4248</SubGroupID>
            <SubGroupDescription>03.08.02.02 - Adhesive &gt;2-5ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5273</SubGroupID>
            <SubGroupDescription>06.03.03.19 - Periarticular anatomic - Humerus ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4249</SubGroupID>
            <SubGroupDescription>03.08.02.03 - Adhesive &gt;5ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5274</SubGroupID>
            <SubGroupDescription>06.03.03.20 - Periarticular anatomic - Humerus ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4250</SubGroupID>
            <SubGroupDescription>03.08.02.04 - Adhesive Accessory</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5275</SubGroupID>
            <SubGroupDescription>06.03.03.21 - Periarticular anatomic - Humerus ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4251</SubGroupID>
            <SubGroupDescription>03.08.02.05 - Adhesive Peristrips</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5276</SubGroupID>
            <SubGroupDescription>06.03.03.22 - Periarticular anatomic - Radius ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4252</SubGroupID>
            <SubGroupDescription>03.08.02.06 - Pleurodesis Powder</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5277</SubGroupID>
            <SubGroupDescription>06.03.03.23 - Periarticular anatomic - Radius ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4253</SubGroupID>
            <SubGroupDescription>07.01.04.01 - Resorbable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5278</SubGroupID>
            <SubGroupDescription>06.03.03.24 - Periarticular anatomic - Radius ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4254</SubGroupID>
            <SubGroupDescription>07.01.04.02 - Polymer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5279</SubGroupID>
            <SubGroupDescription>06.03.03.25 - Periarticular anatomic - Ulna ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4255</SubGroupID>
            <SubGroupDescription>07.01.04.03 - Block</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5280</SubGroupID>
            <SubGroupDescription>06.03.03.26 - Periarticular anatomic - Ulna ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4256</SubGroupID>
            <SubGroupDescription>03.08.03.01 - Clips</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5281</SubGroupID>
            <SubGroupDescription>06.03.03.27 - Periarticular anatomic - Ulna ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4257</SubGroupID>
            <SubGroupDescription>03.08.03.02 - Clip Applier</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4258</SubGroupID>
            <SubGroupDescription>03.08.03.03 - Clips with Disposable Applier</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5282</SubGroupID>
            <SubGroupDescription>06.03.03.28 - Periarticular anatomic - Hand-phalangeal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5283</SubGroupID>
            <SubGroupDescription>06.03.03.29 - Periarticular anatomic - Pelvis ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4259</SubGroupID>
            <SubGroupDescription>03.08.03.04 - Clip Reload Cartridge</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5284</SubGroupID>
            <SubGroupDescription>06.03.03.30 - Periarticular anatomic - Pelvis ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4260</SubGroupID>
            <SubGroupDescription>03.08.03.05 - Sutures</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5285</SubGroupID>
            <SubGroupDescription>06.03.03.31 - Periarticular anatomic - Pelvis ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4261</SubGroupID>
            <SubGroupDescription>07.01.05.01 - &lt;0.5mm thick, &lt;4 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5286</SubGroupID>
            <SubGroupDescription>06.03.03.32 - Periarticular anatomic - Femur ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5287</SubGroupID>
            <SubGroupDescription>06.03.03.33 - Periarticular anatomic - Femur ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4263</SubGroupID>
            <SubGroupDescription>07.01.05.02 - &lt;0.5mm thick, 4-7 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5288</SubGroupID>
            <SubGroupDescription>06.03.03.34 - Periarticular anatomic - Femur ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5289</SubGroupID>
            <SubGroupDescription>06.03.03.35 - Periarticular anatomic - Fibula ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4265</SubGroupID>
            <SubGroupDescription>07.01.05.03 - &lt;0.5mm thick, 8-15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5290</SubGroupID>
            <SubGroupDescription>06.03.03.36 - Periarticular anatomic - Fibula ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4266</SubGroupID>
            <SubGroupDescription>07.01.05.04 - &lt;0.5mm thick, 16-32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5291</SubGroupID>
            <SubGroupDescription>06.03.03.37 - Periarticular anatomic - Fibula ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4267</SubGroupID>
            <SubGroupDescription>07.01.05.05 - 0.5-0.99mm thick, &lt;4 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5292</SubGroupID>
            <SubGroupDescription>06.03.03.38 - Periarticular anatomic - Tibia ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5293</SubGroupID>
            <SubGroupDescription>06.03.03.39 - Periarticular anatomic - Tibia ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5294</SubGroupID>
            <SubGroupDescription>06.03.03.40 - Periarticular anatomic - Tibia ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5295</SubGroupID>
            <SubGroupDescription>06.03.03.41 - Periarticular anatomic - Calcaneal ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4271</SubGroupID>
            <SubGroupDescription>07.01.05.06 - 0.5-0.99mm thick, 4-7 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5296</SubGroupID>
            <SubGroupDescription>06.03.03.42 - Periarticular anatomic - Calcaneal ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5297</SubGroupID>
            <SubGroupDescription>06.03.03.43 - Periarticular anatomic - Calcaneal ≥ 16 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7345</SubGroupID>
            <SubGroupDescription>03.05.05.06 - Powder &gt;6ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5298</SubGroupID>
            <SubGroupDescription>06.03.03.44 - Periarticular anatomic - Foot</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5299</SubGroupID>
            <SubGroupDescription>06.03.03.45 - Periarticular anatomic - Cable plate (hook/grip) ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5300</SubGroupID>
            <SubGroupDescription>06.03.03.46 - Periarticular anatomic - Cable plate (hook/grip) ≥ 7 to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7348</SubGroupID>
            <SubGroupDescription>06.03.12.01 - Elbow</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7349</SubGroupID>
            <SubGroupDescription>08.18.01.01 - Irrigated Cardiac Ablation Catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4277</SubGroupID>
            <SubGroupDescription>07.01.05.07 - 0.5-0.99mm thick, 8-32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7350</SubGroupID>
            <SubGroupDescription>08.18.01.02 - Patch</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5302</SubGroupID>
            <SubGroupDescription>06.03.03.48 - Periarticular anatomic - Cable plate with integrated cables - 2 or less, ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7351</SubGroupID>
            <SubGroupDescription>08.18.01.03 - Mapping Catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5303</SubGroupID>
            <SubGroupDescription>06.03.03.49 - Periarticular anatomic - Cable plate with integrated cables - &gt; 2, ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7352</SubGroupID>
            <SubGroupDescription>08.18.02.01 - Ablation Catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7353</SubGroupID>
            <SubGroupDescription>08.18.02.02 - Mapping Catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7354</SubGroupID>
            <SubGroupDescription>09.14.01.01 - Monopolar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5306</SubGroupID>
            <SubGroupDescription>05.01.01.01 - Pump</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7355</SubGroupID>
            <SubGroupDescription>09.14.01.02 - Bipolar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5307</SubGroupID>
            <SubGroupDescription>05.01.01.02 - Occlusive cuff</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7356</SubGroupID>
            <SubGroupDescription>09.14.01.03 - System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5308</SubGroupID>
            <SubGroupDescription>05.01.01.03 - Regulating Balloon</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4284</SubGroupID>
            <SubGroupDescription>07.01.05.08 - 0.5-0.99mm thick, &gt;32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3261</SubGroupID>
            <SubGroupDescription>06.01.02.01 - Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7358</SubGroupID>
            <SubGroupDescription>09.14.02.01 - Probe</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5310</SubGroupID>
            <SubGroupDescription>05.01.01.05 - Accessory kit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4286</SubGroupID>
            <SubGroupDescription>07.01.05.09 - 1.0-1.99mm thick, &lt;4 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7359</SubGroupID>
            <SubGroupDescription>09.14.02.02 - System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5311</SubGroupID>
            <SubGroupDescription>05.01.01.06 - System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7360</SubGroupID>
            <SubGroupDescription>03.02.03.06 - Insulin Infusion Pump - accessories subsequent annual supply</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4288</SubGroupID>
            <SubGroupDescription>07.01.05.10 - 1.0-1.99mm thick, 4-7 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7361</SubGroupID>
            <SubGroupDescription>03.08.03.10 - Laparoscopic Suturing Device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5314</SubGroupID>
            <SubGroupDescription>05.01.03.01 - Male</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7362</SubGroupID>
            <SubGroupDescription>06.03.01.14 - Calcaneal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7363</SubGroupID>
            <SubGroupDescription>03.07.01.06 - Anal Fistula</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5315</SubGroupID>
            <SubGroupDescription>05.01.03.02 - Female</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5316</SubGroupID>
            <SubGroupDescription>05.01.04.01 - 1 ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7364</SubGroupID>
            <SubGroupDescription>10.01.01.05 - Catheter with 4 or 6 stents</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4293</SubGroupID>
            <SubGroupDescription>07.01.05.11 - 1.0-1.99mm thick, 8-15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7365</SubGroupID>
            <SubGroupDescription>08.17.02.01 - Leaflet</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5318</SubGroupID>
            <SubGroupDescription>05.01.04.03 - 2 ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5319</SubGroupID>
            <SubGroupDescription>05.01.04.04 - 2.5 ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7367</SubGroupID>
            <SubGroupDescription>05.07.02.03 - Recharger</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4296</SubGroupID>
            <SubGroupDescription>07.01.05.12 - 1.0-1.99mm thick, 16-32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5321</SubGroupID>
            <SubGroupDescription>05.02.01.01 - Polyurethane</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7369</SubGroupID>
            <SubGroupDescription>09.09.06.02 - 11-20cm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5322</SubGroupID>
            <SubGroupDescription>05.02.01.02 - Other synthetic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7370</SubGroupID>
            <SubGroupDescription>09.09.06.03 - 21-49cm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5323</SubGroupID>
            <SubGroupDescription>05.02.01.03 - Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7371</SubGroupID>
            <SubGroupDescription>09.09.06.04 - ≥50cm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7372</SubGroupID>
            <SubGroupDescription>08.18.01.04 - Non-irrigated cardiac ablation catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5324</SubGroupID>
            <SubGroupDescription>05.02.02.01 - Polyurethane</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4300</SubGroupID>
            <SubGroupDescription>07.01.05.13 - 1.0-1.99mm thick, &gt;32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5325</SubGroupID>
            <SubGroupDescription>05.02.02.02 - Other synthetic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4301</SubGroupID>
            <SubGroupDescription>07.01.05.14 - 2.0-2.99mm thick, 4-7 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7374</SubGroupID>
            <SubGroupDescription>11.01.01.04 - Polished and Unpolished, Modular</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7375</SubGroupID>
            <SubGroupDescription>08.18.01.05 - Intracardiac Electrophysiology Catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4303</SubGroupID>
            <SubGroupDescription>07.01.05.15 - 2.0-2.99mm thick, 8-15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7377</SubGroupID>
            <SubGroupDescription>03.08.01.04 - Gel/Liquid</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5330</SubGroupID>
            <SubGroupDescription>05.05.03.01 - Cylinder</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5331</SubGroupID>
            <SubGroupDescription>05.05.03.02 - Reservoir</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4307</SubGroupID>
            <SubGroupDescription>07.01.05.16 - 2.0-2.99mm thick, 16-32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5332</SubGroupID>
            <SubGroupDescription>05.05.03.03 - Pump</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5333</SubGroupID>
            <SubGroupDescription>05.05.03.04 - Deactivation set</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5334</SubGroupID>
            <SubGroupDescription>05.05.03.05 - Accessory kit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4310</SubGroupID>
            <SubGroupDescription>07.01.05.17 - 2.0-2.99mm thick, &gt;32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5335</SubGroupID>
            <SubGroupDescription>05.05.03.06 - Pump and cylinder</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4311</SubGroupID>
            <SubGroupDescription>07.01.05.18 - ≥3mm thick, 4-7 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4312</SubGroupID>
            <SubGroupDescription>07.01.05.19 - ≥3mm thick, 8-15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5337</SubGroupID>
            <SubGroupDescription>05.07.02.01 - Programmer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4314</SubGroupID>
            <SubGroupDescription>07.01.05.20 - ≥3mm thick, 16-32 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5339</SubGroupID>
            <SubGroupDescription>05.07.03.01 - Permanent</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5340</SubGroupID>
            <SubGroupDescription>05.07.03.02 - Trial</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5341</SubGroupID>
            <SubGroupDescription>05.07.03.03 - Extension</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4317</SubGroupID>
            <SubGroupDescription>03.08.04.01 - Staples, Non-bone (Reload)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5342</SubGroupID>
            <SubGroupDescription>05.07.04.01 - Implant/Revision Kits</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4318</SubGroupID>
            <SubGroupDescription>03.08.04.02 - Staplers</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5343</SubGroupID>
            <SubGroupDescription>05.07.04.02 - Foramen Needle</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4319</SubGroupID>
            <SubGroupDescription>03.08.04.03 - Staples, Reinforcer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5344</SubGroupID>
            <SubGroupDescription>05.08.01.01 - Clip</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4320</SubGroupID>
            <SubGroupDescription>03.08.04.04 - Staples, Non-bone with Disposable Applier</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5345</SubGroupID>
            <SubGroupDescription>05.08.01.02 - Band</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4321</SubGroupID>
            <SubGroupDescription>07.01.06.01 - Diameter ≤1.24mm</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5346</SubGroupID>
            <SubGroupDescription>08.12.01.01 - General Purpose</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4323</SubGroupID>
            <SubGroupDescription>07.01.06.02 - Diameter 1.25-3.24mm</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5348</SubGroupID>
            <SubGroupDescription>08.12.02.01 - General Purpose</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5349</SubGroupID>
            <SubGroupDescription>08.12.02.02 - Special Purpose for specific indications</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5351</SubGroupID>
            <SubGroupDescription>04.07.01.02 - Lead</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4331</SubGroupID>
            <SubGroupDescription>03.08.04.05 - Tackers</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4332</SubGroupID>
            <SubGroupDescription>07.01.07.01 - Pin</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4334</SubGroupID>
            <SubGroupDescription>07.01.07.03 - Washer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5358</SubGroupID>
            <SubGroupDescription>03.02.02.01 - Fixed Flow Rate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4335</SubGroupID>
            <SubGroupDescription>07.01.07.04 - Wedges and Burr Hole Covers</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5359</SubGroupID>
            <SubGroupDescription>03.02.02.02 - Variable Flow Rate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5360</SubGroupID>
            <SubGroupDescription>06.03.01.08 - Flexible/paediatric</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4336</SubGroupID>
            <SubGroupDescription>07.01.07.05 - Anchor Bone</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5361</SubGroupID>
            <SubGroupDescription>06.03.01.09 - Radial/Ulnar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4337</SubGroupID>
            <SubGroupDescription>07.01.07.06 - Clamps</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5362</SubGroupID>
            <SubGroupDescription>06.03.01.10 - Dynamic distraction - electronic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4338</SubGroupID>
            <SubGroupDescription>07.01.07.07 - Screws</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5363</SubGroupID>
            <SubGroupDescription>06.03.02.04 - End caps and extension caps</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5364</SubGroupID>
            <SubGroupDescription>06.03.05.01 - Wires</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4340</SubGroupID>
            <SubGroupDescription>07.01.07.09 - Probe</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5365</SubGroupID>
            <SubGroupDescription>06.03.05.02 - Pins</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5366</SubGroupID>
            <SubGroupDescription>06.03.05.03 - Cables</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5367</SubGroupID>
            <SubGroupDescription>06.03.05.04 - Cables - with in-built locking device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4343</SubGroupID>
            <SubGroupDescription>07.02.02.01 - Complex</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5368</SubGroupID>
            <SubGroupDescription>06.03.05.05 - Cables - with &gt;1 locking device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5369</SubGroupID>
            <SubGroupDescription>06.03.05.06 - Wire forms (including washers/screws) - all sizes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5370</SubGroupID>
            <SubGroupDescription>06.03.05.07 - Cerclage bands</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4346</SubGroupID>
            <SubGroupDescription>07.02.02.02 - Polymer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5371</SubGroupID>
            <SubGroupDescription>06.03.05.08 - Locking device for wires/cables</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5372</SubGroupID>
            <SubGroupDescription>06.03.05.09 - Hook/Grip for wires/cables</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4348</SubGroupID>
            <SubGroupDescription>07.02.02.03 - Composite</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5373</SubGroupID>
            <SubGroupDescription>06.03.05.10 - Grooved Button for wires/cables</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4349</SubGroupID>
            <SubGroupDescription>07.02.03.01 - Helical Rim</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3326</SubGroupID>
            <SubGroupDescription>06.03.01.01 - Femoral, Proximal short (&lt;220mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4350</SubGroupID>
            <SubGroupDescription>07.02.03.02 - Ear Base</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3327</SubGroupID>
            <SubGroupDescription>06.03.01.02 - Femoral, Proximal long (≥220mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4351</SubGroupID>
            <SubGroupDescription>07.02.04.01 - Complex</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3328</SubGroupID>
            <SubGroupDescription>06.03.01.03 - Femoral, Distal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4352</SubGroupID>
            <SubGroupDescription>07.02.04.02 - Polymer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3329</SubGroupID>
            <SubGroupDescription>06.03.01.04 - Tibial/Fibular</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6401</SubGroupID>
            <SubGroupDescription>06.03.11.20 - Simple fixture kit - Lower body (Uniplanar)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4353</SubGroupID>
            <SubGroupDescription>07.02.05.01 - Mandible, Full</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3330</SubGroupID>
            <SubGroupDescription>06.03.01.05 - Humeral</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4354</SubGroupID>
            <SubGroupDescription>07.02.05.02 - Fossa Replacement</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3331</SubGroupID>
            <SubGroupDescription>06.03.01.06 - Arthrodesis knee</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4355</SubGroupID>
            <SubGroupDescription>07.02.05.03 - Mandibular Angle</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3332</SubGroupID>
            <SubGroupDescription>06.03.01.07 - Arthrodesis ankle</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4357</SubGroupID>
            <SubGroupDescription>07.02.05.04 - Condylar Device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5382</SubGroupID>
            <SubGroupDescription>06.03.07.01 - No suture (including arrows)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4358</SubGroupID>
            <SubGroupDescription>07.02.05.05 - Plate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5384</SubGroupID>
            <SubGroupDescription>06.03.07.02 - Suture, Small anchors (≤2.3mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4360</SubGroupID>
            <SubGroupDescription>07.02.06.01 - Nasal Dorsum</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5385</SubGroupID>
            <SubGroupDescription>06.03.07.03 - Suture, Medium anchors (2.4 – 3.9mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4361</SubGroupID>
            <SubGroupDescription>07.02.06.02 - Nasal Arch</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4362</SubGroupID>
            <SubGroupDescription>07.02.06.03 - Nasal Shell Shape</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5387</SubGroupID>
            <SubGroupDescription>06.03.07.04 - Suture, Large anchors (≥4mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4363</SubGroupID>
            <SubGroupDescription>07.02.06.04 - Nasal Valve Support</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4364</SubGroupID>
            <SubGroupDescription>07.02.06.05 - Naso-orbital Ethmoid Implant</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3341</SubGroupID>
            <SubGroupDescription>06.03.02.01 - Intramedullary nail lag screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5389</SubGroupID>
            <SubGroupDescription>06.03.07.05 - Button/thread/tape or Button/thread/button</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5390</SubGroupID>
            <SubGroupDescription>06.03.07.06 - Button</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4366</SubGroupID>
            <SubGroupDescription>07.02.07.01 - Complete Orbital Shape</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5391</SubGroupID>
            <SubGroupDescription>06.03.07.07 - Interference Screw (± sleeve)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4367</SubGroupID>
            <SubGroupDescription>07.02.07.02 - Orbital Floor</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5394</SubGroupID>
            <SubGroupDescription>06.03.07.08 - Screw/Pin/Post</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4370</SubGroupID>
            <SubGroupDescription>07.02.07.03 - Rim</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4371</SubGroupID>
            <SubGroupDescription>07.02.07.04 - Wedge for Orbit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4373</SubGroupID>
            <SubGroupDescription>07.02.08.01 - Endosseous Implant</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5398</SubGroupID>
            <SubGroupDescription>06.03.08.02 - Non-biological</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4374</SubGroupID>
            <SubGroupDescription>07.02.08.02 - Abutment, Permanent</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5399</SubGroupID>
            <SubGroupDescription>06.03.16.01 - Metallic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4376</SubGroupID>
            <SubGroupDescription>07.02.08.03 - Abutment, Temporary or Healing</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4377</SubGroupID>
            <SubGroupDescription>07.02.08.04 - Abutment Fixtures</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5402</SubGroupID>
            <SubGroupDescription>06.03.17.02 - Spacer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5404</SubGroupID>
            <SubGroupDescription>06.03.17.04 - Central Screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5405</SubGroupID>
            <SubGroupDescription>06.03.17.05 - Healing Cylinder</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5406</SubGroupID>
            <SubGroupDescription>06.03.17.06 - Healing Screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5407</SubGroupID>
            <SubGroupDescription>06.03.17.07 - Fixture</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5408</SubGroupID>
            <SubGroupDescription>06.03.17.08 - Abutment</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5409</SubGroupID>
            <SubGroupDescription>06.03.17.09 - Abutment Screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4385</SubGroupID>
            <SubGroupDescription>07.03.01.01 - Permanent</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5410</SubGroupID>
            <SubGroupDescription>06.03.17.10 - Oncology Humeral Stem</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4386</SubGroupID>
            <SubGroupDescription>07.03.01.02 - Temporary</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5411</SubGroupID>
            <SubGroupDescription>06.03.17.11 - Humeral Ancharge Piece</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4387</SubGroupID>
            <SubGroupDescription>07.03.01.03 - Cover Screw/Cap</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5412</SubGroupID>
            <SubGroupDescription>06.03.17.12 - Humerus Extension Piece</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4389</SubGroupID>
            <SubGroupDescription>07.03.03.01 - Screws</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5414</SubGroupID>
            <SubGroupDescription>06.03.17.14 - Humerus Connection Piece</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4390</SubGroupID>
            <SubGroupDescription>07.03.03.02 - Plates</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5415</SubGroupID>
            <SubGroupDescription>06.03.17.15 - Oncology Humeral Body</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5416</SubGroupID>
            <SubGroupDescription>06.03.17.16 - Wedge</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4392</SubGroupID>
            <SubGroupDescription>07.03.03.03 - Implants and Fixtures</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6441</SubGroupID>
            <SubGroupDescription>01.05.03.01 - at Schlemm's canal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3369</SubGroupID>
            <SubGroupDescription>06.03.04.01 - Standard ( ≥4.5mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5417</SubGroupID>
            <SubGroupDescription>06.03.17.17 - Humerus Connecting Screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4393</SubGroupID>
            <SubGroupDescription>07.03.03.04 - Graft Material &lt;0.5ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6442</SubGroupID>
            <SubGroupDescription>01.05.03.02 - external to Schlemm's canal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3370</SubGroupID>
            <SubGroupDescription>06.03.04.02 - Small (2.71mm – 4.49mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5418</SubGroupID>
            <SubGroupDescription>06.03.17.18 - Humerus Hex Socket Bolt</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4394</SubGroupID>
            <SubGroupDescription>07.03.03.05 - Graft Material 0.5ml-&lt;1.0ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3371</SubGroupID>
            <SubGroupDescription>06.03.04.03 - Mini (2.01 – 2.7 mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5419</SubGroupID>
            <SubGroupDescription>06.03.17.19 - Plug Screw Axis</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4395</SubGroupID>
            <SubGroupDescription>07.03.03.06 - Graft Material ≥1.0ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3372</SubGroupID>
            <SubGroupDescription>06.03.04.04 - Micro (≤ 2.0mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4396</SubGroupID>
            <SubGroupDescription>07.04.01.01 - External Midface System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3373</SubGroupID>
            <SubGroupDescription>06.03.04.05 - Dynamic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5421</SubGroupID>
            <SubGroupDescription>06.03.17.21 - Humeral Bearing</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3374</SubGroupID>
            <SubGroupDescription>06.03.04.06 - Screw Washers</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5422</SubGroupID>
            <SubGroupDescription>06.03.17.22 - Humeral Head/Cap</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4398</SubGroupID>
            <SubGroupDescription>07.04.01.02 - External Set</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5423</SubGroupID>
            <SubGroupDescription>06.03.17.23 - Distal Humerus Flange</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4399</SubGroupID>
            <SubGroupDescription>07.04.01.03 - Internal/Intraoral</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5424</SubGroupID>
            <SubGroupDescription>03.08.02.07 - Sponge ≤10cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5425</SubGroupID>
            <SubGroupDescription>03.08.02.08 - Sponge 10-40cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4402</SubGroupID>
            <SubGroupDescription>07.04.02.01 - Distractor Body</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5426</SubGroupID>
            <SubGroupDescription>03.08.02.09 - Sponge &gt;40cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4403</SubGroupID>
            <SubGroupDescription>07.04.02.02 - Footplate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5428</SubGroupID>
            <SubGroupDescription>06.02.06.06 - Definition screw / Locking Screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4406</SubGroupID>
            <SubGroupDescription>07.04.02.03 - Cross Bar/Rod</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5431</SubGroupID>
            <SubGroupDescription>03.08.01.01 - Sheet ≤100cm2</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4408</SubGroupID>
            <SubGroupDescription>07.04.02.05 - Pin</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5432</SubGroupID>
            <SubGroupDescription>03.08.01.02 - Sheet &gt;100cm2</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4409</SubGroupID>
            <SubGroupDescription>07.04.02.06 - Screws</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5433</SubGroupID>
            <SubGroupDescription>03.08.01.04 - Gel/Liquid</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5434</SubGroupID>
            <SubGroupDescription>03.08.05.01 - ≤200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4410</SubGroupID>
            <SubGroupDescription>07.04.02.07 - External Distractor Component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5435</SubGroupID>
            <SubGroupDescription>03.08.05.02 - 201-400cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4411</SubGroupID>
            <SubGroupDescription>07.04.02.08 - Body Extension</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4412</SubGroupID>
            <SubGroupDescription>07.05.01.01 - Calf Implant</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5437</SubGroupID>
            <SubGroupDescription>03.08.05.04 - &gt;600-&lt;2500cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4413</SubGroupID>
            <SubGroupDescription>07.05.01.02 - Gluteal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5438</SubGroupID>
            <SubGroupDescription>03.08.06.01 - ≤200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4414</SubGroupID>
            <SubGroupDescription>07.05.02.01 - Skin or Mammary</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5439</SubGroupID>
            <SubGroupDescription>03.08.06.02 - 201-400cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5440</SubGroupID>
            <SubGroupDescription>03.08.06.03 - 401-600cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4419</SubGroupID>
            <SubGroupDescription>07.05.03.01 - &lt;50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4420</SubGroupID>
            <SubGroupDescription>07.05.03.02 - 50-149cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4421</SubGroupID>
            <SubGroupDescription>07.05.03.03 - 150-400cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5446</SubGroupID>
            <SubGroupDescription>03.08.08.01 - ≤200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4422</SubGroupID>
            <SubGroupDescription>07.05.03.04 - &gt;400cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5447</SubGroupID>
            <SubGroupDescription>03.08.08.02 - 201-400cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4423</SubGroupID>
            <SubGroupDescription>07.06.01.01 - &lt;500cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5448</SubGroupID>
            <SubGroupDescription>03.08.08.03 - 401-600cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5449</SubGroupID>
            <SubGroupDescription>03.08.08.04 - &gt;600cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3401</SubGroupID>
            <SubGroupDescription>06.03.11.02 - Frame Complete - Monoplanar &amp; Modular Frames</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5450</SubGroupID>
            <SubGroupDescription>05.01.02.01 - Single</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3402</SubGroupID>
            <SubGroupDescription>06.03.11.03 - Frame Component - Monoplanar, Clamp</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4426</SubGroupID>
            <SubGroupDescription>07.06.01.02 - ≥500cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5451</SubGroupID>
            <SubGroupDescription>05.01.02.02 - Double</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3404</SubGroupID>
            <SubGroupDescription>06.03.11.05 - Frame Component - Monoplanar, Adaptor</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5452</SubGroupID>
            <SubGroupDescription>09.05.01.01 - &lt; 25cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3405</SubGroupID>
            <SubGroupDescription>06.03.11.06 - Frame Component - Full Circular Ring</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4429</SubGroupID>
            <SubGroupDescription>07.06.02.01 - &lt;500cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5453</SubGroupID>
            <SubGroupDescription>09.05.01.02 - 25-75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3406</SubGroupID>
            <SubGroupDescription>06.03.11.07 - Frame Component - Partial Circular Ring</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5454</SubGroupID>
            <SubGroupDescription>09.05.01.03 - &gt;75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4432</SubGroupID>
            <SubGroupDescription>07.06.02.02 - ≥500cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5457</SubGroupID>
            <SubGroupDescription>06.03.05.11 - Wedges</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5458</SubGroupID>
            <SubGroupDescription>06.03.17.24 - Humeral Collar Round Smooth</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5459</SubGroupID>
            <SubGroupDescription>06.03.17.25 - Humeral Component for use with Hemi Head</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5460</SubGroupID>
            <SubGroupDescription>06.03.17.26 - Humeral Head Fixation Screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4437</SubGroupID>
            <SubGroupDescription>03.02.01.02 - Multiple Lumen</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5461</SubGroupID>
            <SubGroupDescription>06.03.17.27 - Humeral Component with Liner and re-attachment</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5462</SubGroupID>
            <SubGroupDescription>06.03.17.28 - Humeral Collar Round Coated</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5463</SubGroupID>
            <SubGroupDescription>06.03.17.29 - Humeral Stem</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4439</SubGroupID>
            <SubGroupDescription>10.01.01.01 - Balloon Expandable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5464</SubGroupID>
            <SubGroupDescription>06.03.17.30 - Humeral Shaft</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4440</SubGroupID>
            <SubGroupDescription>10.01.01.02 - Self Expandable, &lt;150mm</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5465</SubGroupID>
            <SubGroupDescription>06.03.17.31 - Humeral Intergral Shaft &amp; Stem Coated</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4441</SubGroupID>
            <SubGroupDescription>10.01.01.03 - Self Expandable, ≥150mm</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4442</SubGroupID>
            <SubGroupDescription>10.02.01.01 - &lt;180mm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5467</SubGroupID>
            <SubGroupDescription>06.03.17.33 - Humeral Component with Liner</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4443</SubGroupID>
            <SubGroupDescription>10.02.01.02 - ≥180mm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5468</SubGroupID>
            <SubGroupDescription>06.03.17.34 - Humeral Component with Reattachment for use with Hemi Head</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4444</SubGroupID>
            <SubGroupDescription>10.02.04.01 - Body and 2 limbs</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5469</SubGroupID>
            <SubGroupDescription>06.03.17.35 - Glenoid / Glensophere component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4445</SubGroupID>
            <SubGroupDescription>10.02.04.02 - Body and 1 limb</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5470</SubGroupID>
            <SubGroupDescription>06.03.17.36 - Humeral Hemi-Head</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4446</SubGroupID>
            <SubGroupDescription>10.02.04.03 - Body only</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5471</SubGroupID>
            <SubGroupDescription>10.01.01.04 - Self-Expanding, large diameter for treatment of aortic dissection disease</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4447</SubGroupID>
            <SubGroupDescription>10.02.07.01 - Thoracic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4448</SubGroupID>
            <SubGroupDescription>10.02.07.02 - Abdominal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5472</SubGroupID>
            <SubGroupDescription>10.08.02.01 - ≤200mm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4449</SubGroupID>
            <SubGroupDescription>10.02.10.01 - ≤12mm diameter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5473</SubGroupID>
            <SubGroupDescription>10.08.02.02 - &gt;200mm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5474</SubGroupID>
            <SubGroupDescription>06.03.01.11 - Arthrodesis Other</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4450</SubGroupID>
            <SubGroupDescription>10.02.10.02 - &gt;12mm diameter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5475</SubGroupID>
            <SubGroupDescription>06.03.17.37 - Femoral Stem - Uncemented</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4451</SubGroupID>
            <SubGroupDescription>10.02.11.01 - &lt;150mm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4452</SubGroupID>
            <SubGroupDescription>10.02.11.02 - 150-249mm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5477</SubGroupID>
            <SubGroupDescription>06.03.17.39 - Tibial Stem - Uncemented</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4453</SubGroupID>
            <SubGroupDescription>10.02.11.03 - ≥250mm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4454</SubGroupID>
            <SubGroupDescription>10.03.01.01 - ≤10cm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5479</SubGroupID>
            <SubGroupDescription>06.03.17.41 - Valgus Sleeve</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4455</SubGroupID>
            <SubGroupDescription>10.03.01.02 - 11-20cm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4456</SubGroupID>
            <SubGroupDescription>10.03.01.03 - 21-49cm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4457</SubGroupID>
            <SubGroupDescription>10.03.01.04 - ≥50cm length</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4458</SubGroupID>
            <SubGroupDescription>10.04.01.01 - 0 - 100 sq cm</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5483</SubGroupID>
            <SubGroupDescription>04.06.04.02 - Refill/Catheter Access Kits</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4459</SubGroupID>
            <SubGroupDescription>10.04.01.02 - 101 - 150 sq cm</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5484</SubGroupID>
            <SubGroupDescription>04.05.05.05 - Connectors and Cables</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4460</SubGroupID>
            <SubGroupDescription>10.04.01.03 - &gt;150 sq cm</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4461</SubGroupID>
            <SubGroupDescription>10.04.01.04 - Pledgets</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5485</SubGroupID>
            <SubGroupDescription>13.10.01.01 - Cervical</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5486</SubGroupID>
            <SubGroupDescription>13.10.01.02 - ThoracoLumbar / Lumbar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5487</SubGroupID>
            <SubGroupDescription>13.11.01.01 - Cervical</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5488</SubGroupID>
            <SubGroupDescription>13.11.01.02 - Lumbar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5489</SubGroupID>
            <SubGroupDescription>03.07.01.03 - Biliary</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5490</SubGroupID>
            <SubGroupDescription>03.08.03.06 - Ligating Bands with Disposable Applier</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4466</SubGroupID>
            <SubGroupDescription>10.08.03.02 - 1ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5491</SubGroupID>
            <SubGroupDescription>03.08.07.01 - ≤200cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4467</SubGroupID>
            <SubGroupDescription>10.08.03.03 - 2ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5492</SubGroupID>
            <SubGroupDescription>03.08.07.02 - 201-400cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4468</SubGroupID>
            <SubGroupDescription>04.03.01.01 - Valve, Externally Adjustable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5493</SubGroupID>
            <SubGroupDescription>03.08.07.03 - 401-600cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4469</SubGroupID>
            <SubGroupDescription>04.03.01.02 - Valve, Non-externally adjustable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5494</SubGroupID>
            <SubGroupDescription>03.08.07.04 - 601-800cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4470</SubGroupID>
            <SubGroupDescription>04.03.06.01 - Connector</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5495</SubGroupID>
            <SubGroupDescription>03.08.07.05 - &gt;800cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4471</SubGroupID>
            <SubGroupDescription>04.03.06.02 - Right Angled Guide</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4472</SubGroupID>
            <SubGroupDescription>04.04.01.01 - Primary Cell Pulse Generator (non-rechargeable)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5496</SubGroupID>
            <SubGroupDescription>07.02.02.04 - Surgical Guide</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6521</SubGroupID>
            <SubGroupDescription>02.01.05.05 - Active Middle Ear Implants</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4473</SubGroupID>
            <SubGroupDescription>04.04.01.02 - Rechargeable Pulse Generator</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4474</SubGroupID>
            <SubGroupDescription>04.04.02.01 - Patient Programmer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5498</SubGroupID>
            <SubGroupDescription>07.02.05.07 - Surgical Guide</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5499</SubGroupID>
            <SubGroupDescription>03.08.11.01 - Closure Set</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4475</SubGroupID>
            <SubGroupDescription>04.04.02.02 - Recharger</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5500</SubGroupID>
            <SubGroupDescription>03.08.11.02 - Extension Kit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4476</SubGroupID>
            <SubGroupDescription>04.04.03.01 - Permanent Lead</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4477</SubGroupID>
            <SubGroupDescription>04.04.03.02 - Lead Extension</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5501</SubGroupID>
            <SubGroupDescription>05.03.01.01 - Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4478</SubGroupID>
            <SubGroupDescription>04.04.05.01 - Burr Hole Cover</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5502</SubGroupID>
            <SubGroupDescription>05.03.01.02 - Paediatric</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5503</SubGroupID>
            <SubGroupDescription>03.08.06.04 - 601cm²-1000cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4479</SubGroupID>
            <SubGroupDescription>04.04.05.02 - Connectors and cables</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4480</SubGroupID>
            <SubGroupDescription>04.05.01.01 - Primary Cell Pulse Generator (non-rechargeable)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5505</SubGroupID>
            <SubGroupDescription>03.08.06.05 - &gt;1000cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4481</SubGroupID>
            <SubGroupDescription>04.05.01.02 - Rechargeable Pulse Generator</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5506</SubGroupID>
            <SubGroupDescription>10.08.06.01 - Catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4483</SubGroupID>
            <SubGroupDescription>04.05.02.01 - Patient Programmer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5507</SubGroupID>
            <SubGroupDescription>10.08.06.02 - Detachment Controller</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4484</SubGroupID>
            <SubGroupDescription>04.05.02.02 - Patient Programmer Antenna</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5508</SubGroupID>
            <SubGroupDescription>06.03.11.18 - Upper body kit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4485</SubGroupID>
            <SubGroupDescription>04.05.02.03 - On/Off switching device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5509</SubGroupID>
            <SubGroupDescription>06.03.11.19 - Lower body kit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4486</SubGroupID>
            <SubGroupDescription>04.05.03.01 - Permanent Lead</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5510</SubGroupID>
            <SubGroupDescription>07.05.01.03 - Pectoral</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4487</SubGroupID>
            <SubGroupDescription>04.05.03.02 - Trial Lead</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5514</SubGroupID>
            <SubGroupDescription>06.03.06.01 - Staples</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4492</SubGroupID>
            <SubGroupDescription>04.06.03.02 - Two piece</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5516</SubGroupID>
            <SubGroupDescription>10.02.05.02 - Multiple Branch</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4493</SubGroupID>
            <SubGroupDescription>04.07.01.01 - Implantable pulse generator</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5517</SubGroupID>
            <SubGroupDescription>05.07.04.03 - Connectors and Cables</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4494</SubGroupID>
            <SubGroupDescription>04.08.03.01 - Catheters</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5518</SubGroupID>
            <SubGroupDescription>05.07.02.02 - External Neurostimulator</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4495</SubGroupID>
            <SubGroupDescription>04.08.03.02 - Coil detachment device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4496</SubGroupID>
            <SubGroupDescription>07.01.02.16 - &gt;0.8mm thick, 101-200cm2</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4497</SubGroupID>
            <SubGroupDescription>04.05.02.04 - Recharger</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4498</SubGroupID>
            <SubGroupDescription>04.04.05.03 - Intraoperative accessories</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4499</SubGroupID>
            <SubGroupDescription>04.05.05.01 - Revision Kits</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4500</SubGroupID>
            <SubGroupDescription>04.05.05.02 - Plug</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4501</SubGroupID>
            <SubGroupDescription>04.05.05.03 - Intraoperative Accessories</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4502</SubGroupID>
            <SubGroupDescription>04.05.05.04 - Lead Delivery System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4503</SubGroupID>
            <SubGroupDescription>04.06.04.01 - Revision Kit</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4504</SubGroupID>
            <SubGroupDescription>07.02.05.06 - External Midface System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4505</SubGroupID>
            <SubGroupDescription>06.03.11.09 - Frame Component - Circular Frame Strut Device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5530</SubGroupID>
            <SubGroupDescription>06.02.02.05 - Thumb, carpometacarpal - proximal component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4506</SubGroupID>
            <SubGroupDescription>06.03.11.10 - Frame Component - Foot Plate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4507</SubGroupID>
            <SubGroupDescription>06.03.11.11 - Frame Component - Circular Frame, Nuts &amp; Spacers</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4508</SubGroupID>
            <SubGroupDescription>06.03.11.12 - Frame Component - Coupling Device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4509</SubGroupID>
            <SubGroupDescription>06.03.11.13 - Frame Component - Rods</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4510</SubGroupID>
            <SubGroupDescription>06.03.11.14 - Frame Component - Pins</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4511</SubGroupID>
            <SubGroupDescription>06.03.11.15 - Frame Component - Pin Clamp Assembly</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4512</SubGroupID>
            <SubGroupDescription>06.03.11.16 - Frame Component  - Pin Clamp Assembly Post</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6561</SubGroupID>
            <SubGroupDescription>06.03.01.13 - Arthrodesis</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4513</SubGroupID>
            <SubGroupDescription>06.03.11.17 - Articulating Hinge</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6562</SubGroupID>
            <SubGroupDescription>10.01.02.01 - Self Expandable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4519</SubGroupID>
            <SubGroupDescription>03.08.09.01 - Fistula Closure</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4521</SubGroupID>
            <SubGroupDescription>06.03.04.07 - Screw post/peg</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4522</SubGroupID>
            <SubGroupDescription>06.03.04.08 - Screw Accessories - Nuts</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4523</SubGroupID>
            <SubGroupDescription>06.03.04.09 - Screw Accessories - Locking Nuts / Insert</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3645</SubGroupID>
            <SubGroupDescription>06.01.01.01 - Liner - fixed bearing</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3646</SubGroupID>
            <SubGroupDescription>06.01.01.02 - Liner - mobile bearing</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3664</SubGroupID>
            <SubGroupDescription>06.02.01.01 - Carpal component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3665</SubGroupID>
            <SubGroupDescription>06.02.01.02 - Radial component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3666</SubGroupID>
            <SubGroupDescription>06.02.01.03 - Carpal spacer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3667</SubGroupID>
            <SubGroupDescription>06.02.01.04 - Distal ulnar stem</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3668</SubGroupID>
            <SubGroupDescription>06.02.01.05 - Distal ulnar head</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6741</SubGroupID>
            <SubGroupDescription>07.02.05.09 - Hemi-mandible</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6742</SubGroupID>
            <SubGroupDescription>02.01.08.01 - Xenografts, Small (≤10cm2)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6743</SubGroupID>
            <SubGroupDescription>02.01.08.02 - Xenografts, Medium (&gt;10cm2 to 50cm2)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3673</SubGroupID>
            <SubGroupDescription>06.02.03.01 - Distal humeral component/s</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3674</SubGroupID>
            <SubGroupDescription>06.02.03.02 - Proximal radial stem</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3675</SubGroupID>
            <SubGroupDescription>06.02.03.03 - Proximal radial head/neck</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3676</SubGroupID>
            <SubGroupDescription>06.02.03.04 - Proximal ulnar component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3678</SubGroupID>
            <SubGroupDescription>06.02.03.06 - Elbow pin</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3701</SubGroupID>
            <SubGroupDescription>06.02.05.01 - Glenoid component, All poly</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3702</SubGroupID>
            <SubGroupDescription>06.02.05.02 - Glenoid component, Metal backed</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3703</SubGroupID>
            <SubGroupDescription>06.02.05.03 - Glenoid component &amp; insert</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3704</SubGroupID>
            <SubGroupDescription>06.02.05.04 - Glenoid insert</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3712</SubGroupID>
            <SubGroupDescription>06.03.02.02 - Reconstruction screw</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3713</SubGroupID>
            <SubGroupDescription>06.03.02.03 - Set screw/Locking bolt</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5768</SubGroupID>
            <SubGroupDescription>03.08.02.12 - Pleural Sealant</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5769</SubGroupID>
            <SubGroupDescription>03.08.03.07 - Cinched suture applier</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3732</SubGroupID>
            <SubGroupDescription>06.03.04.10 - Screw Accessories - Caps</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5782</SubGroupID>
            <SubGroupDescription>07.02.05.08 - Maxilla</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5783</SubGroupID>
            <SubGroupDescription>07.02.06.07 - Zygoma Plate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3756</SubGroupID>
            <SubGroupDescription>06.03.11.04 - Frame Component - Monoplanar, Body</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3757</SubGroupID>
            <SubGroupDescription>06.03.11.08 - Frame Component - Circular Coupling Device</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5854</SubGroupID>
            <SubGroupDescription>04.05.02.05 - External Neurostimulator</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3887</SubGroupID>
            <SubGroupDescription>01.01.01.01 - Rigid</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3888</SubGroupID>
            <SubGroupDescription>01.01.02.01 - Rigid</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3889</SubGroupID>
            <SubGroupDescription>01.01.02.02 - Foldable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3890</SubGroupID>
            <SubGroupDescription>01.02.02.01 - Microincision</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5938</SubGroupID>
            <SubGroupDescription>06.03.05.12 - Chest Wall Reconstruction Plates</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3892</SubGroupID>
            <SubGroupDescription>01.02.02.03 - Edge modification</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3893</SubGroupID>
            <SubGroupDescription>01.02.02.04 - Presbyopia correcting</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3895</SubGroupID>
            <SubGroupDescription>01.02.03.01 - Monofocal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3896</SubGroupID>
            <SubGroupDescription>01.02.03.02 - Multi-focal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3897</SubGroupID>
            <SubGroupDescription>01.03.01.01 - Dual Fluids</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3898</SubGroupID>
            <SubGroupDescription>01.05.02.01 - Cannulated</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3899</SubGroupID>
            <SubGroupDescription>01.05.02.02 - Non-Cannulated</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5947</SubGroupID>
            <SubGroupDescription>03.08.05.05 - ≥2500cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3900</SubGroupID>
            <SubGroupDescription>01.06.02.01 - Gold &lt;1.8 grams</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3901</SubGroupID>
            <SubGroupDescription>01.06.02.02 - Gold ≥1.8 grams</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3902</SubGroupID>
            <SubGroupDescription>01.06.02.03 - Platinum</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3903</SubGroupID>
            <SubGroupDescription>01.08.02.01 - Complex and permeable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3905</SubGroupID>
            <SubGroupDescription>01.09.01.01 - Sponges</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3906</SubGroupID>
            <SubGroupDescription>12.01.01.01 - Minimally Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3907</SubGroupID>
            <SubGroupDescription>12.01.01.02 - Posterior Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3908</SubGroupID>
            <SubGroupDescription>12.01.01.03 - Totally Constrained</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3909</SubGroupID>
            <SubGroupDescription>12.01.02.01 - Minimally Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3910</SubGroupID>
            <SubGroupDescription>12.01.02.02 - Posterior Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3911</SubGroupID>
            <SubGroupDescription>12.01.03.01 - Minimally Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3912</SubGroupID>
            <SubGroupDescription>12.01.03.02 - Posterior Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3913</SubGroupID>
            <SubGroupDescription>12.01.03.03 - Totally Constrained</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3914</SubGroupID>
            <SubGroupDescription>12.01.04.01 - Minimally Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3915</SubGroupID>
            <SubGroupDescription>12.01.04.02 - Posterior Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3917</SubGroupID>
            <SubGroupDescription>12.01.05.01 - Minimally Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3918</SubGroupID>
            <SubGroupDescription>12.01.05.02 - Posterior Stabilised</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3919</SubGroupID>
            <SubGroupDescription>12.02.01.01 - PMMA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3920</SubGroupID>
            <SubGroupDescription>12.02.03.01 - HA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3921</SubGroupID>
            <SubGroupDescription>12.03.02.01 - PMMA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3922</SubGroupID>
            <SubGroupDescription>12.03.04.01 - PMMA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3923</SubGroupID>
            <SubGroupDescription>12.03.05.01 - HA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3924</SubGroupID>
            <SubGroupDescription>12.03.07.01 - HA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3925</SubGroupID>
            <SubGroupDescription>12.04.05.01 - HA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3926</SubGroupID>
            <SubGroupDescription>12.04.06.01 - HA Coating</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3927</SubGroupID>
            <SubGroupDescription>12.08.02.01 - Mobile</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3928</SubGroupID>
            <SubGroupDescription>12.08.03.01 - Mobile</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3929</SubGroupID>
            <SubGroupDescription>12.08.03.02 - Moulded</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5978</SubGroupID>
            <SubGroupDescription>04.03.01.03 - Valve and gravitational unit, externally adjustable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3930</SubGroupID>
            <SubGroupDescription>12.09.01.01 - Condylar only (only when combined with a proximal tibial replacement)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3931</SubGroupID>
            <SubGroupDescription>12.09.01.02 - Condylar, including metaphyseal and/or diaphyseal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3932</SubGroupID>
            <SubGroupDescription>12.09.02.01 - Condylar only (only when combined with a proximal tibial replacement)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3933</SubGroupID>
            <SubGroupDescription>12.09.02.02 - Condylar, including metaphyseal and/or diaphyseal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3934</SubGroupID>
            <SubGroupDescription>12.09.03.01 - Incorporating Bone Fixation</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3935</SubGroupID>
            <SubGroupDescription>12.09.04.01 - With Compression</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3936</SubGroupID>
            <SubGroupDescription>12.09.08.01 - Collar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5984</SubGroupID>
            <SubGroupDescription>03.05.02.01 - Integrated Delivery System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3937</SubGroupID>
            <SubGroupDescription>12.09.08.02 - Adaptor</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5985</SubGroupID>
            <SubGroupDescription>03.05.02.02 - Delivery Catheter</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3938</SubGroupID>
            <SubGroupDescription>12.09.08.03 - Stem extender</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5987</SubGroupID>
            <SubGroupDescription>05.01.02.03 - Port</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3939</SubGroupID>
            <SubGroupDescription>11.01.01.01 - Unpolished</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3940</SubGroupID>
            <SubGroupDescription>11.01.01.02 - Unpolished - precoat</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5988</SubGroupID>
            <SubGroupDescription>03.08.04.06 - Suture Fasteners</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3941</SubGroupID>
            <SubGroupDescription>11.01.01.03 - Polished</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3944</SubGroupID>
            <SubGroupDescription>11.01.02.01 - Polished and Unpolished, Conventional</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3945</SubGroupID>
            <SubGroupDescription>11.01.03.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5994</SubGroupID>
            <SubGroupDescription>06.03.03.50 - Cable plate with 1 or more cables, ≤ 6 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3946</SubGroupID>
            <SubGroupDescription>11.01.03.02 - Beaded</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3947</SubGroupID>
            <SubGroupDescription>11.01.03.03 - Mesh</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>5996</SubGroupID>
            <SubGroupDescription>06.03.03.51 - Cable plate with 1 or more cables, ≥ 7 holes to ≤ 15 holes</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3948</SubGroupID>
            <SubGroupDescription>11.01.03.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3949</SubGroupID>
            <SubGroupDescription>11.01.04.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3950</SubGroupID>
            <SubGroupDescription>11.01.04.02 - Beaded</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6000</SubGroupID>
            <SubGroupDescription>03.07.01.04 - Para/Thoraceulesis</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3952</SubGroupID>
            <SubGroupDescription>11.01.04.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6001</SubGroupID>
            <SubGroupDescription>03.07.01.05 - Percutaneous</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3953</SubGroupID>
            <SubGroupDescription>11.01.05.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6003</SubGroupID>
            <SubGroupDescription>03.08.04.07 - Tacks, Reload</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6004</SubGroupID>
            <SubGroupDescription>03.08.04.08 - Adhesive Tackers</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3957</SubGroupID>
            <SubGroupDescription>11.01.06.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3960</SubGroupID>
            <SubGroupDescription>11.01.06.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6008</SubGroupID>
            <SubGroupDescription>03.05.04.01 - Absorbable ≤50cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3961</SubGroupID>
            <SubGroupDescription>11.01.07.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6009</SubGroupID>
            <SubGroupDescription>03.05.04.02 - Absorbable 51 cm² – 75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3962</SubGroupID>
            <SubGroupDescription>11.01.07.02 - Beaded</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6010</SubGroupID>
            <SubGroupDescription>03.05.04.03 - Absorbable &gt;75cm²</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6011</SubGroupID>
            <SubGroupDescription>03.06.04.01 - Self-expanding metal, Covered</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6012</SubGroupID>
            <SubGroupDescription>No subgroup</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3964</SubGroupID>
            <SubGroupDescription>11.01.07.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6013</SubGroupID>
            <SubGroupDescription>No subgroup</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3965</SubGroupID>
            <SubGroupDescription>11.01.07.05 - Unpolished and Polished</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3966</SubGroupID>
            <SubGroupDescription>11.01.08.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3967</SubGroupID>
            <SubGroupDescription>11.01.08.02 - Beaded</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7041</SubGroupID>
            <SubGroupDescription>10.08.05.02 - Cyanoacrylate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3969</SubGroupID>
            <SubGroupDescription>11.01.08.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3970</SubGroupID>
            <SubGroupDescription>11.01.08.05 - Unpolished and Polished</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3971</SubGroupID>
            <SubGroupDescription>11.01.09.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6021</SubGroupID>
            <SubGroupDescription>06.01.03.04 - Stem extension</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6022</SubGroupID>
            <SubGroupDescription>04.08.03.04 - Vascular embolisation balloon</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3974</SubGroupID>
            <SubGroupDescription>11.01.09.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6023</SubGroupID>
            <SubGroupDescription>07.02.07.05 - Surgical Guide</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3975</SubGroupID>
            <SubGroupDescription>11.01.09.05 - Unpolished and Polished</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6024</SubGroupID>
            <SubGroupDescription>07.02.06.06 - Surgical Guide</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3976</SubGroupID>
            <SubGroupDescription>11.01.10.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6025</SubGroupID>
            <SubGroupDescription>03.06.03.04 - Biodegradable</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6027</SubGroupID>
            <SubGroupDescription>08.11.02.01 - No SubGroup</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3979</SubGroupID>
            <SubGroupDescription>11.01.10.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6028</SubGroupID>
            <SubGroupDescription>09.11.02.01 - System Controller</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6030</SubGroupID>
            <SubGroupDescription>09.11.02.03 - Battery Set</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6031</SubGroupID>
            <SubGroupDescription>09.11.03.01 - Stabilisation Belt</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6032</SubGroupID>
            <SubGroupDescription>09.11.02.04 - Battery Clip Set</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6033</SubGroupID>
            <SubGroupDescription>09.11.03.02 - Modular Belt</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6034</SubGroupID>
            <SubGroupDescription>09.11.03.03 - Shower Bag</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6036</SubGroupID>
            <SubGroupDescription>05.07.03.04 - Trial kit including leads</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3988</SubGroupID>
            <SubGroupDescription>11.02.01.01 - Stainless Steel</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>7061</SubGroupID>
            <SubGroupDescription>06.02.01.07 - Distal Radio-Ulnar Plate</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3989</SubGroupID>
            <SubGroupDescription>11.02.01.02 - Cobalt Chrome</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6037</SubGroupID>
            <SubGroupDescription>03.03.02.03 - Placement set</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3990</SubGroupID>
            <SubGroupDescription>11.02.01.03 - Alumina</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3992</SubGroupID>
            <SubGroupDescription>11.02.01.05 - Ceramic Mix</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6041</SubGroupID>
            <SubGroupDescription>06.02.02.06 - Thumb, carpometacarpal - distal component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3993</SubGroupID>
            <SubGroupDescription>11.02.01.06 - Ceramicised Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3994</SubGroupID>
            <SubGroupDescription>11.02.02.01 - Stainless Steel</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3995</SubGroupID>
            <SubGroupDescription>11.02.02.02 - Cobalt Chrome</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6044</SubGroupID>
            <SubGroupDescription>06.02.02.09 - Finger, metacarpophalangeal - proximal component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3996</SubGroupID>
            <SubGroupDescription>11.02.02.03 - Alumina</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3998</SubGroupID>
            <SubGroupDescription>11.02.02.05 - Ceramic Mix</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>3999</SubGroupID>
            <SubGroupDescription>11.02.02.06 - Ceramicised Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4000</SubGroupID>
            <SubGroupDescription>11.02.04.01 - Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4004</SubGroupID>
            <SubGroupDescription>11.02.06.01 - Bipolar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4005</SubGroupID>
            <SubGroupDescription>11.02.06.02 - Tripolar/Multipolar</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4006</SubGroupID>
            <SubGroupDescription>11.03.01.01 - Unmodified polyethylene</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4007</SubGroupID>
            <SubGroupDescription>11.03.01.02 - Modified polyethylene</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4008</SubGroupID>
            <SubGroupDescription>11.03.01.03 - Constrained, modified and unmodified polythylene</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4009</SubGroupID>
            <SubGroupDescription>11.03.01.04 - Metal Shell</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4010</SubGroupID>
            <SubGroupDescription>11.03.02.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4011</SubGroupID>
            <SubGroupDescription>11.03.02.02 - Beaded</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4012</SubGroupID>
            <SubGroupDescription>11.03.02.03 - Mesh</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6061</SubGroupID>
            <SubGroupDescription>03.01.03.01 - Gel 3ml</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4013</SubGroupID>
            <SubGroupDescription>11.03.02.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4014</SubGroupID>
            <SubGroupDescription>11.03.02.05 - Porous Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4015</SubGroupID>
            <SubGroupDescription>11.03.03.01 - Grit Blast</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4016</SubGroupID>
            <SubGroupDescription>11.03.03.02 - Beaded</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4017</SubGroupID>
            <SubGroupDescription>11.03.03.03 - Mesh</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4018</SubGroupID>
            <SubGroupDescription>11.03.03.04 - Plasma</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4020</SubGroupID>
            <SubGroupDescription>11.03.04.01 - Unmodified polyethylene</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4021</SubGroupID>
            <SubGroupDescription>11.03.04.02 - Modified polyethylene</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4022</SubGroupID>
            <SubGroupDescription>11.03.04.03 - Ceramic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4023</SubGroupID>
            <SubGroupDescription>11.03.04.04 - Metal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4024</SubGroupID>
            <SubGroupDescription>11.03.04.05 - Constrained</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4025</SubGroupID>
            <SubGroupDescription>11.03.04.06 - Ceramic Mix</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4026</SubGroupID>
            <SubGroupDescription>11.03.05.01 - Unmodified polyethylene</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4027</SubGroupID>
            <SubGroupDescription>11.03.05.02 - Modified polyethylene</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4030</SubGroupID>
            <SubGroupDescription>11.03.05.05 - Ceramic Mix</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4032</SubGroupID>
            <SubGroupDescription>11.03.07.02 - Metal, HA Coated</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4034</SubGroupID>
            <SubGroupDescription>11.03.08.01 - Shell</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4035</SubGroupID>
            <SubGroupDescription>11.03.08.02 - Cage</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4040</SubGroupID>
            <SubGroupDescription>06.01.03.01 - Talar component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4041</SubGroupID>
            <SubGroupDescription>06.01.03.02 - Tibial component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4042</SubGroupID>
            <SubGroupDescription>06.01.03.03 - Tibial component, cemented/uncemented, fixed bearing</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4047</SubGroupID>
            <SubGroupDescription>06.01.04.04 - Great toe, resurfacing hemi articulation, metatarsal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4048</SubGroupID>
            <SubGroupDescription>06.01.04.05 - Great toe, resurfacing hemi articulation, phalangeal</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4049</SubGroupID>
            <SubGroupDescription>06.01.04.06 - Great toe, non articulating articulation (for silastic implant replacement)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4050</SubGroupID>
            <SubGroupDescription>06.02.01.06 - Tendon Spacer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4052</SubGroupID>
            <SubGroupDescription>06.02.03.07 - Accessories - bushing / insert / spool</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4053</SubGroupID>
            <SubGroupDescription>06.02.03.08 - Accessories - circlips</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6101</SubGroupID>
            <SubGroupDescription>03.08.03.08 - Suture with cinch</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4055</SubGroupID>
            <SubGroupDescription>06.02.03.10 - Accessories - cement restrictor</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4057</SubGroupID>
            <SubGroupDescription>06.02.04.02 - Humeral component - cemented</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4058</SubGroupID>
            <SubGroupDescription>06.02.04.03 - Humeral component - uncemented </SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4059</SubGroupID>
            <SubGroupDescription>06.02.04.04 - Modular humeral component - metaphyseal, cemented</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4060</SubGroupID>
            <SubGroupDescription>06.02.04.05 - Modular humeral component - metaphyseal, uncemented</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4062</SubGroupID>
            <SubGroupDescription>06.02.04.07 - Modular humeral component - diaphyseal, uncemented, long (&gt;220mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4063</SubGroupID>
            <SubGroupDescription>06.02.04.08 - Modular Humeral component - diaphyseal, cemented, short (≤220mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4064</SubGroupID>
            <SubGroupDescription>06.02.04.09 - Modular Humeral component - diaphyseal, uncemented, short (≤220mm)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4067</SubGroupID>
            <SubGroupDescription>06.02.04.12 - Standard humeral head</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4068</SubGroupID>
            <SubGroupDescription>06.02.04.13 - Resurfacing humeral head </SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4069</SubGroupID>
            <SubGroupDescription>06.02.04.14 - Humeral cup</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4073</SubGroupID>
            <SubGroupDescription>06.02.04.18 - Special purpose/tumour prosthesis - tumour section</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4076</SubGroupID>
            <SubGroupDescription>06.02.04.21 - Necks/collar (modular)</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4078</SubGroupID>
            <SubGroupDescription>06.02.05.05 - Reverse glenoid component, Base plate, uncemented</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4079</SubGroupID>
            <SubGroupDescription>06.02.05.06 - Glenosphere</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4080</SubGroupID>
            <SubGroupDescription>06.02.06.01 - Humeral sleeve</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4081</SubGroupID>
            <SubGroupDescription>06.02.06.02 - Humeral spacer</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4083</SubGroupID>
            <SubGroupDescription>06.02.06.04 - Taper assembly</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4084</SubGroupID>
            <SubGroupDescription>06.02.06.05 - Eccentrical adaptor</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4086</SubGroupID>
            <SubGroupDescription>06.02.06.07 - Reverse humeral tray</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4087</SubGroupID>
            <SubGroupDescription>06.03.14.01 - Cement only</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4088</SubGroupID>
            <SubGroupDescription>06.03.14.02 - Cement with Antibiotic</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4089</SubGroupID>
            <SubGroupDescription>06.03.14.03 - Cement with Complex Delivery System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4090</SubGroupID>
            <SubGroupDescription>06.03.14.04 - Cement with Antibiotic and Complex Delivery System</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4091</SubGroupID>
            <SubGroupDescription>06.03.14.05 - Accessories - Restrictors</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4092</SubGroupID>
            <SubGroupDescription>06.03.15.01 - Ceramic, 0-5cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4093</SubGroupID>
            <SubGroupDescription>06.03.15.02 - Ceramic, &gt;5cc - 10cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4094</SubGroupID>
            <SubGroupDescription>06.03.15.03 - Ceramic, &gt;10cc - 20cc</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>6143</SubGroupID>
            <SubGroupDescription>06.02.02.10 - Finger, metacarpophalangeal - distal component</SubGroupDescription>
        </SubGroup>
        <SubGroup>
            <SubGroupID>4095</SubGroupID>
            <SubGroupDescription>06.03.15.04 - Ceramic, &gt;20cc</SubGroupDescription>
        </SubGroup>
    </SubGroups>
    <ProsthesisItems>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV01</BillingCode>
            <Name>Valve - Aortic</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10132</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV02</BillingCode>
            <Name>Valve - Pulmonary</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10132</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV03</BillingCode>
            <Name>Patch - Mitral</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2432</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV04</BillingCode>
            <Name>Patch - Tricuspid</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2432</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV05</BillingCode>
            <Name>Patch - Pericardium</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2672</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV07</BillingCode>
            <Name>Conduit - Pulmonary large</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2939</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV08</BillingCode>
            <Name>Conduit - Pulmonary + Valve</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10132</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV09</BillingCode>
            <Name>Conduit - Aortic + Valve</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9670</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV10</BillingCode>
            <Name>Valve - Mitral</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8791</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QHV11</BillingCode>
            <Name>Thoracic Aorta</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>235366</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2939</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SHV01</BillingCode>
            <Name>Valve - Aortic</Name>
            <Description>Valve - Aortic</Description>
            <SupplierCode>SHV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>246032</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10099</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SHV02</BillingCode>
            <Name>Valve - Pulmonary</Name>
            <Description>Valve - Pulmonary</Description>
            <SupplierCode>SHV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>246032</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10099</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SHV03</BillingCode>
            <Name>Conduit - Arterial</Name>
            <Description>Conduit - Arterial</Description>
            <SupplierCode>SHV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>246032</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3979</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV01</BillingCode>
            <Name>Valve - Aortic</Name>
            <Description>Valve - Aortic</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>236613</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10405</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV02</BillingCode>
            <Name>Valve - Pulmonary</Name>
            <Description>Valve - Pulmonary</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>236613</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10405</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV03</BillingCode>
            <Name>Conduit - Pulmonary</Name>
            <Description>Conduit - Pulmonary</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>236613</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2247</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV50</BillingCode>
            <Name>Pericardium</Name>
            <Description>Pericardium</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>236613</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2734</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV56</BillingCode>
            <Name>Conduit - Aortic</Name>
            <Description>Conduit - Aortic</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>6</CategoryID>
            <ARTGs>
                <ARTG>236613</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2247</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>LEM01</BillingCode>
            <Name>Cornea</Name>
            <SupplierCode>LEM</SupplierCode>
            <CategoryID>41</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2600</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>LEM02</BillingCode>
            <Name>Sclera</Name>
            <SupplierCode>LEM</SupplierCode>
            <CategoryID>41</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>300</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>LEM04</BillingCode>
            <Name>Cornea for Endothelial Lamellar Keratoplasty</Name>
            <SupplierCode>LEM</SupplierCode>
            <CategoryID>41</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3260</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>LEW01</BillingCode>
            <Name>Cornea</Name>
            <SupplierCode>LEW</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>239107</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2950</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>LEW02</BillingCode>
            <Name>Sclera</Name>
            <SupplierCode>LEW</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>239107</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>295</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>LEW03</BillingCode>
            <Name>Cornea for Endothelial Keratoplasty</Name>
            <SupplierCode>LEW</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>239107</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3525</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAB01</BillingCode>
            <Name>Cornea for Endothelial Keratoplasty</Name>
            <Description>Pre-cut cornea for Descemet Stripping Automated Endothelial Keratoplasty (DSAEK)</Description>
            <Size>Variable</Size>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>232299</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3740</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC71</BillingCode>
            <Name>Cornea</Name>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>232298</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2801</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC72</BillingCode>
            <Name>Sclera</Name>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>232298</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>420</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC73</BillingCode>
            <Name>Cornea For Lamellar</Name>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>232298</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1682</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC74</BillingCode>
            <Name>Cornea for Endothelial Keratoplasty</Name>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>232298</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3300</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QEB01</BillingCode>
            <Name>Cornea</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>232299</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3056</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QEB02</BillingCode>
            <Name>Sclera</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>41</CategoryID>
            <ARTGs>
                <ARTG>232299</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>394</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAE01</BillingCode>
            <Name>Cornea</Name>
            <SupplierCode>SAE</SupplierCode>
            <CategoryID>41</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2600</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAE02</BillingCode>
            <Name>Sclera</Name>
            <SupplierCode>SAE</SupplierCode>
            <CategoryID>41</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>290</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAE03</BillingCode>
            <Name>Cornea for Endothelial Keratoplasty</Name>
            <SupplierCode>SAE</SupplierCode>
            <CategoryID>41</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3350</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA02</BillingCode>
            <Name>Femoral Ring</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2277</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA05</BillingCode>
            <Name>Tendon Patch Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA06</BillingCode>
            <Name>Peroneus Longus Tendon</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3125</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA08</BillingCode>
            <Name>Radius – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3541</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA09</BillingCode>
            <Name>Femoral Condyle Half – Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3016</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA14</BillingCode>
            <Name>Morsellised Bone (10-20 cc/g)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2707</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA15</BillingCode>
            <Name>Cortical Cancellous Block</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1674</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA16</BillingCode>
            <Name>Peroneus Longus Tendon Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3187</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA19</BillingCode>
            <Name>Cortical Sheet</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1522</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA21</BillingCode>
            <Name>Femoral Strut</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3996</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA22</BillingCode>
            <Name>Cancellous Cube – Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1593</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA23</BillingCode>
            <Name>Femur – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9013</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA24</BillingCode>
            <Name>Unicortical Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1553</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA25</BillingCode>
            <Name>Patella Tendon with Bone Block – Whole with Quads</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3804</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA27</BillingCode>
            <Name>Achilles Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4001</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA28</BillingCode>
            <Name>Morsellised Bone (Freeze Dried) (6-10cc)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2707</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA29</BillingCode>
            <Name>Humerus – Proximal Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4061</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA32</BillingCode>
            <Name>Cervical Spacers - Parrallel</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1840</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA35</BillingCode>
            <Name>Cancellous Plug Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1593</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA36</BillingCode>
            <Name>Cortical Ring</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1840</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA37</BillingCode>
            <Name>Humerus – Strut</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA40</BillingCode>
            <Name>Patella Tendon with Bone Block – Whole Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3879</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA43</BillingCode>
            <Name>Femoral Ring Super Critical CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2112</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA50</BillingCode>
            <Name>Ulna – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4008</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA51</BillingCode>
            <Name>Cortical Plate Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1553</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA52</BillingCode>
            <Name>Semitendonosis Tendon</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3126</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA54</BillingCode>
            <Name>Cancellous Cube</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1718</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA57</BillingCode>
            <Name>Gracilis Tendon Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2445</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA58</BillingCode>
            <Name>Cervical Spacers - Lordotic</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1840</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA59</BillingCode>
            <Name>Patella Tendon with Bone Block – Whole with Quads – Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3879</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA62</BillingCode>
            <Name>Humeral Head – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2188</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA63</BillingCode>
            <Name>Bone Dowel / Plug Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1752</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA66</BillingCode>
            <Name>Morsellised Bone (Freeze Dried) (1-5cc)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2432</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA68</BillingCode>
            <Name>Malleable Bone Segments Super Critical Fluid CO2Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2400</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA70</BillingCode>
            <Name>Hemi Patella Tendon with Bone Block Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3879</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA71</BillingCode>
            <Name>Semitendonosis Tendon Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3188</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA72</BillingCode>
            <Name>Cortical Strut</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA73</BillingCode>
            <Name>Tricortical Cancellous Wedge</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1674</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA75</BillingCode>
            <Name>Anterior Tibialis Tendon</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3125</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA77</BillingCode>
            <Name>Cancellous Plug</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1718</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA78</BillingCode>
            <Name>Cervical Spacers - Parallel Super Critical Fluid CO2Treated 5mm-9mm</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2065</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA79</BillingCode>
            <Name>Humeral Head – Whole Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2029</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA81</BillingCode>
            <Name>Tricortical Cancellous Wedge Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1553</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA83</BillingCode>
            <Name>Tibial Shaft</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5416</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA84</BillingCode>
            <Name>Tibia – Distal</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3743</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA85</BillingCode>
            <Name>Cortical Segment</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3449</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA86</BillingCode>
            <Name>Morsellised Bone – Super Critical Fluid CO2 Treated (1-4g)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2314</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA87</BillingCode>
            <Name>Femoral Condyle Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3743</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA88</BillingCode>
            <Name>Tendon Patch</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA89</BillingCode>
            <Name>Humerus – Distal Segment</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3075</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA90</BillingCode>
            <Name>Morsellised Bone (1-4 cc/g)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2268</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA92</BillingCode>
            <Name>Bone Dowel / Plug (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1562</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA95</BillingCode>
            <Name>Achilles Tendon with Bone Block</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AAA97</BillingCode>
            <Name>Cortical Cancellous Block Super Critical Fluid CO2Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1553</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB02</BillingCode>
            <Name>Malleable Bone Segments Super Critical Fluid CO2Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2400</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB05</BillingCode>
            <Name>Fibula – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8780</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB07</BillingCode>
            <Name>Tibial Strut</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3515</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB08</BillingCode>
            <Name>Femoral Condyle Half</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3253</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB09</BillingCode>
            <Name>Cervical Spacers - Lordotic (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1840</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB10</BillingCode>
            <Name>Fibular Ring Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1877</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB11</BillingCode>
            <Name>Posterior Tibialis Tendon Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3187</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB12</BillingCode>
            <Name>Patella Tendon with Bone Blocks - Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3804</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB14</BillingCode>
            <Name>HTO Wedge</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1694</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB15</BillingCode>
            <Name>Humerus – Proximal</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3620</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB18</BillingCode>
            <Name>Humerus – Strut Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2504</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB19</BillingCode>
            <Name>Cancellous Block</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1718</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB20</BillingCode>
            <Name>Posterior Tibialis Tendon</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3125</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB26</BillingCode>
            <Name>Cortical Plate</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1522</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB27</BillingCode>
            <Name>Achilles Tendon Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4001</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB28</BillingCode>
            <Name>Cervical Spacers – Lordotic Super Critical Fluid CO2Treated 5mm-9mm</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2065</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB32</BillingCode>
            <Name>Unicortical Cancellous Wedge (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1522</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB34</BillingCode>
            <Name>Femoral Head – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3773</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB35</BillingCode>
            <Name>Fibular Ring</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2024</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB37</BillingCode>
            <Name>Tibia – Proximal</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB38</BillingCode>
            <Name>Achilles Tendon with Pre-Shaped Bone Block</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB39</BillingCode>
            <Name>HTO Wedge – Super Critical Fluid CO2  Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1571</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB43</BillingCode>
            <Name>Malleable Bone Segments</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2587</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB44</BillingCode>
            <Name>Humerus – Shaft</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4453</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB45</BillingCode>
            <Name>Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3526</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB50</BillingCode>
            <Name>Unicortical Cancellous Block</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1674</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB52</BillingCode>
            <Name>Femur – Distal</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3743</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB56</BillingCode>
            <Name>Morsellised Bone (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2211</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB57</BillingCode>
            <Name>Femoral Shaft</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3598</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB59</BillingCode>
            <Name>Fascia Lata</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB60</BillingCode>
            <Name>Femoral Head – Hemi</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3773</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB63</BillingCode>
            <Name>Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3879</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB64</BillingCode>
            <Name>Anterior Tibialis Tendon Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3187</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB68</BillingCode>
            <Name>Femur – Proximal</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3996</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB69</BillingCode>
            <Name>Cortical Sheet Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1553</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB74</BillingCode>
            <Name>Patella Tendon with Pre-Shaped Bone Blocks</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3804</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB78</BillingCode>
            <Name>Femoral Ring Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2112</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB79</BillingCode>
            <Name>Tibia – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>7921</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB80</BillingCode>
            <Name>Cortical Ring Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1877</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB83</BillingCode>
            <Name>Humerus – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4530</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB86</BillingCode>
            <Name>Morsellised Bone (5-9 cc/g)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2432</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB87</BillingCode>
            <Name>Hemipelvis – Segment Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1708</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB88</BillingCode>
            <Name>Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1593</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB89</BillingCode>
            <Name>Cervical Spacers - Parrallel (Freeze Dried)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1840</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB91</BillingCode>
            <Name>Fascia Lata Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4001</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB92</BillingCode>
            <Name>Achilles Tendon</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB93</BillingCode>
            <Name>Gracilis Tendon</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2398</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB94</BillingCode>
            <Name>Morsellised Bone Super Critical Fluid CO2 Treated (5-9g)</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2482</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB96</BillingCode>
            <Name>Hemipelvis – Whole</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9452</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB97</BillingCode>
            <Name>Achilles Tendon with Bone Block Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4001</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB98</BillingCode>
            <Name>Hemi Patella Tendon with Bone Block</Name>
            <SupplierCode>AAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3804</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ABB99</BillingCode>
            <Name>Demineralized Bone Fibres (FZ) 1-4g</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD01</BillingCode>
            <Name>Demineralized Bone Fibres (FZ) 5-9g</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD03</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 1-4g</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD04</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 5-9g</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD06</BillingCode>
            <Name>Demineralized Bone Fibres (FD) 2-4cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD07</BillingCode>
            <Name>Demineralized Bone Fibres (FD) 5-9cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD09</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 2-4cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD10</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 5-9cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD12</BillingCode>
            <Name>Compressible Cancellous Block (FD)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD13</BillingCode>
            <Name>Compressible Cancellous Block (FZ)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD14</BillingCode>
            <Name>Compressible Cancellous Strip (FD)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD15</BillingCode>
            <Name>Compressible Cancellous Strip (FZ)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD16</BillingCode>
            <Name>Patella Quadriceps Tendon with Patellar Bone</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3902</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD17</BillingCode>
            <Name>Spinal Anterior Longitudonal Ligament Patch</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4023</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD18</BillingCode>
            <Name>Pre-Shaped Cancellous/Cortical Block (Various Sizes)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD19</BillingCode>
            <Name>Engineered Cancellous Block with DBM Component (Various Sizes)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD20</BillingCode>
            <Name>Bone allograft kit (Demineralized and Mineralized Bone Matrix) 5-10g / 5-10cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6193</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD22</BillingCode>
            <Name>Pre-Shaped Hyaline Cartilage Segment</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD23</BillingCode>
            <Name>Cortical – Demineralized Bone Matrix 1-4g/1-4cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2676</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD25</BillingCode>
            <Name>Moulded Demineralized Fibres (Small)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD26</BillingCode>
            <Name>Moulded Demineralized Fibres (Large)</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD27</BillingCode>
            <Name>Demineralized Bone Matrix/Cortico-Cancellous Granules 5-9cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD29</BillingCode>
            <Name>Freeze Dried Cortico-Cancellous Bone Granules 2-4cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2450</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD30</BillingCode>
            <Name>Freeze Dried Cortico-Cancellous Bone Granules 5-9cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD32</BillingCode>
            <Name>Bone allograft kit (Demineralized and Mineralized Bone Matrix) 1-4g / 1-4cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4376</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>ADD33</BillingCode>
            <Name>Demineralized Bone Matrix/Cortico-Cancellous Granules 1-4cc</Name>
            <SupplierCode>ABB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB02</BillingCode>
            <Name>Bone - Milled Femoral Head</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2457</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB03</BillingCode>
            <Name>Femoral Head</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2354</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB04</BillingCode>
            <Name>Bone – Cortico-Cancellous Crunch &lt;30g</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2070</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB05</BillingCode>
            <Name>Cortical Strut</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2451</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB06</BillingCode>
            <Name>Tibia – Proximal third</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2562</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB07</BillingCode>
            <Name>Spinal Ring</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1854</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB08</BillingCode>
            <Name>Bone – Cortico-Cancellous Crunch &lt;20g Sterile</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2215</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB09</BillingCode>
            <Name>Tendon - Achilles with bone plug</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2228</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>AUB10</BillingCode>
            <Name>Tendon</Name>
            <SupplierCode>AUB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2184</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA01</BillingCode>
            <Name>Semitendinosis, Tendon, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2840</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA02</BillingCode>
            <Name>Semitendinosus Tendon, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA03</BillingCode>
            <Name>Peroneus Longus Tendon, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2783</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA04</BillingCode>
            <Name>Peroneus Longus Tendon, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2420</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA05</BillingCode>
            <Name>Fascia Lata, ≥ 120cm²  ≤ 180cm², Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2400</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA06</BillingCode>
            <Name>Anterior Tibialis Tendon, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3102</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA07</BillingCode>
            <Name>Anterior Tibialis Tendon, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3029</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA08</BillingCode>
            <Name>Gracilis Tendon, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2586</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA09</BillingCode>
            <Name>Gracilis Tendon, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2222</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA10</BillingCode>
            <Name>Achillies Tendon, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2971</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA11</BillingCode>
            <Name>Revision Core, Various Sizes, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2136</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA12</BillingCode>
            <Name>Evans Wedge, Freeze dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2339</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA13</BillingCode>
            <Name>High Tibial Osteotomy Wedge Cortical Bone Wedges, (2-Piece), Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2134</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA14</BillingCode>
            <Name>Brachymetatarsal Lengthening Graft Segment, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2404</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA15</BillingCode>
            <Name>Milled Cancellous Chips, Freeze dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1455</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA16</BillingCode>
            <Name>Demineralized Cancellous Chips, Freeze dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1449</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA17</BillingCode>
            <Name>ENHANCE® Demineralized Cortical Fiber, 2.5cc, Dehydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1544</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA18</BillingCode>
            <Name>Achilles Tendon, with Calcaneus, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2787</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA19</BillingCode>
            <Name>Achilles Tendon, with Shaped Bone Blocks, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3450</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA20</BillingCode>
            <Name>Patella Bone-Tendon-Bone, Hemi with Quadriceps, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3540</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA21</BillingCode>
            <Name>Patella Bone-Tendon-Bone, Whole with Quadriceps, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5917</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA22</BillingCode>
            <Name>ENHANCE® Demineralized Cortical Fiber, 5cc, Dehydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1962</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA23</BillingCode>
            <Name>ENHANCE® Demineralized Cortical Fiber, 10cc, Dehydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2287</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA24</BillingCode>
            <Name>Cotton Wedge, Freeze dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2326</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA25</BillingCode>
            <Name>Arch Wedge, Freeze dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2089</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA26</BillingCode>
            <Name>Proximal Metatarsal Lengthening Graft Segment, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2374</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA27</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis, ≤ 25cm²  ≥ 1.8mm, Dehydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2733</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA28</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis, ≥ 25cm² ≤1.7mm, Dehydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2777</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA29</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis, ≥ 25cm² ≤ 1.7mm, Hydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2591</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA30</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis, ≥ 25cm² ≥ 1.8mm, Hydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2762</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA31</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis, ≤ 25cm² ≤ 1.7mm, Dehydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2391</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA32</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis, ≤ 25cm² ≤1.7mm thick, Hydrated, Non- Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2391</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA33</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis - Meshed, ≤ 25cm² ≤0.7mm, Hydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2372</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA34</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis, ≤25cm² ≥1.8mm, Hydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2731</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA35</BillingCode>
            <Name>AlloPatchHD Acellular Human Dermis - Meshed, ≥ 26cm² ≤0.7mm, Hydrated, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2869</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA36</BillingCode>
            <Name>Patella Bone-Tendon-Bone, Hemi without Quadriceps, Frozen, Non-irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3629</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA37</BillingCode>
            <Name>Patella Bone-Tendon-Bone, Hemi with 10.0mm Shaped Bone Blocks, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA38</BillingCode>
            <Name>Quadriceps Tendon, with 10.0mm Shaped Bone Blocks, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2900</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA39</BillingCode>
            <Name>Menisci with Tibial Plateau, Frozen, Non-irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5807</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA40</BillingCode>
            <Name>Patella Bone-Tendon-Bone, Whole (Special) with Quadriceps, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6150</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA41</BillingCode>
            <Name>Posterior Tibialis Tendon, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3098</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA42</BillingCode>
            <Name>Quadriceps Tendon, with Bone Block, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3172</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA43</BillingCode>
            <Name>Quadriceps Tendon, without Bone Block, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3172</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA44</BillingCode>
            <Name>Fascia Lata, ≥ 60cm² - ≤100cm² ≥, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1869</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA45</BillingCode>
            <Name>Fascia Lata, ≤ 60cm², Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2110</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA46</BillingCode>
            <Name>MPJ Arthrodesis Lengthening Graft Segment, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2721</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA47</BillingCode>
            <Name>Bone-Tendon-Bone, Hemi with Quadriceps, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3832</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA48</BillingCode>
            <Name>Bone-Tendon-Bone, Hemi with 10.0mm Shaped Bone Blocks, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3680</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA49</BillingCode>
            <Name>Achilles Tendon, with Calcaneus, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3121</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA50</BillingCode>
            <Name>Achilles Tendon, without Calcaneus, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2992</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA51</BillingCode>
            <Name>Posterior Tibialis Tendon, Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3106</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA52</BillingCode>
            <Name>Demineralized 80%Cortical/20%Cancellous Granules, Freeze dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA53</BillingCode>
            <Name>Meniscus with Hemi Plateau, Medial, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5680</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA54</BillingCode>
            <Name>Fascia Lata, ≤ 60cm², Freeze Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1821</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA55</BillingCode>
            <Name>Fascia Lata,  ≥ 120cm² ≤ 180cm², Freeze-Dried, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2259</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA56</BillingCode>
            <Name>Meniscus with Hemi Plateau, Lateral, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6047</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CAA57</BillingCode>
            <Name>Meniscus for Interpositional Arthroplasty, Frozen, Non-Irradiated</Name>
            <SupplierCode>CAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3067</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>CSA01</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Femoral Head, whole, frozen, non-irradiated</Description>
            <Size>Single, whole femoral head</Size>
            <SupplierCode>SAC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>233823</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3367</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>DHR01</BillingCode>
            <Name>Femoral Head</Name>
            <SupplierCode>DHR</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>260540</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4616</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA01</BillingCode>
            <Name>Grafton Plus Demineralized Bone Matrix: Paste, 10cc</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229635</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA02</BillingCode>
            <Name>Grafton Plus Demineralized Bone Matrix: Paste, 1-5cc</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229635</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>581</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA03</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Orthoblend, 15cc</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229633</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1978</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA04</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Matrix PLF, 2.5cm x 10cm x 0.8cm (2)</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229633</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1978</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA05</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Orthoblend, 5cc</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229633</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>581</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA06</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Orthoblend, 10cc</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229633</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA07</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Flex, 1.5cm x 1.5cm x 0.25cm</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229634</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>581</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA08</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Flex, &gt;5cc to 10cc</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229634</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA09</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Matrix PLF, 2.5cm x 5cm x 0.8cm (2)</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229636</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA10</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Matrix Strips, 1cm x 20cm x 0.8cm (2)</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229636</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1978</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA11</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Matrix Strips, 1cm x 10cm x 0.8cm (2)</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229636</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAA13</BillingCode>
            <Name>Grafton Demineralized Bone Matrix: Flex, 2.5cm x 5cm</Name>
            <SupplierCode>MAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229634</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1099</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MVS05</BillingCode>
            <Name>Femoral Head</Name>
            <SupplierCode>MVS</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2370</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MVS23</BillingCode>
            <Name>Autologous Skull Flap</Name>
            <SupplierCode>MVS</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1396</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA01</BillingCode>
            <Name>Ulna – Whole Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4008</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA02</BillingCode>
            <Name>Gracilis Tendon Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2293</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA03</BillingCode>
            <Name>Femur – Proximal Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3996</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA04</BillingCode>
            <Name>Cortical Ring Super Critical Fluid CO2 Treated (Freeze Dried) 5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1947</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA05</BillingCode>
            <Name>Fibula – Whole Super Critical Fluid CO2 Treated (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8780</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA06</BillingCode>
            <Name>Bone Dowel / Plug Super Critical Fluid CO2 Treated (Freeze Dried) various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA07</BillingCode>
            <Name>Cancellous Dowel Plug Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1752</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA08</BillingCode>
            <Name>Cortical Sheet (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA09</BillingCode>
            <Name>Peroneus Longus Tendon Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2967</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA10</BillingCode>
            <Name>Tibia – Distal Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3743</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA11</BillingCode>
            <Name>Cancellous Cube (Frozen) 3cm3 cubes</Name>
            <Description>See attached documents</Description>
            <Size>See attached documents</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1718</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA12</BillingCode>
            <Name>Cortical Strut (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA13</BillingCode>
            <Name>Achilles Tendon with Bone Block Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3027</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA14</BillingCode>
            <Name>Hemi Patella Tendon with Bone Block (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3528</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA15</BillingCode>
            <Name>Femoral Condyle Half (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3027</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA16</BillingCode>
            <Name>Humeral Head – Whole (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2188</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA17</BillingCode>
            <Name>Tibial Strut Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3515</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA18</BillingCode>
            <Name>Cancellous Block (Frozen) - various sizes</Name>
            <Description>See attached documents</Description>
            <Size>See attached documents</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1718</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA19</BillingCode>
            <Name>Cortical Plate (Frozen) various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA20</BillingCode>
            <Name>Humerus – Strut (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA21</BillingCode>
            <Name>Tibia – Proximal Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3466</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA22</BillingCode>
            <Name>Morsellised Bone Super Critical Fluid CO2 Treated  (Frozen) Packs of 15mg – 30mg</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2580</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA23</BillingCode>
            <Name>Cortical Sheet Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA24</BillingCode>
            <Name>Femoral Head – Hemi (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3499</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA25</BillingCode>
            <Name>Fibular Ring Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1947</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA26</BillingCode>
            <Name>Humerus – Whole Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4530</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA27</BillingCode>
            <Name>Cancellous Block Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA28</BillingCode>
            <Name>Fascia Lata Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1253</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA29</BillingCode>
            <Name>Tricortical Cancellous Wedge (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1674</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA30</BillingCode>
            <Name>Cancellous Dowel (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1632</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA31</BillingCode>
            <Name>Humerus – Distal Segment Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3206</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA32</BillingCode>
            <Name>Morsellised Bone – Super Critical Fluid CO2 Treated  Packs of 2.5gm – 5gm</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2314</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA33</BillingCode>
            <Name>Tibial Shaft Super Critical Fluid CO2  Treated  (Frozen) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5416</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA34</BillingCode>
            <Name>Tibia – Whole Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>7921</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA35</BillingCode>
            <Name>Tricortical Cancellous Wedge Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA36</BillingCode>
            <Name>Humerus – Shaft (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4453</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA37</BillingCode>
            <Name>Cervical Spacers - Parrallel (Freeze Dried) 5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA38</BillingCode>
            <Name>Cortical Cancellous Block Super Critical Fluid CO2Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA39</BillingCode>
            <Name>Bone Dowel / Plug (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1632</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA40</BillingCode>
            <Name>Femur – Distal Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3775</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA41</BillingCode>
            <Name>Humerus – Proximal (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3690</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA42</BillingCode>
            <Name>Cancellous Cube – Super Critical Fluid CO2 Treated (Frozen) 3cm3 cubes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA43</BillingCode>
            <Name>Femur – Proximal Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3969</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA44</BillingCode>
            <Name>Tibia – Distal (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3743</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA45</BillingCode>
            <Name>Cortical Cancellous Block (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1674</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA46</BillingCode>
            <Name>Femoral Strut (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3703</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA47</BillingCode>
            <Name>Femoral Head Whole Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3499</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA48</BillingCode>
            <Name>Tricortical Cancellous Wedge – Super Critical Fluid CO2 Treated  (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA49</BillingCode>
            <Name>Humerus – Strut Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2574</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA50</BillingCode>
            <Name>Humerus – Proximal Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4061</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA51</BillingCode>
            <Name>Posterior Tibialis Tendon Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2967</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA52</BillingCode>
            <Name>Femur – Proximal (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3996</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA53</BillingCode>
            <Name>Morsellised Bone Super Critical Fluid CO2 Treated  (Freeze Dried) Packs of 5 – 10cc</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2482</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA54</BillingCode>
            <Name>Cortical Strut (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2525</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA55</BillingCode>
            <Name>Femoral Shaft Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2292</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA56</BillingCode>
            <Name>Femur – Whole Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9013</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA57</BillingCode>
            <Name>Cortical Plate Super Critical Fluid CO2 Treated (Frozen) various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA58</BillingCode>
            <Name>Malleable Bone Segments Super Critical Fluid CO2Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3541</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA59</BillingCode>
            <Name>Tibia – Distal (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3473</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA60</BillingCode>
            <Name>Femoral Condyle Whole (Frozen) - various sizes</Name>
            <Description>See attached documents</Description>
            <Size>See attached documents</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3743</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA61</BillingCode>
            <Name>Cortical Sheet (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA62</BillingCode>
            <Name>Unicortical Cancellous Wedge (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA63</BillingCode>
            <Name>Gracilis Tendon (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA64</BillingCode>
            <Name>Tendon Patch Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3707</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA65</BillingCode>
            <Name>Bone Dowel / Plug Super Critical Fluid CO2 Treated (Frozen) various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA66</BillingCode>
            <Name>Morsellised Bone 7.5mg - 15mg</Name>
            <Description>Please see attached documents</Description>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2326</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA67</BillingCode>
            <Name>Unicortical Cancellous Wedge  (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA68</BillingCode>
            <Name>Cancellous Plug Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA69</BillingCode>
            <Name>Femoral Strut Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3996</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA70</BillingCode>
            <Name>Tibial Shaft Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5091</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA71</BillingCode>
            <Name>Patella Tendon with Bone Block – Whole Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2917</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA72</BillingCode>
            <Name>Tibia – Distal Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3541</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA73</BillingCode>
            <Name>Radius – Whole Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4109</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA74</BillingCode>
            <Name>Cortical Ring (Freeze Dried)  5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA75</BillingCode>
            <Name>Humeral Head – Whole Super Critical Fluid CO2 Treated (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2029</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA76</BillingCode>
            <Name>Anterior Tibialis Tendon Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2967</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA77</BillingCode>
            <Name>Femoral Condyle Whole Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3541</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA78</BillingCode>
            <Name>Morsellised Bone Super Critical Fluid CO2 Treated  (Frozen) Packs of 7.5gm – 15gm</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2482</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA79</BillingCode>
            <Name>Morsellised Bone (frozen) 15-30g</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2531</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA80</BillingCode>
            <Name>Femoral Condyle Half – Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3086</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA81</BillingCode>
            <Name>Fibular Ring (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2024</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA82</BillingCode>
            <Name>HTO Wedge (Frozen) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1694</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA83</BillingCode>
            <Name>Cortical Sheet Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA84</BillingCode>
            <Name>Cortical Plate Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA85</BillingCode>
            <Name>Unicortical Cancellous Wedge Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA86</BillingCode>
            <Name>Tendon Patch (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3636</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA87</BillingCode>
            <Name>Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA88</BillingCode>
            <Name>Humerus – Shaft Super Critical Fluid CO2 Treated  (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4198</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA89</BillingCode>
            <Name>Cortical Segment (Frozen) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3449</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA90</BillingCode>
            <Name>Humerus – Distal Segment Super Critical Fluid CO2 Treated  (Frozen(</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3206</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA91</BillingCode>
            <Name>Hemi Patella Tendon with Bone Block Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3596</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA92</BillingCode>
            <Name>HTO Wedge – Super Critical Fluid CO2  Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1641</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA93</BillingCode>
            <Name>Fibular Ring Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1947</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA94</BillingCode>
            <Name>Cortical Plate (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA95</BillingCode>
            <Name>Tibial Shaft (Freeze Dried) - various sizes</Name>
            <Description>See attached documents</Description>
            <Size>See attached documents</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5416</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA96</BillingCode>
            <Name>Femoral Head – Hemi Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3499</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA97</BillingCode>
            <Name>Femur – Distal (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3775</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA98</BillingCode>
            <Name>Femoral Head – Whole (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3499</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NAA99</BillingCode>
            <Name>Unicortical Cancellous Wedge Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB01</BillingCode>
            <Name>Tendon - Achilles</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2562</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB02</BillingCode>
            <Name>Tendon - Achilles with bone block</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2969</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB05</BillingCode>
            <Name>Bone Plug/Dowel - Cancellous</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1632</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB06</BillingCode>
            <Name>Radius</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4030</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB07</BillingCode>
            <Name>Ulna</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3714</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB09</BillingCode>
            <Name>Fascia Lata</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1229</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB10</BillingCode>
            <Name>Femur - Distal Half</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3703</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB11</BillingCode>
            <Name>Femur - Distal third</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3372</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB12</BillingCode>
            <Name>Femur - Entire</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8264</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB13</BillingCode>
            <Name>Femoral Shaft - Middle Third</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3244</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB14</BillingCode>
            <Name>Femur - Proximal third</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1690</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB15</BillingCode>
            <Name>Femur - Proximal half</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3893</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB16</BillingCode>
            <Name>Femoral Head</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3499</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB17</BillingCode>
            <Name>Femoral Rings</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2140</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB18</BillingCode>
            <Name>Fibula - Entire</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8052</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB21</BillingCode>
            <Name>Hemipelvis - Acetabulum</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3759</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB22</BillingCode>
            <Name>Hemipelvis - iliac crest</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB23</BillingCode>
            <Name>Hemipelvis - Tricortical iliac wedge</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB24</BillingCode>
            <Name>Hemipelvis - Complete</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB25</BillingCode>
            <Name>Humerus - Distal</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3145</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB26</BillingCode>
            <Name>Humeral Head Addition</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2059</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB27</BillingCode>
            <Name>Humerus - Proximal</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3690</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB28</BillingCode>
            <Name>Humerus - Proximal half with rotator cuff</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3595</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB29</BillingCode>
            <Name>Humerus - Entire</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4188</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB30</BillingCode>
            <Name>Humerus - Entire with rotator cuff</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4118</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB31</BillingCode>
            <Name>Ligament - Medial</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2305</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB33</BillingCode>
            <Name>Tendon - Patellar with bone plugs</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2861</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB35</BillingCode>
            <Name>Tibia - Plateau (prox 1/3)</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3258</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB36</BillingCode>
            <Name>Tibia - Proximal</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3400</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB37</BillingCode>
            <Name>Tibia - Whole</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5418</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB38</BillingCode>
            <Name>Ulna - Shaft</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3170</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB40</BillingCode>
            <Name>Ulna - Ring</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2399</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB41</BillingCode>
            <Name>Tibial Shaft</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4994</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB42</BillingCode>
            <Name>Tibial Shaft - third</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3423</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB43</BillingCode>
            <Name>Tibial Shaft - half</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3170</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB44</BillingCode>
            <Name>Tibia - Whole with Patellar Tendon</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>7059</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB45</BillingCode>
            <Name>Tibia - Ring</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1874</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB46</BillingCode>
            <Name>Tibia - Proximal with Patellar Tendon</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5158</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB47</BillingCode>
            <Name>Radius - Shaft</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3850</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB49</BillingCode>
            <Name>Radius - Ring</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2399</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB50</BillingCode>
            <Name>Humeral Shaft</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4118</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB51</BillingCode>
            <Name>Humeral Shaft - Half</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2162</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB53</BillingCode>
            <Name>Humerus - Ring</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1874</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB54</BillingCode>
            <Name>Fibula - Segment</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3053</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB55</BillingCode>
            <Name>Femoral Shaft - Third</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2183</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB56</BillingCode>
            <Name>Femoral Shaft - Segment</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2248</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB57</BillingCode>
            <Name>Femoral Shaft - Half</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3595</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB59</BillingCode>
            <Name>Femoral Hemi-condyle</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3027</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB60</BillingCode>
            <Name>Bone - Cancellous Crunch 60cc</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3232</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB61</BillingCode>
            <Name>Bone - Cancellous Crunch 30cc</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2131</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB62</BillingCode>
            <Name>Bone - Cancellous Crunch 15cc</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1169</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB63</BillingCode>
            <Name>Bone - Cortico-Cancellous Crunch (40/60) 60cc</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3232</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB64</BillingCode>
            <Name>Bone - Cortico-Cancellous Crunch (40/60) 30cc</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2131</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB65</BillingCode>
            <Name>Bone - Cortico-Cancellous Crunch (40/60) 15cc</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1169</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB66</BillingCode>
            <Name>Tri Cortical Osteotomy</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1563</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB67</BillingCode>
            <Name>Tendon - Tibialis Anterior</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2911</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB68</BillingCode>
            <Name>Tendon - Patellar with machined conical bone plug</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3528</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB69</BillingCode>
            <Name>Tendon - Achilles with machined conical bone block</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3636</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB70</BillingCode>
            <Name>Tendon - Semi tendinosis</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2912</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB71</BillingCode>
            <Name>Tendon - Tibialis Posterior</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2911</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB72</BillingCode>
            <Name>Tendon - Patellar with Quads</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2911</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NBB73</BillingCode>
            <Name>Tendon - Peroneus Longus</Name>
            <SupplierCode>NBB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2911</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA01</BillingCode>
            <Name>Cancellous Plug</Name>
            <Description>Plug of bone made from piece of cancellous bone cleaned, treated with SCF CO2, packaged, irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1718</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA02</BillingCode>
            <Name>Cancellous Plug Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <Description>Plug of bone made from piece of cancellous bone cleaned, treated with SCF CO2, packaged, irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1593</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA03</BillingCode>
            <Name>Unicortical Cancellous Block</Name>
            <Description>Plug of bone made from piece of cancellous bone cleaned, treated with SCF CO2, packaged, irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1674</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA04</BillingCode>
            <Name>Unicortical Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <Description>Plug of bone made from piece of cancellous bone cleaned, treated with SCF CO2, packaged, irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1553</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA05</BillingCode>
            <Name>Compressible Cancellous Block (FD)</Name>
            <Description>Strips of cortico-cancellous bone cut from the distal femur or proximal tibia, hand fashioned to various pieces/ sizes, cleaned, treated to induce malleability, cleaned with SCF CO2, packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA06</BillingCode>
            <Name>Compressible Cancellous Block (FZ)</Name>
            <Description>Strips of cortico-cancellous bone cut from the distal femur or proximal tibia, hand fasioned to various pieces/ sizes, cleaned, trated to induce malleability, cleaned with SCF CO2, packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA07</BillingCode>
            <Name>Pre-Shaped Hyaline Cartilage Segment</Name>
            <Description>Strips/sheets of hyaline cartilage cut from articular surfaces and/or costal cartilage, cleaned to remove surrounding unwanted tissue, packaged and exposed to Gamma Irradiation</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA08</BillingCode>
            <Name>Fascia Lata [Small; Medium; Large pieces]</Name>
            <Description>Fascia Lata removed in strips, cleaned, treated with SCF CO2, trimmed to size, Packaged, irradiated</Description>
            <Size>[Small; Medium; Large pieces]</Size>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA09</BillingCode>
            <Name>Spinal Anterior Longitudonal Ligament Patch</Name>
            <Description>Piece of tendon, cleaned trimmed to various sizes, treated with SCF, CO2, packaged , Irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4023</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA10</BillingCode>
            <Name>Achilles Tendon</Name>
            <Description>Achillies Tendon that has been shaped, trimmed, cleaned, treated with SCF, CO2, packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA11</BillingCode>
            <Name>Achilles Tendon with Bone Block</Name>
            <Description>Achillies Tendon with bone block attachment that has been , trimmed, cleaned, treated with SCF, CO2,packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA12</BillingCode>
            <Name>Achilles Tendon with Pre-Shaped Bone Block</Name>
            <Description>Achillies Tendon with bone block attachment that has been , trimmed, cleaned, treated with SCF, CO2,packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3923</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA13</BillingCode>
            <Name>Patella Tendon with Bone Blocks - Whole</Name>
            <Description>Achillies Tendon with bone block attachment that has been , trimmed, cleaned, treated with SCF, CO2,packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3804</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA14</BillingCode>
            <Name>Patella Quadriceps Tendon with Patellar Bone</Name>
            <Description>Achillies Tendon with bone block attachment that has been , trimmed, cleaned, treated with SCF, CO2,packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3902</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA15</BillingCode>
            <Name>Patella Tendon with Pre-Shaped Bone Blocks</Name>
            <Description>Achillies Tendon with bone block attachment that has been , trimmed, cleaned, treated with SCF, CO2,packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3804</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCA16</BillingCode>
            <Name>Anterior Tibialis Tendon</Name>
            <Description>Achillies Tendon with bone block attachment that has been , trimmed, cleaned, treated with SCF, CO2,packaged and irradiated</Description>
            <SupplierCode>NCA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3125</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC01</BillingCode>
            <Name>Femoral Ring Super Critical CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2182</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC02</BillingCode>
            <Name>Cortical Cancellous Block Super Critical Fluid CO2Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC03</BillingCode>
            <Name>Femoral Ring Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2182</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC04</BillingCode>
            <Name>Femoral Shaft (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2248</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC05</BillingCode>
            <Name>Fibular Ring (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC06</BillingCode>
            <Name>Cervical Spacers – Lordotic Super Critical Fluid CO2Treated (Freeze Dried) 5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1947</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC07</BillingCode>
            <Name>Cervical Spacers - Lordotic (Freeze Dried)  5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC08</BillingCode>
            <Name>Femoral Head – Whole Super Critical Fluid CO2 Treated  (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3499</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC09</BillingCode>
            <Name>HTO Wedge Super Critical Fluid CO2 Treated  (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1641</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC10</BillingCode>
            <Name>Cortical Cancellous Block (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC11</BillingCode>
            <Name>Femoral Strut (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3996</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC12</BillingCode>
            <Name>Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3596</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC13</BillingCode>
            <Name>Cancellous Cube (Freeze Dried) 3cm3 cubes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1632</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC14</BillingCode>
            <Name>Tibial Strut (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3515</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC15</BillingCode>
            <Name>Cancellous Cube – Super Critical Fluid CO2 Treated (Freeze Dried) 3cm3 cubes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC16</BillingCode>
            <Name>Femur – Distal Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3775</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC17</BillingCode>
            <Name>Cortical Ring Super Critical Fluid CO2 Treated  (Frozen)  5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1947</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC18</BillingCode>
            <Name>Cortical Strut Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2574</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC19</BillingCode>
            <Name>Morsellised Bone (Freeze Dried) Packs of 5 – 10cc</Name>
            <Description>Please see attached documents</Description>
            <Size>Please see attached documents</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2432</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC20</BillingCode>
            <Name>Cervical Spacers – Lordotic Super Critical Fluid CO2Treated (Frozen) 5mm – 9mm</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2065</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC21</BillingCode>
            <Name>Tibial Strut Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3329</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC22</BillingCode>
            <Name>Patella Tendon with Bone Block – Whole with Quads – Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2967</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC23</BillingCode>
            <Name>Malleable Bone Segments (Freeze Dried) various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3541</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC24</BillingCode>
            <Name>Achilles Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3707</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC25</BillingCode>
            <Name>Humerus – Strut Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2574</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC26</BillingCode>
            <Name>Humeral Head – Whole Super Critical Fluid CO2 Treated, (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2099</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC27</BillingCode>
            <Name>Cancellous Dowel - Frozen - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1632</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC28</BillingCode>
            <Name>Cortical Segment Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3206</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC29</BillingCode>
            <Name>Hemipelvis – Segment Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1623</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC30</BillingCode>
            <Name>Femoral Shaft Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3598</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC31</BillingCode>
            <Name>Tibia – Proximal (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC32</BillingCode>
            <Name>Humerus – Shaft Super Critical Fluid CO2 Treated (Frozen) - various sizes</Name>
            <Description>See attached documents</Description>
            <Size>See attached documents</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4453</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC33</BillingCode>
            <Name>Hemipelvis – Whole Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9452</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC34</BillingCode>
            <Name>Femoral Condyle Whole (Frozen) Super Critical Fluid CO2 Treated</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3541</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC35</BillingCode>
            <Name>Cortical Segment Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3206</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC36</BillingCode>
            <Name>Malleable Bone Segments (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2422</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC37</BillingCode>
            <Name>Cervical Spacers - Parallel Super Critical Fluid CO2 Treated (Freeze Dried) 5mm – 9mm</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2065</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC38</BillingCode>
            <Name>Semitendonosis Tendon Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2968</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC39</BillingCode>
            <Name>Femoral Strut Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3775</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC40</BillingCode>
            <Name>Cervical Spacers - Parallel Super Critical Fluid CO2Treated (Frozen)  5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1947</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC41</BillingCode>
            <Name>Morsellised Bone Super Critical Fluid CO2 Treated  (Freeze Dried) Packs of 15 – 30cc</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2580</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC42</BillingCode>
            <Name>Hemipelvis – Segment (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC43</BillingCode>
            <Name>Morsellised Bone (Freeze Dried) Packs of 15 – 30cc</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2531</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC44</BillingCode>
            <Name>Malleable Bone Segments Super Critical Fluid CO2Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3541</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC45</BillingCode>
            <Name>Femoral Condyle Whole (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3473</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC46</BillingCode>
            <Name>Femoral Head – Hemi (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3773</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC47</BillingCode>
            <Name>Tibial Strut (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3265</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC48</BillingCode>
            <Name>Hemipelvis – Segment Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1708</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC49</BillingCode>
            <Name>Cortical Segment (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3145</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC50</BillingCode>
            <Name>Humerus – Proximal Super Critical Fluid CO2 Treated (Freeze Dried)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3762</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC51</BillingCode>
            <Name>HTO Wedge (Freeze Dried) - Various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1610</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC52</BillingCode>
            <Name>Tibia – Proximal Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3663</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC53</BillingCode>
            <Name>Cervical Spacers - Lordotic (Frozen) 5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC54</BillingCode>
            <Name>Cancellous Block (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1632</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC55</BillingCode>
            <Name>Morsellised Bone 2.5-5mg</Name>
            <Description>Please see attached documents.</Description>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2268</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC56</BillingCode>
            <Name>Cortical Ring (Frozen) 5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC57</BillingCode>
            <Name>Femoral Condyle Whole – Super Critical Fluid CO2 Treated  (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3086</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC58</BillingCode>
            <Name>Humerus – Strut (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2525</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC59</BillingCode>
            <Name>Cervical Spacers - Parrallell (frozen) 5mm – 9mm</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1910</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC60</BillingCode>
            <Name>Achilles Tendon Super Critical Fluid CO2 Treated (Frozen)</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2611</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC61</BillingCode>
            <Name>Hemipelvis – Segment (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1592</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC62</BillingCode>
            <Name>Femoral Head – Hemi Super Critical Fluid CO2 Treated  (Frozen) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3499</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC63</BillingCode>
            <Name>Cortical Strut Super Critical Fluid CO2 Treated (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2574</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC64</BillingCode>
            <Name>Humerus – Distal Segment (Freeze Dried) - various sizes</Name>
            <SupplierCode>NAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3145</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC65</BillingCode>
            <Name>Femoral Ring (Freeze Dried) - various sizes</Name>
            <Description>Please see attachments</Description>
            <Size>Please see attachments</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2277</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC75</BillingCode>
            <Name>Pre-Shaped Cancellous/Cortical Block (Various Sizes)</Name>
            <Description>Blocks of cancellous bone cut from distal femur or proximal tibia, hand fashioned to various sizes based on surgeon's requests, cleaned with Supercritical CO2 to remove blood and lipids, packaged and exposed to Gamma Irradiation</Description>
            <Size>Various</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC76</BillingCode>
            <Name>Cortical – Demineralized Bone Matrix 5-10g/5-10cc</Name>
            <Description>Cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve  &gt;8% mineral content (Demineralized), packaged and exposed to Gamma Irradiation</Description>
            <Size>5-10g/5-10cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3100</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC77</BillingCode>
            <Name>Demineralized Bone Matrix/Cortico-Cancellous Granules 1-4cc</Name>
            <Description>Milled cortico-cancellous bone cleaned with supercritical CO2 to remove blood and lipid, mixed with cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve  &gt;8% mineral content (Demineralized), packaged and exposed to Gamma Irradiation</Description>
            <Size>1-4cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC78</BillingCode>
            <Name>Demineralized Bone Matrix/Cortico-Cancellous Granules 5-9cc</Name>
            <Description>Milled cortico-cancellous bone cleaned with supercritical CO2 to remove blood and lipid, mixed with cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve  &gt;8% mineral content (Demineralized), packaged and exposed to Gamma Irradiation</Description>
            <Size> 5-9cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC79</BillingCode>
            <Name>Compressible Cancellous Strip (FD)</Name>
            <Description>Srips of cortico -cancellous bone cut from the distal femur or proximal tibia, hand fasioned to various sizes, cleaned treated to induce malleability, cleaned with SCF CO2, packaged and irradiated.</Description>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC80</BillingCode>
            <Name>Compressible Cancellous Strip (FZ)</Name>
            <Description>Srips of cortico -cancellous bone cut from the distal femur or proximal tibia, hand fasioned to various sizes, cleaned treated to induce malleability, cleaned with SCF CO2, packaged and irradiated.</Description>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC81</BillingCode>
            <Name>Freeze Dried Cortico-Cancellous Bone Granules 2-4cc</Name>
            <Description>Cortico-cancellous bone milled to various particle sizes, cleaned with Supercritical CO2 to remove blood and lipids, packaged in specialised biocompatible Hydration/delivery device or mixing PETG tray and exposed to Gamma Irradiation</Description>
            <Size>2-4cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2450</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC82</BillingCode>
            <Name>Freeze Dried Cortico-Cancellous Bone Granules 5-9cc</Name>
            <Description>Cortico-cancellous bone milled to various particle sizes, cleaned with Supercritical CO2 to remove blood and lipids, packaged in specialised biocompatible Hydration/delivery device or mixing PETG tray and exposed to Gamma Irradiation</Description>
            <Size>5-9cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC83</BillingCode>
            <Name>Freeze Dried Cortico-Cancellous Bone Granules 10-15cc</Name>
            <Description>Cortico-cancellous bone milled to various particle sizes, cleaned with Supercritical CO2 to remove blood and lipids, packaged in specialised biocompatible Hydration/delivery device or mixing PETG tray and exposed to Gamma Irradiation</Description>
            <Size>10-15cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC84</BillingCode>
            <Name>Semitendonosis Tendon</Name>
            <Description>Entire Semitendonosis Tendon cleaned, packaged, irradiated</Description>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3125</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC85</BillingCode>
            <Name>Engineered Cancellous Block with DBM Component (Various Sizes)</Name>
            <Description>Blocks of cancellous bone cut from distal femur or proximal tibia, hand fashioned to various sizes based on surgeon's requests, cleaned with Supercritical CO2 to remove blood and lipids, packaged and exposed to Gamma Irradiation</Description>
            <Size>Various Sizes</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC86</BillingCode>
            <Name>Demineralized Bone Fibres (FD) 2-4cc</Name>
            <Description>Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, pressed into a mold to achieve specific shapes, packaged and exposed to Gamma Irradiation</Description>
            <Size>2-4cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC87</BillingCode>
            <Name>Demineralized Bone Fibres (FD) 5-9cc</Name>
            <Description>Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, pressed into a mold to achieve specific shapes, packaged and exposed to Gamma Irradiation</Description>
            <Size>5-9cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC88</BillingCode>
            <Name>Demineralized Bone Fibres (FZ) 1-4g</Name>
            <Description>Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, pressed into a mold to achieve specific shapes, packaged and exposed to Gamma Irradiation</Description>
            <Size>1-4g</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC89</BillingCode>
            <Name>Demineralized Bone Fibres (FZ) 5-9g</Name>
            <Description>Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, pressed into a mold to achieve specific shapes, packaged and exposed to Gamma Irradiation</Description>
            <Size>5-9g</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC90</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 2-4cc</Name>
            <Description>Cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve &gt;8% mineral content ( Demineralized), packaged and exposed to Gamma irradiation</Description>
            <Size>2-4cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC91</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 5-9cc</Name>
            <Description>Cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve &gt;8% mineral content ( Demineralized), packaged and exposed to Gamma irradiation</Description>
            <Size>5-9cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC92</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 1-4g</Name>
            <Description>Cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve &gt;8% mineral content ( Demineralized), packaged and exposed to Gamma irradiation</Description>
            <Size>1-4g</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC93</BillingCode>
            <Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 5-9g</Name>
            <Description>Cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve &gt;8% mineral content ( Demineralized), packaged and exposed to Gamma irradiation</Description>
            <Size>5-9g</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC94</BillingCode>
            <Name>Moulded Demineralized Fibres (Large) </Name>
            <Description>Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, pressed into a mold to achieve specific shapes, packaged and exposed to Gamma Irradiation</Description>
            <Size>Large</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC95</BillingCode>
            <Name>Moulded Demineralized Fibres (Small) </Name>
            <Description>Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, pressed into a mold to achieve specific shapes, packaged and exposed to Gamma Irradiation</Description>
            <Size>Small</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC96</BillingCode>
            <Name>Bone allograft kit (Demineralized and Mineralized Bone Matrix) 1-4g / 1-4cc </Name>
            <Description>Biological kit containing 2 components for intraoperative mixing. Kit content 1: Cortico-cancellous Crunch milled to various sizes, cleaned with supercritical CO2 to remove blood and lipid contents, packaged and exposed to supercritical CO2 terminal bioburden reduction. Kit content 2: Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, packaged and exposed to Gamma Irradiation</Description>
            <Size>1-4g / 1-4cc </Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4376</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC97</BillingCode>
            <Name>Bone allograft kit (Demineralized and Mineralized Bone Matrix) 5-10g / 5-10cc </Name>
            <Description>Biological kit containing 2 components for intraoperative mixing. Kit content 1: Cortico-cancellous Crunch milled to various sizes, cleaned with supercritical CO2 to remove blood and lipid contents, packaged and exposed to supercritical CO2 terminal bioburden reduction. Kit content 2: Demineralized cortical fibres with controlled geometry to achieve physical consistency, cleaned with supercritical CO2 to remove blood and lipids, packaged and exposed to Gamma Irradiation</Description>
            <Size>5-10g / 5-10cc </Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6193</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC98</BillingCode>
            <Name>Cortical – Demineralized Bone Matrix 1-4g/1-4cc</Name>
            <Description>Cortical bone milled to various sizes, cleaned with supercritical CO2 to remove blood and lipids, treated to achieve  &gt;8% mineral content (Demineralized), packaged and exposed to Gamma Irradiation</Description>
            <Size>1-4g/1-4cc</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2676</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC99</BillingCode>
            <Name>Malleable Bone Segments</Name>
            <Description>Strips of cortico- cancellous bone cut from the distal femur or proximal tibia, hand fasioned to various sizes cleaned and treated to induce malleabillity, packaged, SCF CO2 treated, demineralised packaged and irradiated.</Description>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>277310</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2587</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT01</BillingCode>
            <Name>Tendon - Achilles with bone block</Name>
            <Description>Tendon - Achilles with bone block</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4256</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT02</BillingCode>
            <Name>Tendon - Patellar split with bone plugs</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT03</BillingCode>
            <Name>Bone Plug/Dowel - Cancellous</Name>
            <Description>Bone Plug/Dowel - Cancellous</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4256</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT06</BillingCode>
            <Name>Cortical Struts 10-15cm</Name>
            <Description>Cortical Struts 10-15cm</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3696</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT07</BillingCode>
            <Name>Cortical Strut &gt;15 - 20cm</Name>
            <Description>Cortical Strut &gt;15 - 20cm</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3920</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT08</BillingCode>
            <Name>Bone - Milled 20-29gr (40-58cc equivalent)</Name>
            <Description>Bone - Milled 20-29gr (40-58cc equivalent)</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4536</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT09</BillingCode>
            <Name>Bone - Milled 30 - 50gr (60 - 100cc equivalent)</Name>
            <Description>Bone - Milled 30 - 50gr (60 - 100cc equivalent)</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5208</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT10</BillingCode>
            <Name>Bone - Milled &gt;50gr (100cc equivalent)</Name>
            <Description>Bone - Milled &gt;50gr (100cc equivalent)</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5544</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT11</BillingCode>
            <Name>Cartilage - costal segments</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>300</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT13</BillingCode>
            <Name>Radius</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT14</BillingCode>
            <Name>Ulna</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT15</BillingCode>
            <Name>Fascia Lata - Large (15cm x 10cm)</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1590</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT16</BillingCode>
            <Name>Fascia Lata - Small (10cm x 5cm)</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>854</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT17</BillingCode>
            <Name>Femur - Distal (Shaft &amp; Condyles)</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4726</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT18</BillingCode>
            <Name>Femur - Entire head removed</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT19</BillingCode>
            <Name>Femoral Shaft/Tibial Shaft - Middle third</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3640</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT20</BillingCode>
            <Name>Femur - Proximal (shaft, trochanter, neck)</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4726</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT21</BillingCode>
            <Name>Femoral Hemi-condyle</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2900</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT22</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Femoral Head</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4221</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT24</BillingCode>
            <Name>Femoral Rings</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT25</BillingCode>
            <Name>Fibula - Entire</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3920</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT28</BillingCode>
            <Name>Fibula - Segment</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT29</BillingCode>
            <Name>Hemipelvis - Acetabulum</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3150</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT30</BillingCode>
            <Name>Hemipelvis - Complete</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>7000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT31</BillingCode>
            <Name>Hemipelvis - iliac crest</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT32</BillingCode>
            <Name>Hemipelvis - Tricortical iliac wedge</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT33</BillingCode>
            <Name>Humerus - Entire with rotator cuff</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT34</BillingCode>
            <Name>Humerus - Proximal with rotator cuff</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT35</BillingCode>
            <Name>Humerus - Proximal</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT37</BillingCode>
            <Name>Bone - Milled &lt;30g Freeze Dried</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT38</BillingCode>
            <Name>Bone - Milled 30-50g Freeze Dried</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>900</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT40</BillingCode>
            <Name>Patellar unit whole with or without tibial block</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT41</BillingCode>
            <Name>Rib (5cm)</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>300</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT44</BillingCode>
            <Name>Tibia - Proximal with Patella &amp; Tendon</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5600</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT45</BillingCode>
            <Name>Tibia - Proximal</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT46</BillingCode>
            <Name>Tendon - Single (ant and post tibilias, FDL, EDL, hamstring, gracilis)</Name>
            <Description>Tendon - Single (ant and post tibilias, FDL, EDL, hamstring, gracilis)</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4256</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT47</BillingCode>
            <Name>Meniscal Graft</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1921</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT48</BillingCode>
            <Name>Cortical Strut &gt;20cm</Name>
            <Description>Cortical Strut &gt;20cm</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4144</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT60</BillingCode>
            <Name>Osteotomy Wedge</Name>
            <Description>Osteotomy Wedge</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3640</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT61</BillingCode>
            <Name>Tendon - Achilles</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT62</BillingCode>
            <Name>Bone - Milled &lt;5 gr (&lt;10cc equivalent)</Name>
            <Description>Bone - Milled &lt;5 gr (&lt;10cc equivalent)</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1848</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT63</BillingCode>
            <Name>Bone - Milled 5-9 gr (10-18cc equivalent)</Name>
            <Description>Bone - Milled 5-9 gr (10-18cc equivalent)</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2964</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT64</BillingCode>
            <Name>Bone - Milled 10-19 gr (20-38cc equivalent)</Name>
            <Description>Bone - Milled 10-19 gr (20-38cc equivalent)</Description>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3750</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT65</BillingCode>
            <Name>Proximal Femur with Femoral Head</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6300</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>PBT66</BillingCode>
            <Name>Milled Bone Pellets (x3)</Name>
            <SupplierCode>PBT</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229915</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB01</BillingCode>
            <Name>Tendon - Achilles with bone block</Name>
            <Description>Tendon - Achilles with bone block</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2838</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB02</BillingCode>
            <Name>Tibial Shaft Freeze Dried</Name>
            <Description>Tibial Shaft Freeze Dried</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1172</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB03</BillingCode>
            <Name>Bone - Milled 20g Freeze Dried</Name>
            <Description>Bone - Milled 20g Freeze Dried</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3389</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB05</BillingCode>
            <Name>Meniscus</Name>
            <Description>Meniscus</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2067</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB08</BillingCode>
            <Name>Tibia - Proximal with Patella</Name>
            <Description>Tibia - Proximal with Patella</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4034</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB09</BillingCode>
            <Name>Bone - Cancellous Cubes (6) Freeze Dried</Name>
            <Description>Bone - Cancellous Cubes (6) Freeze Dried</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2160</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB12</BillingCode>
            <Name>Cartilage - costal segments</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>259</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB15</BillingCode>
            <Name>Radius</Name>
            <Description>Radius</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3334</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB16</BillingCode>
            <Name>Ulna</Name>
            <Description>Ulna</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3334</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB22</BillingCode>
            <Name>Femur - Entire</Name>
            <Description>Femur - Entire</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6303</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB23</BillingCode>
            <Name>Femoral Shaft</Name>
            <Description>Femoral Shaft</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3319</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB25</BillingCode>
            <Name>Femur - Proximal half</Name>
            <Description>Femur - Proximal half</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4459</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB27</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Femoral Head</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3781</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB28</BillingCode>
            <Name>Femoral Head - Freeze Dried</Name>
            <Description>Femoral Head - Freeze Dried</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3437</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB32</BillingCode>
            <Name>Fibula - Entire</Name>
            <Description>Fibula - Entire</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3916</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB33</BillingCode>
            <Name>Hemipelvis - Acetabulum</Name>
            <Description>Hemipelvis - Acetabulum</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3707</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB34</BillingCode>
            <Name>Hemipelvis - iliac crest</Name>
            <Description>Hemipelvis - iliac crest</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3326</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB35</BillingCode>
            <Name>Hemipelvis - Tricortical iliac wedge</Name>
            <Description>Hemipelvis - Tricortical iliac wedge</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2091</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB37</BillingCode>
            <Name>Hemipelvis - Complete</Name>
            <Description>Hemipelvis - Complete</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6303</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB43</BillingCode>
            <Name>Humerus - Entire</Name>
            <Description>Humerus - Entire</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4480</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB45</BillingCode>
            <Name>Bone - Milled 20g</Name>
            <Description>Bone - Milled 20g</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2941</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB48</BillingCode>
            <Name>Tendon - Patellar</Name>
            <Description>Tendon - Patellar</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3034</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB58</BillingCode>
            <Name>Tendon - Tibialis Anterior</Name>
            <Description>Tendon - Tibialis Anterior</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2838</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB60</BillingCode>
            <Name>Autologous Skull Flap</Name>
            <Description>Autologous Skull Flap</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>826</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB64</BillingCode>
            <Name>Tibia - Whole with Patella</Name>
            <Description>Tibia - Whole with Patella</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5730</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB66</BillingCode>
            <Name>Femoral Shaft - Freeze Dried</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3184</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB69</BillingCode>
            <Name>Tendon - EHL</Name>
            <Description>Tendon - EHL</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2838</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB74</BillingCode>
            <Name>Demineralised Bone Matrix - 5cc - Freeze Dried</Name>
            <Description>Demineralised bone matrix 5g</Description>
            <Size>5g</Size>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2926</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB75</BillingCode>
            <Name>Demineralised Bone Matrix - 2cc - Freeze Dried</Name>
            <Description>Demineralised bone matrix 2g</Description>
            <Size>2g</Size>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2342</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB76</BillingCode>
            <Name>Bone, Cancellous, Engineered</Name>
            <Description>Engineered Bone (Cancellous) sourced from Tibial and Femoral Epiphyses.  Irradiated at minimum dose of 11kGy  Clinical uses include filling osseous cavities and spinal fusion</Description>
            <Size>Cut to shape with specifically designed precision instruments</Size>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4679</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB77</BillingCode>
            <Name>Bone - Milled 15g</Name>
            <Description>Milled bone sourced from tibial and femoral epiphyses. Irradiated at a minimum dose of 11kGy.  Clinical uses include revision orthopaedic procedures; Filling osseous cavities; spinal fusion</Description>
            <Size>Less than 15g</Size>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>231769</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2354</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>RNB01</BillingCode>
            <Name>Femoral Head</Name>
            <SupplierCode>HAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229914</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>RNB02</BillingCode>
            <Name>Autologous Skull Flap</Name>
            <SupplierCode>RNB</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1470</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAB01</BillingCode>
            <Name>Grafton Plus  </Name>
            <Description>Demineralized Bone Matrix: Paste  </Description>
            <Size>10cc  </Size>
            <SupplierCode>SAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229635</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAB02</BillingCode>
            <Name>Grafton</Name>
            <Description>Demineralized Bone Matrix: Orthoblend</Description>
            <Size>10cc</Size>
            <SupplierCode>SAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229633</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAB03</BillingCode>
            <Name>Grafton</Name>
            <Description>Demineralized Bone Matrix: Flex</Description>
            <Size>&gt;5cc to 10cc</Size>
            <SupplierCode>SAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229634</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1539</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAB04</BillingCode>
            <Name>Grafton Plus</Name>
            <Description>Demineralized Bone Matrix: Paste</Description>
            <Size>1-5cc</Size>
            <SupplierCode>SAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229635</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>581</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SAB05</BillingCode>
            <Name>Grafton</Name>
            <Description>Demineralized Bone Matrix: Orthoblend</Description>
            <Size>5cc</Size>
            <SupplierCode>SAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>229633</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>581</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN01</BillingCode>
            <Name>Bone - Demineralised Bone Matrix, DBX Putty, 5cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2650</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN02</BillingCode>
            <Name>Bone - Demineralised Bone Matrix, DBX Putty, 10cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3400</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN08</BillingCode>
            <Name>DBX Putty - 1.00cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1450</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN09</BillingCode>
            <Name>DBX Putty - 2.5cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1800</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN10</BillingCode>
            <Name>Bone, Cancellous Chips - 15cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN11</BillingCode>
            <Name>Bone, Cancellous Granules - 15cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1250</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN12</BillingCode>
            <Name>Bone, Cancellous Chips - 30cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN13</BillingCode>
            <Name>Bone, Cancellous Granules - 30cc</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>3</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV05</BillingCode>
            <Name>Tendon - Achilles</Name>
            <Description>Tendon - Achilles</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2302</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV06</BillingCode>
            <Name>Tendon - Achilles with bone block</Name>
            <Description>Tendon - Achilles with bone block</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3930</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV07</BillingCode>
            <Name>Bone Plug/Dowel - Cancellous</Name>
            <Description>Bone Plug/Dowel - Cancellous</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1566</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV08</BillingCode>
            <Name>Cancellous Wedge</Name>
            <Description>Bone Plug/Dowel - Tricortical</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1653</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV09</BillingCode>
            <Name>Bone - Chips/cubes 40cc</Name>
            <Description>Bone - Chips/cubes 40cc</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1641</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV10</BillingCode>
            <Name>Bone - Chips/cubes 80cc</Name>
            <Description>Bone - Chips/cubes 80cc</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2848</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV11</BillingCode>
            <Name>Bone - Milled 40cc</Name>
            <Description>Bone - Milled 40cc</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2878</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV12</BillingCode>
            <Name>Bone - Milled 80cc</Name>
            <Description>Bone - Milled 80cc</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4479</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV14</BillingCode>
            <Name>Cortical Strut</Name>
            <Description>Cortical Strut</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1672</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV17</BillingCode>
            <Name>Cartilage - costal segments</Name>
            <Description>Cartilage - costal segments</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1126</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV18</BillingCode>
            <Name>Elbow - joint</Name>
            <Description>Elbow - joint</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8221</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV19</BillingCode>
            <Name>Radius</Name>
            <Description>Radius</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5107</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV20</BillingCode>
            <Name>Ulna</Name>
            <Description>Ulna</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4752</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV21</BillingCode>
            <Name>Fascia Lata</Name>
            <Description>Fascia Lata</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1734</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV22</BillingCode>
            <Name>Femur - Distal (Shaft &amp; Condyles)</Name>
            <Description>Femur - Distal (Shaft &amp; Condyles)</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6187</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV23</BillingCode>
            <Name>Femur - Entire</Name>
            <Description>Femur - Entire</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9987</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV24</BillingCode>
            <Name>Femoral Shaft - Middle Third</Name>
            <Description>Femoral Shaft - Middle Third</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3678</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV25</BillingCode>
            <Name>Femur - Proximal (shaft, trochanter, neck)</Name>
            <Description>Femur - Proximal (shaft, trochanter, neck)</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>6145</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV26</BillingCode>
            <Name>Femoral head</Name>
            <Description>Femoral head</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4068</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV27</BillingCode>
            <Name>Fibula - Entire</Name>
            <Description>Fibula - Entire</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9646</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV28</BillingCode>
            <Name>Fibula - Segment (6cm)</Name>
            <Description>Fibula - Segment (6cm)</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1566</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV29</BillingCode>
            <Name>Fibula - Segment (12cm)</Name>
            <Description>Fibula - Segment (12cm)</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2099</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV30</BillingCode>
            <Name>Fibular Shaft</Name>
            <Description>Fibular Shaft</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3763</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV31</BillingCode>
            <Name>Hemipelvis - Acetabulum</Name>
            <Description>Hemipelvis - Acetabulum</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4927</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV32</BillingCode>
            <Name>Hemipelvis - Complete</Name>
            <Description>Hemipelvis - Complete</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>10472</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV33</BillingCode>
            <Name>Hemipelvis - iliac crest</Name>
            <Description>Hemipelvis - iliac crest</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4509</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV34</BillingCode>
            <Name>Hemipelvis - Tricortical iliac wedge</Name>
            <Description>Hemipelvis - Tricortical iliac wedge</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2078</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV35</BillingCode>
            <Name>Humerus - Proximal with rotator cuff</Name>
            <Description>Humerus - Proximal with rotator cuff</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4424</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV36</BillingCode>
            <Name>Humerus - Proximal</Name>
            <Description>Humerus - Proximal</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4601</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV37</BillingCode>
            <Name>Humeral Head</Name>
            <Description>Humeral Head</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2972</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV38</BillingCode>
            <Name>Ligament - Medial</Name>
            <Description>Ligament - Medial</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3158</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV39</BillingCode>
            <Name>Meniscus with Ligaments</Name>
            <Description>Meniscus with Ligaments</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3694</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV40</BillingCode>
            <Name>Meniscus</Name>
            <Description>Meniscus</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2287</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV41</BillingCode>
            <Name>Patella</Name>
            <Description>Patella</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2048</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV42</BillingCode>
            <Name>Tendon - Patellar with bone plugs</Name>
            <Description>Tendon - Patellar with bone plugs</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4010</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV43</BillingCode>
            <Name>Rib (5cm)</Name>
            <Description>Rib (5cm)</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1268</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV44</BillingCode>
            <Name>Tibia - Proximal 7-15cm</Name>
            <Description>Tibia - Proximal 7-15cm</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4299</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV45</BillingCode>
            <Name>Tibia - Proximal 16-25cm</Name>
            <Description>Tibia - Proximal 16-25cm</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4162</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV46</BillingCode>
            <Name>Femoral Hemi-condyle</Name>
            <Description>Femoral Hemi-condyle</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2319</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV47</BillingCode>
            <Name>Tibia - Condyles only</Name>
            <Description>Tibia - Condyles only</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2983</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV48</BillingCode>
            <Name>Tibia - Distal</Name>
            <Description>Tibia - Distal</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3737</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV49</BillingCode>
            <Name>Humerus - Distal</Name>
            <Description>Humerus - Distal</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3829</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV51</BillingCode>
            <Name>Femur - Proximal with femoral head</Name>
            <Description>Femur - Proximal with femoral head</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5981</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV52</BillingCode>
            <Name>Bone - Cancellous Bone Matrix, Lyophilised 40cc</Name>
            <Description>Bone - Cancellous Bone Matrix, Lyophilised 40cc</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3615</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV54</BillingCode>
            <Name>Bone - Demineralised Bone Matrix, Lyophilised 1-5cc</Name>
            <Description>Bone - Demineralised Bone Matrix, Lyophilised 5g</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1962</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV55</BillingCode>
            <Name>Bone - Demineralised Bone Matrix, Lyophilised 10cc</Name>
            <Description>Bone - Demineralised Bone Matrix, Lyophilised 10g</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2904</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV57</BillingCode>
            <Name>Tendon - Tibialis Anterior</Name>
            <Description>Tendon - Tibialis Anterior</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3930</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV58</BillingCode>
            <Name>Tendon - Semitendinosus</Name>
            <Description>Tendon - Semitendinosus</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3930</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV59</BillingCode>
            <Name>Tendon - Peroneus Longus</Name>
            <Description>Tendon - Peroneus Longus</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3930</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV60</BillingCode>
            <Name>Tendon - EHL</Name>
            <Description>Extensor hallicus longus tendon</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3930</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV61</BillingCode>
            <Name>Tendon - Tibialis Posterior</Name>
            <Description>Tendon - Tibialis Posterior</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3930</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV62</BillingCode>
            <Name>Bone – Cancellous Bone Matrix Lyophilised 20cc</Name>
            <Description>As per product name</Description>
            <Size>20cc</Size>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2667</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV63</BillingCode>
            <Name>Bone - Cancellous Bone Matrix Lyophilised 10cc</Name>
            <Description>As per product name</Description>
            <Size>10cc</Size>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2312</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>TBV64</BillingCode>
            <Name>Bone - Cancellous Bone Matrix Lyophilised 1 - 5cc</Name>
            <Description>Bone Cancellous Bone Matrix Lyophilised 5cc</Description>
            <SupplierCode>TBV</SupplierCode>
            <CategoryID>3</CategoryID>
            <ARTGs>
                <ARTG>238244</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1746</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC66</BillingCode>
            <Name>Skin</Name>
            <Description>Frozen skin from human origin</Description>
            <Size>&lt;50 cm²</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>303206</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>206</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC67</BillingCode>
            <Name>Skin</Name>
            <Description>Frozen skin from human origin</Description>
            <Size>51 to 80 cm²</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>303206</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>330</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC68</BillingCode>
            <Name>Skin</Name>
            <Description>Frozen skin from human origin</Description>
            <Size>81 to 110 cm²</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>303206</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>454</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC69</BillingCode>
            <Name>Skin</Name>
            <Description>Frozen skin from human origin</Description>
            <Size>111 to 150 cm²</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>303206</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>619</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>NCC70</BillingCode>
            <Name>Skin</Name>
            <Description>Frozen skin from human origin</Description>
            <Size>151 to 200 cm²</Size>
            <SupplierCode>NCC</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>303206</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>826</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB73</BillingCode>
            <Name>Skin 200cm² - frozen skin graft from human origin</Name>
            <Description>Skin 200cm² - frozen skin graft from human origin</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>230058</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>933</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN03</BillingCode>
            <Name>Skin &lt; 25cm² - acellular dermal matrix allograft from human origin</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>28</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2200</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN04</BillingCode>
            <Name>Skin 26 to 60cm² - acellular dermal matrix allograft from human origin</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>28</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3500</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN05</BillingCode>
            <Name>Skin 61 to 120cm² - acellular dermal matrix allograft from human origin</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>28</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5700</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN06</BillingCode>
            <Name>Skin 181 to 300cm² - acellular dermal matrix allograft from human origin</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>211608</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>14000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN07</BillingCode>
            <Name>Skin &gt; 300cm² - acellular dermal matrix allograft from human origin</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>28</CategoryID>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>27000</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>SYN14</BillingCode>
            <Name>Skin 121 to 180cm² - acellular dermal matrix allograft from human origin</Name>
            <SupplierCode>JAA</SupplierCode>
            <CategoryID>28</CategoryID>
            <ARTGs>
                <ARTG>211608</ARTG>
            </ARTGs>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>9900</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AN014</BillingCode>
            <Name>t:slim X2 Insulin Pump</Name>
            <Description>Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability</Description>
            <Size>One size only.</Size>
            <SupplierCode>AN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4183</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>304861</ARTG>
            </ARTGs>
            <MinimumBenefit>8077</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DF003</BillingCode>
            <Name>DANA RS Diabecare insulin pump</Name>
            <Description>DANA RS insulin pump is a BLE (bluetooth low energy) insulin pump which can be connected to and controlled from a BLE Smart Phone.  Smart Phone connection is via a secure (alpha-numeric) pairing code, creating a large easy to read display for set-up and control of the DANA RS insulin pump.</Description>
            <Size>75mm x 45mm x 19mm (63grams)</Size>
            <SupplierCode>DF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4183</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>252214</ARTG>
            </ARTGs>
            <MinimumBenefit>8077</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DF004</BillingCode>
            <Name>DANA-i Insulin Pump</Name>
            <Description>ACE (Alternate Control Enabled) secure Bluetooth low energy insulin pump.  EC certified to be connected to approved CGM systems and approved control algorithms (APS - Artificial Pancreas Systems).  </Description>
            <Size>97mm x 44mm x 20mm 85grams</Size>
            <SupplierCode>DF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4183</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>340938</ARTG>
            </ARTGs>
            <MinimumBenefit>8077</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RB001</BillingCode>
            <Name>Accu-Chek Combo System</Name>
            <Description>Insulin delivery device capable of remotely receiving and acting on information about blood glucose levels, performing bolus calculation and bolus advice on additional parameters than what is normally provided.</Description>
            <Size>The Accu-Chek Combo System is only available in one size.</Size>
            <SupplierCode>RB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4183</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>214240</ARTG>
            </ARTGs>
            <MinimumBenefit>8077</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>YA001</BillingCode>
            <Name>mylife™ YpsoPump Insulin Pump System</Name>
            <Description>The mylife™ YpsoPump Insulin Pump System is a BLE (bluetooth low energy) insulin pump which can be connected to a BLE Smart Phone. Smart Phone connection is via a secure pairing code, creating a large easy to read display for set-up and monitoring of the system. The system is also TGA-approved to be connected to approved CGM systems.</Description>
            <Size>One size only</Size>
            <SupplierCode>YA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4183</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>298274</ARTG>
            </ARTGs>
            <MinimumBenefit>8077</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RB006</BillingCode>
            <Name>Accu-Chek Solo micropump - starter kit</Name>
            <Description>Starter kit supply of insulin pump system to accommodate first year of use of Accu-Chek Solo micropump system. Starter kit includes insulin pump base components, blood glucose monitoring system handset control with integrated insulin bolus advisor (diabetes manager) and accessory pack.</Description>
            <Size>Micropump: 68 x 40 x 15 mm  Handset control (diabetes manager): 124 x 64 x 17 mm</Size>
            <SupplierCode>RB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4183</SubGroupID>
            <Suffix>DE, SS, MP</Suffix>
            <ARTGs>
                <ARTG>311431</ARTG>
            </ARTGs>
            <MinimumBenefit>2375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AN017</BillingCode>
            <Name>t:slim X2 Insulin Pump with Basal-IQ Technology</Name>
            <Description>Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability and incorporating Basal-IQ Predictive Low Glucose Suspend (PLGS) Technology.</Description>
            <Size>One size only.</Size>
            <SupplierCode>AN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4187</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>304681</ARTG>
            </ARTGs>
            <MinimumBenefit>8574</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AN018</BillingCode>
            <Name>t:slim X2 Insulin Pump with Control-IQ Technology</Name>
            <Description>Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability and incorporating Control-IQ Technology.</Description>
            <Size>One size only</Size>
            <SupplierCode>AN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4187</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>304681</ARTG>
            </ARTGs>
            <MinimumBenefit>8574</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI150</BillingCode>
            <Name>MiniMed 640G Insulin Pump</Name>
            <Description>MiniMed 640G Insulin Pump with SmartGuard Technology and continuous glucose monitoring capability, designed to automatically suspend insulin delivery before dangerous lows occur, and automatically resume after levels recover.</Description>
            <Size>1.8ml and 3.0ml</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4187</SubGroupID>
            <Suffix>DE, SS</Suffix>
            <ARTGs>
                <ARTG>95763</ARTG>
            </ARTGs>
            <MinimumBenefit>8574</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI330</BillingCode>
            <Name>Medtronic MiniMed 770G Insulin Pump</Name>
            <Description>MiniMed 770G Insulin Pump with SmartGuard Hybrid Closed Loop (HCL) technology, with Bluetooth® connectivity and continuous glucose monitoring (CGM) capability which can be programmed to automatically adjust delivery of basal insulin based on CGM, and can suspend delivery of insulin when the sensor glucose value falls below or is predicted to fall below predefined threshold values.</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4187</SubGroupID>
            <Suffix>DE, SS, ABD</Suffix>
            <ARTGs>
                <ARTG>332201</ARTG>
            </ARTGs>
            <MinimumBenefit>8574</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI452</BillingCode>
            <Name>MiniMed 780G Insulin Pump</Name>
            <Description>MiniMed 780G Insulin Pump with SmartGuard advanced Hybrid Closed Loop (HCL) technology capable of operating in Manual Mode or Auto Mode, with Bluetooth® connectivity and continuous glucose monitoring (CGM) capability.  Provides 3 user selectable targets and can be set to automatically adjust delivery of basal insulin based on CGM. This includes automatically suspending insulin delivery or providing additional insulin delivery as required. </Description>
            <Size>One size only.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4187</SubGroupID>
            <Suffix>DE, SS, ABD</Suffix>
            <ARTGs>
                <ARTG>376091</ARTG>
            </ARTGs>
            <MinimumBenefit>8574</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RB005</BillingCode>
            <Name>Accu-Chek Solo micropump   subsequent supply</Name>
            <Description>Subsequent supply of replaceable components of Accu-Chek Solo insulin pump system to accommodate a subsequent year usage after the initial year of use of Accu-Chek Solo (via Accu-Chek Solo micropump   starter kit).</Description>
            <Size>Micropump: 68 x 40 x 15 mm</Size>
            <SupplierCode>RB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>7360</SubGroupID>
            <ARTGs>
                <ARTG>308702</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>II001</BillingCode>
            <Name>Omnipod DASH® Insulin Management System - Personal Diabetes Manager (PDM) &amp; Software only</Name>
            <Description>An insulin pump system for the continuous subcutaneous delivery of insulin at set and variable rates that receives and stores external glucose information via a rechargeable Personal Diabetes Manager (PDM). The PDM wirelessly activates/deactivates, controls, directs and monitors operation of a tubeless wearable waterproof Pod via secure Bluetooth Low Energy communication, as well as serves as a bolus calculator. The PDM provides audio alarms, alerts and reminders related to insulin delivery and the Pod. The PDM handles all processes for operation of the system and displays up to 90 days of information including basal rates, bolus doses, carbohydrates, alarms and blood glucose entries that are entered manually from any BGM meter. </Description>
            <Size> The Personal Diabetes Manager (PDM)  is 6.3 cm wide x 13.0 cm long x 1.0 cm high) and weighs 106grams.                                                                                                                                                                                                                                           </Size>
            <SupplierCode>II</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>294</SubCategoryID>
            <GroupID>2964</GroupID>
            <ARTGs>
                <ARTG>344290</ARTG>
            </ARTGs>
            <Note>The benefit for the device is payable no more frequently than once every 4 years.</Note>
            <ChangeExplanation>New Listing</ChangeExplanation>
            <MinimumBenefit>8077</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>Insert</ActionFlag>
            <CycleStartDate>2022-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT244</BillingCode>
            <Name>BIOMONITOR III  </Name>
            <Description>Injectable cardiac monitor for continuous remote monitoring of patients </Description>
            <Size>77.5 mm x 8.6 mm x 4.6 mm; 4 g; 1.9 cm3</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>249</SubCategoryID>
            <GroupID>1770</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>326015</ARTG>
                <ARTG>326016</ARTG>
            </ARTGs>
            <MinimumBenefit>2886</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT247</BillingCode>
            <Name>BIOMONITOR III m  </Name>
            <Description>Injectable cardiac monitor for continuous remote monitoring of patients with extended AF Detection</Description>
            <Size>77.5 mm x 8.6 mm x 4.6 mm; 4 g; 1.9 cm3</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>249</SubCategoryID>
            <GroupID>1770</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>348390</ARTG>
            </ARTGs>
            <MinimumBenefit>2886</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI141</BillingCode>
            <Name>Reveal LINQ</Name>
            <Description>Insertable Cardiac Monitor</Description>
            <Size>45 x 7 x 3.5mm, 1.18cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>249</SubCategoryID>
            <GroupID>1770</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>218791</ARTG>
            </ARTGs>
            <MinimumBenefit>2886</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI438</BillingCode>
            <Name>Reveal LINQ II™</Name>
            <Description>Insertable Cardiac Monitor</Description>
            <Size>45.1 mm x 8mm x 4.2mm, 1.4cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>293</SubCategoryID>
            <GroupID>2962</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>355313</ARTG>
            </ARTGs>
            <MinimumBenefit>2886</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ390</BillingCode>
            <Name>Confirm RX</Name>
            <Description>Insertable Cardiac Monitor</Description>
            <Size>5cm X 0.95cm X 0.33cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>249</SubCategoryID>
            <GroupID>1770</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>292930</ARTG>
            </ARTGs>
            <MinimumBenefit>2886</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS294</BillingCode>
            <Name>Latitude Communicator</Name>
            <Description>Remote patient management system for implanted cardiac devices </Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>201875</ARTG>
                <ARTG>230414</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT187</BillingCode>
            <Name>CardioMessenger Smart 3G</Name>
            <Description>Bedside/Remote transmitter w/ pacemaker/ICD device life network access to Biotronik standard home monitoring data management service.</Description>
            <Size>Length - 130mm, Width - 65mm,  Height - 13mm        Weight - 75g</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>273716</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT246</BillingCode>
            <Name>CardioMessenger Smart 4G</Name>
            <Description>Bedside/Remote transmitter w/ pacemaker/ICD device life network access to Biotronik standard home monitoring data management service.</Description>
            <Size>Length - 130mm, Width - 65mm,  Height - 13mm        Weight - 75g</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>352258</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI180</BillingCode>
            <Name>MyCareLink Patient Monitor</Name>
            <Description>Electronic cellular patient monitor which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>297224</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI196</BillingCode>
            <Name>MyCareLink Smart Patient Reader</Name>
            <Description>Electronic cellular patient reader which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>235570</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI296</BillingCode>
            <Name>MyCareLink Relay Home Communicator</Name>
            <Description>Electronic cellular (optional wifi) patient monitor which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>313825</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA173</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Smartview Remote Monitoring Solution</Name>
            <Description>The Smartview PSTN monitor and Smartview Monitor GPRS - Pacemaker programmer is designed to allow physicians and nurses following patients with a Sorin PARADYMTM RF or INTENSIA family of ICD and CRT-D devices to access valuable cardiac data and alert messages from the device while the patient is at home.</Description>
            <Size>Single Device Product</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>217759</ARTG>
                <ARTG>217760</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF033</BillingCode>
            <Name>Smart Monitor</Name>
            <Description>Monitoring Device for Smartview Remote Monitoring System</Description>
            <Size>One size only</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>350770</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF036</BillingCode>
            <Name>Smart Spot</Name>
            <Description>Remote Monitoring System</Description>
            <Size>One size only</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>355435</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF038</BillingCode>
            <Name>SmartView Connect™</Name>
            <Description>Bluetooth Remote Monitoring Device</Description>
            <Size>Monitor: 65 X118 X 15mm  Docking Station: 84 X46 X 115mm</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>379251</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ369</BillingCode>
            <Name>Merlin@Home wireless</Name>
            <Description>Home cardiac monitor (RF) with landline, cellular and broadband connectivity</Description>
            <Size>one size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>161670</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ370</BillingCode>
            <Name>Merlin@Home Inductive</Name>
            <Description>Home cardiac monitor (inductive) with landline, cellular and broadband connectivity</Description>
            <Size>one size </Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>266</SubCategoryID>
            <GroupID>1832</GroupID>
            <ARTGs>
                <ARTG>163472</ARTG>
            </ARTGs>
            <MinimumBenefit>1450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ409</BillingCode>
            <Name>FlexAbility Ablation Catheter</Name>
            <Description>Sensor Enabled and Non-Sensor Enabled</Description>
            <Size>D, F, J, D-F, F-J, D-D, F-F, J-J</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>327822</ARTG>
                <ARTG>327823</ARTG>
                <ARTG>327824</ARTG>
                <ARTG>327825</ARTG>
            </ARTGs>
            <MinimumBenefit>3700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ410</BillingCode>
            <Name>TactiCath™ Contact Force Ablation Catheter</Name>
            <Description>Sensor Enabled and Non-Sensor Enabled catheter</Description>
            <Size>DD, DF, FF, FJ, JJ, D, F.</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>327316</ARTG>
                <ARTG>327321</ARTG>
            </ARTGs>
            <MinimumBenefit>3700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ465</BillingCode>
            <Name>TactiFlex™ Ablation Catheter, Sensor Enabled™  </Name>
            <Description>Contact Force Sensor Enabled  </Description>
            <Size>DD, DF, FF, FJ, JJ, D, F, J</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>380981</ARTG>
                <ARTG>380982</ARTG>
            </ARTGs>
            <MinimumBenefit>3700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT221</BillingCode>
            <Name>AlCath Force</Name>
            <Description>Mapping and Ablation Cardiac Catheter, Advanced 3D irrigation (eXtra), Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection with Optical Contact Force Sensor</Description>
            <Size>7F, 110cm , 3.5mm tip</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Biotronik</Suffix>
            <ARTGs>
                <ARTG>279638</ARTG>
            </ARTGs>
            <MinimumBenefit>3280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT223</BillingCode>
            <Name>AlCath Flux G eXtra</Name>
            <Description>Mapping and Ablation Cardiac Catheter, Advanced 3D irrigation (eXtra), Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection</Description>
            <Size>7F , 110cm , 3.5mm irrigated gold tip</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Biotronik</Suffix>
            <ARTGs>
                <ARTG>193331</ARTG>
            </ARTGs>
            <MinimumBenefit>3280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT224</BillingCode>
            <Name>AlCath Flutter Flux G eXtra</Name>
            <Description>Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, Advanced 3D irrigation (eXtra), FullCircle Deflection, Optimised stability,control &amp; length for flutter</Description>
            <Size>7F ,95cm , 3.5mm Gold tip</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Biotronik</Suffix>
            <ARTGs>
                <ARTG>221411</ARTG>
            </ARTGs>
            <MinimumBenefit>3280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS361</BillingCode>
            <Name>IntellaNav™ MiFi™ Open-Irrigated Ablation Catheter</Name>
            <Description>IntellaNav™ Open-Irrigated, MiFi™ Mini-electrode Technology, Nav-abled</Description>
            <Size>110cm, shaft size 7.5F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Boston Scientific</Suffix>
            <ARTGs>
                <ARTG>300198</ARTG>
            </ARTGs>
            <MinimumBenefit>3500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS380</BillingCode>
            <Name>Blazer™ Open Irrigated Ablation Catheter </Name>
            <Description>Open Irrigated Ablation bidirectional catheter with Total Tip Cooling™ Design technology</Description>
            <Size>110cm, shaft size 7.5F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Boston Scientific</Suffix>
            <ARTGs>
                <ARTG>186659</ARTG>
            </ARTGs>
            <MinimumBenefit>3500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS385</BillingCode>
            <Name>IntellaTip MiFi™ Open Irrigated Ablation Catheter</Name>
            <Description>Intella MiFi™ Mini- electrode Technology; Open-Irrigated</Description>
            <Size>110cm, shaft size 7.5F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Boston Scientific</Suffix>
            <ARTGs>
                <ARTG>231654</ARTG>
            </ARTGs>
            <MinimumBenefit>3500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS405</BillingCode>
            <Name>INTELLANAV STABLEPOINT™ </Name>
            <Description>Open Irrigated Ablation bidirectional catheter with Total Tip Cooling™ Design technology; Contact Force Sensing</Description>
            <Size>110cm, shaft size 7.5F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Boston Scientific</Suffix>
            <ARTGs>
                <ARTG>354210</ARTG>
            </ARTGs>
            <MinimumBenefit>3500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN310</BillingCode>
            <Name>CARTO System Therapeutic Catheters, THERMOCOOL</Name>
            <Description>Navigation, irrigated</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>JJM, nav</Suffix>
            <ARTGs>
                <ARTG>149553</ARTG>
                <ARTG>157811</ARTG>
                <ARTG>178843</ARTG>
            </ARTGs>
            <MinimumBenefit>2750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN238</BillingCode>
            <Name>CARTO System Therapeutic Catheters, THERMOCOOL SMARTTOUCH</Name>
            <Description>Navigation, contact-force, irrigated</Description>
            <Size>One size only</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>JJM, nav, cf</Suffix>
            <ARTGs>
                <ARTG>184035</ARTG>
                <ARTG>198574</ARTG>
                <ARTG>233354</ARTG>
                <ARTG>233355</ARTG>
            </ARTGs>
            <MinimumBenefit>3700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN304</BillingCode>
            <Name>CARTO System Therapeutic Catheters, QDOT MICRO</Name>
            <Description>Navigation, contact-force, irrigated, very high-power short-duration</Description>
            <Size>One size only</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>JJM, nav, cf</Suffix>
            <ARTGs>
                <ARTG>345779</ARTG>
                <ARTG>345780</ARTG>
            </ARTGs>
            <MinimumBenefit>3700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN301</BillingCode>
            <Name>THERMOCOOL</Name>
            <Description>Non-nav, irrigated</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>JJM, non-nav</Suffix>
            <ARTGs>
                <ARTG>149552</ARTG>
                <ARTG>155131</ARTG>
                <ARTG>178844</ARTG>
            </ARTGs>
            <MinimumBenefit>2000</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI397</BillingCode>
            <Name>DiamondTemp Ablation Catheter</Name>
            <Description>An irrigated, multi-electrode, temperature-controlled, radio-frequency catheter for mapping, pacing and cardiac ablation</Description>
            <Size>7.5F</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Medtronic</Suffix>
            <ARTGs>
                <ARTG>318542</ARTG>
                <ARTG>318543</ARTG>
            </ARTGs>
            <MinimumBenefit>3700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI300</BillingCode>
            <Name>PVAC Gold Phased RF catheter</Name>
            <Description>The Pulmonary Vein Ablation Catheter (PVAC) Gold is a three-dimensional, anatomically designed, multi-electrode phased RF catheter used to map, pace, and ablate the pulmonary veins.</Description>
            <Size>9Fr</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Medtronic, single unit</Suffix>
            <ARTGs>
                <ARTG>235158</ARTG>
            </ARTGs>
            <MinimumBenefit>6399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF024</BillingCode>
            <Name>FireMagic 3D Irrigated Ablation Catheter</Name>
            <Description>Irrigated ablation catheter with a deflectable tip containing an array of platinum electrodes</Description>
            <Size>8 French  105cm</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7349</SubGroupID>
            <Suffix>Microport</Suffix>
            <ARTGs>
                <ARTG>333751</ARTG>
            </ARTGs>
            <MinimumBenefit>3500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ408</BillingCode>
            <Name>EnSite Patch</Name>
            <Description>Surface Electrodes</Description>
            <Size>Patch/Kit</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7350</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>274633</ARTG>
                <ARTG>195707</ARTG>
            </ARTGs>
            <MinimumBenefit>399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT253</BillingCode>
            <Name>BIOTRONIK AcQMap Patient Electrode Kit</Name>
            <Description>The BIOTRONIK AcQMap Patient Electrode Kit  compatible with the AcQMap High Resolution 3D Imaging and Mapping System </Description>
            <Size>Localization Dispersive Electrodes,  Patient Return Electrode,  Repositionable Monitoring Electrodes </Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7350</SubGroupID>
            <Suffix>Biotronik</Suffix>
            <ARTGs>
                <ARTG>323077</ARTG>
            </ARTGs>
            <MinimumBenefit>385</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS360</BillingCode>
            <Name>Rhythmia™ Location Reference Patch Kit</Name>
            <Description>Rhythmia™ Location Reference Patch Kit (Box of 1)</Description>
            <Size>50mm diameter</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7350</SubGroupID>
            <Suffix>Boston Scientific</Suffix>
            <ARTGs>
                <ARTG>282996</ARTG>
            </ARTGs>
            <MinimumBenefit>350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN239</BillingCode>
            <Name>CARTO Reference</Name>
            <Description>External Reference</Description>
            <Size>One size only</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7350</SubGroupID>
            <Suffix>JJM, nav</Suffix>
            <ARTGs>
                <ARTG>157549</ARTG>
            </ARTGs>
            <MinimumBenefit>499</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF023</BillingCode>
            <Name>Columbus Reference Patch</Name>
            <Description>Adhesive patch with embedded magnetic location sensors</Description>
            <Size>One size only</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7350</SubGroupID>
            <Suffix>Microport</Suffix>
            <ARTGs>
                <ARTG>323487</ARTG>
            </ARTGs>
            <MinimumBenefit>399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ404</BillingCode>
            <Name>Inquiry Optima Diagnostic Catheter</Name>
            <Description>mapping catheter</Description>
            <Size>5F-8F</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>136233</ARTG>
            </ARTGs>
            <MinimumBenefit>2300</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ405</BillingCode>
            <Name>Reflexion Spiral Variable Radius Catheter</Name>
            <Description>mapping catheter</Description>
            <Size>5F-8F</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>145053</ARTG>
            </ARTGs>
            <MinimumBenefit>2300</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ406</BillingCode>
            <Name>Advisor mapping catheter</Name>
            <Description>mapping catheter</Description>
            <Size>5F-8F</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>282186</ARTG>
                <ARTG>282187</ARTG>
                <ARTG>308920</ARTG>
                <ARTG>327686</ARTG>
                <ARTG>327732</ARTG>
                <ARTG>327761</ARTG>
                <ARTG>334635</ARTG>
                <ARTG>334636</ARTG>
            </ARTGs>
            <MinimumBenefit>2300</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ407</BillingCode>
            <Name>Afocus II EB Inquiry Steerable Catheter</Name>
            <Description>mapping catheter</Description>
            <Size>5F-8F</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>136211</ARTG>
            </ARTGs>
            <MinimumBenefit>2300</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ454</BillingCode>
            <Name>Livewire Electrophysiology Catheter</Name>
            <Description>Duodecapolar 2-2-2 epi/endo VT mapping catheter  </Description>
            <Size>115cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott</Suffix>
            <ARTGs>
                <ARTG>141868</ARTG>
            </ARTGs>
            <MinimumBenefit>2300</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ457</BillingCode>
            <Name>Abbott Medical electrophysiology mapping catheters - 10 pole</Name>
            <Description>Steerable mapping catheter Livewire, Inquiry</Description>
            <Size>10 pole</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott - 10 pole</Suffix>
            <ARTGs>
                <ARTG>136206</ARTG>
                <ARTG>141868</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ456</BillingCode>
            <Name>Abbott Medical electrophysiology mapping catheters - 20 pole</Name>
            <Description>Steerable mapping catheter - Livewire, Inquiry </Description>
            <Size>20 pole</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott - 20 pole</Suffix>
            <ARTGs>
                <ARTG>141868</ARTG>
                <ARTG>136206</ARTG>
            </ARTGs>
            <MinimumBenefit>1549</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ458</BillingCode>
            <Name>Abbott Medical Electrophysiology mapping catheter - 4/5 pole</Name>
            <Description>Steerable mapping catheter Livewire, Inquiry</Description>
            <Size>4 pole, 5 pole</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott - 4/5 pole</Suffix>
            <ARTGs>
                <ARTG>136206</ARTG>
                <ARTG>141868</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ466</BillingCode>
            <Name>Abbott Medical fixed mapping catheter 4 pole</Name>
            <Description>Fixed diagnostic</Description>
            <Size>Size(s):* various</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott fix 4 pole</Suffix>
            <ARTGs>
                <ARTG>138701</ARTG>
                <ARTG>139001</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ467</BillingCode>
            <Name>Abbott Medical fixed mapping catheter 6-10 pole</Name>
            <Description>Fixed diagnostic</Description>
            <Size>various</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Abbott fix 6-10 pole</Suffix>
            <ARTGs>
                <ARTG>141875</ARTG>
                <ARTG>139001</ARTG>
            </ARTGs>
            <MinimumBenefit>365</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT252</BillingCode>
            <Name>BIOTRONIK AcQMap 3D Imaging and Mapping Catheter</Name>
            <Description>The BIOTRONIK AcQMap 3D Imaging and Mapping Catheter is an advanced, non-contact, intracardiac catheter used for mapping the atrial substrate.</Description>
            <Size>10F x 100cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Biotronik</Suffix>
            <ARTGs>
                <ARTG>340470</ARTG>
            </ARTGs>
            <MinimumBenefit>3890</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT250</BillingCode>
            <Name>ViaCath  20- Pole</Name>
            <Description>Steerable Diagnostic Catheter</Description>
            <Size>6F , 90cm, 2,8,2mm electrode spacing's, 2mm tip , Curve - Extra Large</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Biotronik - 20 pole</Suffix>
            <ARTGs>
                <ARTG>281001</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT248</BillingCode>
            <Name>ViaCath 4 &amp; 10 Pole</Name>
            <Description>Steerable Diagnostic Catheter</Description>
            <Size>6F , 110cm , 2mm Electrode tip , Electrode spacing's - various, Curve- standard, large, Extra large</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Biotronik - 4 &amp; 10 pole</Suffix>
            <ARTGs>
                <ARTG>281000</ARTG>
            </ARTGs>
            <MinimumBenefit>885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT251</BillingCode>
            <Name>MultiCath 4 ,5 &amp; 10 Pole</Name>
            <Description>Steerable Diagnostic Catheter</Description>
            <Size>4,5, 6F ;  80,100,110cm length :  Various Types ; Various Electrode Spacing's ; Curve - Standard or Soft Tipped.</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Biotronik - MultiCath</Suffix>
            <ARTGs>
                <ARTG>280999</ARTG>
            </ARTGs>
            <MinimumBenefit>675</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS359</BillingCode>
            <Name>IntellaMap  Orion High Resolution Mapping Catheter</Name>
            <Description>High resolution 64-electrode steerable mapping catheter</Description>
            <Size>8.5F, 115cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Boston Scientific</Suffix>
            <ARTGs>
                <ARTG>271032</ARTG>
            </ARTGs>
            <MinimumBenefit>2549</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS399</BillingCode>
            <Name>Dynamic </Name>
            <Description>Steerable Diagnostic Catheter</Description>
            <Size>110 cm, 6F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Boston Scientific, Deflecting</Suffix>
            <ARTGs>
                <ARTG>281427</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS393</BillingCode>
            <Name>Polaris X</Name>
            <Description>Steerable Diagnostic Catheters</Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Boston Scientific, Deflecting, 10-pole</Suffix>
            <ARTGs>
                <ARTG>164184</ARTG>
            </ARTGs>
            <MinimumBenefit>750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS396</BillingCode>
            <Name>Dynamic XT</Name>
            <Description>Steerable Diagnostic Catheters</Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Boston Scientific, Deflecting, 10-pole</Suffix>
            <ARTGs>
                <ARTG>281428</ARTG>
            </ARTGs>
            <MinimumBenefit>750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS398</BillingCode>
            <Name>Woven, WovenFlexi</Name>
            <Description>Fixed Curve Diagnostic Catheter </Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Boston Scientific, Fixed</Suffix>
            <ARTGs>
                <ARTG>281436</ARTG>
                <ARTG>281442</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS401</BillingCode>
            <Name>Viking, Viking Soft Tip</Name>
            <Description>Fixed Curve Diagnostic Catheters</Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Boston Scientific, Fixed</Suffix>
            <ARTGs>
                <ARTG>281431</ARTG>
                <ARTG>285279</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS392</BillingCode>
            <Name>Blazer Dx-20</Name>
            <Description>Steerable Diagnostic Catheter </Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Boston Scientific. Deflecting, 20-pole</Suffix>
            <ARTGs>
                <ARTG>170631</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN303</BillingCode>
            <Name>WEBSTER</Name>
            <Description>Non-nav, deflectable diagnostic, less than 10-pole</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>JJM, defl</Suffix>
            <ARTGs>
                <ARTG>145984</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN302</BillingCode>
            <Name>WEBSTER</Name>
            <Description>Non-nav, deflectable, 10-pole CS diagnostic</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>JJM, deflect, 10-pole</Suffix>
            <ARTGs>
                <ARTG>145984</ARTG>
                <ARTG>162172</ARTG>
                <ARTG>219252</ARTG>
            </ARTGs>
            <MinimumBenefit>750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN300</BillingCode>
            <Name>WEBSTER</Name>
            <Description>Non-nav, fixed HIS diagnostic</Description>
            <Size>One size only</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>JJM, fix</Suffix>
            <ARTGs>
                <ARTG>145984</ARTG>
                <ARTG>219254</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN307</BillingCode>
            <Name>WEBSTER</Name>
            <Description>Non-nav, fixed diagnostic</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>JJM, fix</Suffix>
            <ARTGs>
                <ARTG>145985</ARTG>
                <ARTG>146266</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN311</BillingCode>
            <Name>CARTO System Diagnostic Catheters, DECANAV</Name>
            <Description>Navigation, deflectable, 10-pole diagnostic</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>JJM, nav, defl, 10-pole</Suffix>
            <ARTGs>
                <ARTG>217338</ARTG>
            </ARTGs>
            <MinimumBenefit>799</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN240</BillingCode>
            <Name>LASSO/ PENTARAY</Name>
            <Description>Circular/High Density</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>JJM, nav, defl, hd</Suffix>
            <ARTGs>
                <ARTG>121901</ARTG>
                <ARTG>122187</ARTG>
                <ARTG>145997</ARTG>
                <ARTG>203362</ARTG>
                <ARTG>231772</ARTG>
                <ARTG>278955</ARTG>
                <ARTG>278956</ARTG>
            </ARTGs>
            <MinimumBenefit>2200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI486</BillingCode>
            <Name>TORQR Quadripolar Fixed-Curve Diagnostic Catheters </Name>
            <Description>Fixed-Curve, Quadripolar Electrode Catheter.</Description>
            <Size>5Fr, 6Fr</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Medtronic - Torqr quad</Suffix>
            <ARTGs>
                <ARTG>203290</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF040</BillingCode>
            <Name>EasyFinder™</Name>
            <Description>Steerable diagnostic catheter</Description>
            <Size>Length 115cm 6Fr</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>MicroPort, Steerable</Suffix>
            <ARTGs>
                <ARTG>339196</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF041</BillingCode>
            <Name>EasyFinder™</Name>
            <Description>Non-navigational defelectable, 10-pole diagnostic catheter</Description>
            <Size>115cm, 6Fr</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>MicroPort, deflect, 10-pole</Suffix>
            <ARTGs>
                <ARTG>339196</ARTG>
            </ARTGs>
            <MinimumBenefit>750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF025</BillingCode>
            <Name>EasyLoop Circular Mapping Catheter</Name>
            <Description>Diagnostic pulmonary vein catheter for cardiac electrophysiological mapping</Description>
            <Size>7 French  115cm</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Microport</Suffix>
            <ARTGs>
                <ARTG>332882</ARTG>
            </ARTGs>
            <MinimumBenefit>2500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF039</BillingCode>
            <Name>EasyFinder™</Name>
            <Description>Non-navigational fixed curve diagnostic catheter</Description>
            <Size>Length: 60-115cm   Diameter: 5-6Fr  </Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7351</SubGroupID>
            <Suffix>Microport, Fix</Suffix>
            <ARTGs>
                <ARTG>339195</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS375</BillingCode>
            <Name>Blazer II</Name>
            <Description>Non-irrigated temperature ablation catheters </Description>
            <Size>104-115 cm, shaft size 6-7F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>164506</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS376</BillingCode>
            <Name>IntellaTip MiFi™ XP</Name>
            <Description>Non-irrigated ablation catheter with 3 mini-electrodes (MiFi) for more accurate mapping</Description>
            <Size>110 cm, shaft size 7F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>232994</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS377</BillingCode>
            <Name>Blazer Prime </Name>
            <Description>Non-irrigated ablation catheter</Description>
            <Size>104-115 cm, 7F     </Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>179887</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS378</BillingCode>
            <Name>Blazer II XP</Name>
            <Description>Non-irrigated ablation catheters</Description>
            <Size>104-115 cm, 8F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>164229</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS386</BillingCode>
            <Name>IntellaNav MiFi XP</Name>
            <Description>Non-irrigated ablation catheter with 3 mini-electrodes (MiFi), navigation enabled</Description>
            <Size>110 cm, shaft size 7F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>289500</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS391</BillingCode>
            <Name>IntellaNav ST</Name>
            <Description>Non-irrigated temperature ablation catheters; navigation enabled</Description>
            <Size>110 cm, 7F</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>354210</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT222</BillingCode>
            <Name>AlCath G FullCircle</Name>
            <Description>Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection, Standard or Long Tip.</Description>
            <Size>7F, 110cm , 4 mm Tip Gold (G) and 8mm (LT) Long Tip Gold(G)</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>281003</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT225</BillingCode>
            <Name>AlCath Flutter LT G</Name>
            <Description>Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection, Long 8mm Tip (LT), Optimised stability,control &amp; length for flutter</Description>
            <Size>7F , 95cm , 8mm(LT) gold tip</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>221412</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI428</BillingCode>
            <Name>RF Marinr</Name>
            <Description>The Medtronic RF Marinr catheters are steerable, flexible, radiopaque ablation catheters, designed for intracardiac radiofrequency ablation. The catheters have  intracardiac recording and stimulation capabilities. </Description>
            <Size>5Fr, 7Fr</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>202411</ARTG>
                <ARTG>202423</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN277</BillingCode>
            <Name>CELSIUS</Name>
            <Description>4mm non-nav, non-irrigated</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>135671</ARTG>
                <ARTG>135732</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN281</BillingCode>
            <Name>CARTO System Therapeutic Catheters, NAVISTAR</Name>
            <Description>4mm navigation, non-irrigated</Description>
            <Size>One size only</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>135672</ARTG>
                <ARTG>135731</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF032</BillingCode>
            <Name>FireMagic RF Ablation Catheter</Name>
            <Description>Flexible insulative radiofrequency ablation catheter with a deflectable tip</Description>
            <Size>7 French  90-115cm</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>333859</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ430</BillingCode>
            <Name>Abbott Non Irrigated Ablation Catheters – 8mm</Name>
            <Description>Non Irrigated Ablation catheter</Description>
            <Size>8mm tip</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>136321</ARTG>
                <ARTG>137384</ARTG>
                <ARTG>141867</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ431</BillingCode>
            <Name>Abbott Non Irrigated Ablation Catheters – 4mm</Name>
            <Description>Non Irrigated Ablation catheter</Description>
            <Size>4mm tip</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7372</SubGroupID>
            <ARTGs>
                <ARTG>141867</ARTG>
                <ARTG>136320</ARTG>
                <ARTG>137384</ARTG>
            </ARTGs>
            <MinimumBenefit>900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS394</BillingCode>
            <Name>Ultra ICE </Name>
            <Description>Intracardiac Electrophysiology Catheter</Description>
            <Size>One size </Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7375</SubGroupID>
            <Suffix>Boston Scientific</Suffix>
            <ARTGs>
                <ARTG>284615</ARTG>
            </ARTGs>
            <MinimumBenefit>1550</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN333</BillingCode>
            <Name>SOUNDSTAR</Name>
            <Description>3D Ultrasound Diagnostic Catheter</Description>
            <Size>One size only</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7375</SubGroupID>
            <Suffix>JJM</Suffix>
            <ARTGs>
                <ARTG>221253</ARTG>
            </ARTGs>
            <MinimumBenefit>2200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ455</BillingCode>
            <Name>ViewFlex™ Xtra ICE mapping Catheter</Name>
            <Description>Intracardiac Echocardiography (ICE) Catheter</Description>
            <Size>9 F catheter size, 10 F introducer, 90cm insertable length</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2946</GroupID>
            <SubGroupID>7375</SubGroupID>
            <ARTGs>
                <ARTG>214203</ARTG>
            </ARTGs>
            <MinimumBenefit>2549</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI399</BillingCode>
            <Name>Freezor Cardiac Cryoablation Catheters</Name>
            <Description>Freezor, Freezor Xtra, Freezor Max: Focal Cryoablation Catheters</Description>
            <Size>7Fr, 9Fr</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2947</GroupID>
            <SubGroupID>7352</SubGroupID>
            <Suffix>Medtronic</Suffix>
            <ARTGs>
                <ARTG>164123</ARTG>
            </ARTGs>
            <MinimumBenefit>3550</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI301</BillingCode>
            <Name>Arctic Front Advance Cardiac CryoAblation Catheter / Pro</Name>
            <Description>A flexible, over-the-wire balloon catheter used to ablate cardiac tissue</Description>
            <Size>23mm, 28mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2947</GroupID>
            <SubGroupID>7352</SubGroupID>
            <ARTGs>
                <ARTG>201541</ARTG>
                <ARTG>302439</ARTG>
            </ARTGs>
            <MinimumBenefit>5100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI302</BillingCode>
            <Name>Achieve / Achieve Advance Mapping Catheter</Name>
            <Description>Intra-cardiac electrophysiology circular mapping catheter</Description>
            <Size>15mm, 20mm, 25mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>290</SubCategoryID>
            <GroupID>2947</GroupID>
            <SubGroupID>7353</SubGroupID>
            <ARTGs>
                <ARTG>188676</ARTG>
                <ARTG>231648</ARTG>
                <ARTG>286735</ARTG>
            </ARTGs>
            <MinimumBenefit>1299</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI309</BillingCode>
            <Name>Cardioblate® Surgical Ablation Pen XL</Name>
            <Description>The Cardioblate® Surgical Ablation Pen XL facilitates cardiac ablation in areas that are difficult to ablate with a bipolar device.</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7354</SubGroupID>
            <Suffix>Medtronic</Suffix>
            <ARTGs>
                <ARTG>140537</ARTG>
            </ARTGs>
            <MinimumBenefit>2876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI487</BillingCode>
            <Name>Cardioblate MAPS </Name>
            <Description>Surgical RF Mapping, Ablation, Pacing and Sensing catheter.</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7354</SubGroupID>
            <Suffix>Medtronic - MAPS</Suffix>
            <ARTGs>
                <ARTG>155379</ARTG>
            </ARTGs>
            <MinimumBenefit>2000</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ064</BillingCode>
            <Name>ATRICURE COOLRAIL LINEAR PEN</Name>
            <Description>Surgical Radio Frequency (RF) Irrigated Linear Pen for Atrial Fibrillation surgery</Description>
            <Size>One size only</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7355</SubGroupID>
            <Suffix>AA-Med - Coolrail</Suffix>
            <ARTGs>
                <ARTG>326625</ARTG>
            </ARTGs>
            <MinimumBenefit>2600</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ065</BillingCode>
            <Name>Atricure Isolator Linear Pen</Name>
            <Description>Surgical Radio Frequency (RF) Isolator Linear Pen for Atrial Fibrillation surgery</Description>
            <Size>One size only</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7355</SubGroupID>
            <Suffix>AA-Med - Isolator Linear Pen</Suffix>
            <ARTGs>
                <ARTG>326626</ARTG>
                <ARTG>326627</ARTG>
            </ARTGs>
            <MinimumBenefit>2000</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ055</BillingCode>
            <Name>ATRICURE ISOLATOR SYNERGY RF CLAMPS</Name>
            <Description>Surgical Radio Frequency (RF) Clamps for Atrial Fibrillation surgery</Description>
            <Size>Short, Long</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7355</SubGroupID>
            <Suffix>AA-Med - Isolator Synergy</Suffix>
            <ARTGs>
                <ARTG>163534</ARTG>
            </ARTGs>
            <MinimumBenefit>4200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ056</BillingCode>
            <Name>Isolator Synergy Access</Name>
            <Description>Articulating Surgical Radio Frequency (RF) Clamp for Atrial Fibrillation Surgery</Description>
            <Size>One size only</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7355</SubGroupID>
            <Suffix>AA-Med - Isolator Synergy</Suffix>
            <ARTGs>
                <ARTG>167710</ARTG>
                <ARTG>297560</ARTG>
            </ARTGs>
            <MinimumBenefit>4200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI308</BillingCode>
            <Name>Cardioblate BP2 RF Surgical Ablation Device</Name>
            <Description>The Cardioblate BP2 RF Surgical Ablation devices feature dual electrodes for the delivery of irrigated RF energy.  iRF technology combines saline to facilitate treatment</Description>
            <Size>Standard, Low Profile</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7355</SubGroupID>
            <Suffix>Medtronic</Suffix>
            <ARTGs>
                <ARTG>140537</ARTG>
            </ARTGs>
            <MinimumBenefit>3523</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ080</BillingCode>
            <Name>EPi-Sense Guided Coagulation System with VisiTrax Device CDK-1413 </Name>
            <Description>Surgical Radio Frequency (RF) catheter for Atrial Fibrillation surgery</Description>
            <Size>EPi-Sense Probe: 3cm (end effector) </Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7356</SubGroupID>
            <Suffix>AA-Med Episense</Suffix>
            <ARTGs>
                <ARTG>347670</ARTG>
            </ARTGs>
            <MinimumBenefit>6040</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI312</BillingCode>
            <Name>Cardioblate® BP2 RF Surgical Ablation System</Name>
            <Description>The Cardioblate® BP2 RF Surgical Ablation system features dual electrodes for the delivery of irrigated RF energy.  iRF technology combines saline to facilitate treatment</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7356</SubGroupID>
            <Suffix>Medtronic - Cardioblate BP2</Suffix>
            <ARTGs>
                <ARTG>146949</ARTG>
            </ARTGs>
            <MinimumBenefit>4614</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI310</BillingCode>
            <Name>Cardioblate® Gemini® Surgical Ablation System</Name>
            <Description>The Cardioblate® Gemini® Surgical Ablation System is designed for minimally invasive ablation procedures. Gemini-s combines the efficacy of irrigated RF energy through a bipolar jaw, to facilitate deeper energy penetration, with real time measured customised energy delivery for greater confidence in achieving transmural cardiac lesions.</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2948</GroupID>
            <SubGroupID>7356</SubGroupID>
            <Suffix>Medtronic - Cardioblate Gemini</Suffix>
            <ARTGs>
                <ARTG>153878</ARTG>
            </ARTGs>
            <MinimumBenefit>6040</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ057</BillingCode>
            <Name>cryoICE Cryoablation Surgical Probes</Name>
            <Description>Surgical Cryoablation probes for atrial fibrillation surgery</Description>
            <Size>One size only</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2949</GroupID>
            <SubGroupID>7358</SubGroupID>
            <Suffix>AA-Med cryoICE</Suffix>
            <ARTGs>
                <ARTG>202110</ARTG>
                <ARTG>311095</ARTG>
            </ARTGs>
            <MinimumBenefit>3800</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI311</BillingCode>
            <Name>CryoFlex™ Surgical Ablation Probe</Name>
            <Description>The CryoFlex™ Surgical Ablation Probe utilises a gas for freezing cells in the surgical treatment of cardiac arrhythmias.</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2949</GroupID>
            <SubGroupID>7358</SubGroupID>
            <Suffix>Medtronic - CryoFlex</Suffix>
            <ARTGs>
                <ARTG>158928</ARTG>
            </ARTGs>
            <MinimumBenefit>4695</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI307</BillingCode>
            <Name>SurgiFrost 10</Name>
            <Description>SurgiFrost 10 is a malleable, single-use cryosurgical device developed to treat cardiac arrhythmias during heart surgery.  Freezing preserves tissue integrity. SurgiFrost10 features a malleable shaft and flexible tip with adjustable insulation sleeve.</Description>
            <Size>One size ony</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2949</GroupID>
            <SubGroupID>7358</SubGroupID>
            <Suffix>Medtronic - SurgiFrost 10</Suffix>
            <ARTGs>
                <ARTG>158928</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI306</BillingCode>
            <Name>CryoFlex™ Surgical Clamp and Probe</Name>
            <Description>The CryoFlex™ Surgical Clamp and Probe combines the utility of the CryoFlex™ Probe with the delivery of a clamp.</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>291</SubCategoryID>
            <GroupID>2949</GroupID>
            <SubGroupID>7359</SubGroupID>
            <Suffix>Medtronic</Suffix>
            <ARTGs>
                <ARTG>158929</ARTG>
            </ARTGs>
            <MinimumBenefit>5095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG009</BillingCode>
            <Name>Artisan Anterior Chamber Intraocular Lens</Name>
            <Description>Aphakia Model
Composition: PMMA</Description>
            <Size>5.00mm Optic Diameter x 8.5 in overall length</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>140</SubCategoryID>
            <GroupID>1324</GroupID>
            <SubGroupID>3887</SubGroupID>
            <Suffix>ifc</Suffix>
            <ARTGs>
                <ARTG>92476</ARTG>
            </ARTGs>
            <MinimumBenefit>203</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL003</BillingCode>
            <Name>MTA2UO - MTA6UO</Name>
            <Description>PMMA</Description>
            <Size>+5 to +30 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>140</SubCategoryID>
            <GroupID>1324</GroupID>
            <SubGroupID>3887</SubGroupID>
            <ARTGs>
                <ARTG>144332</ARTG>
            </ARTGs>
            <MinimumBenefit>126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL005</BillingCode>
            <Name>Storz (Coburn) Intraocular Lens  121UV; L122UV PMMA Anterior Chamber Lens</Name>
            <Description>PMMA Anterior Chamber Intraocular lens 1 piece</Description>
            <Size>13.75mm length. 6.0mm optic size, diopter range 3-30d. L122UV: 6.0mm optic, 13.75mm length, power range; 5.0 to 30.0 Diopters</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>140</SubCategoryID>
            <GroupID>1324</GroupID>
            <SubGroupID>3887</SubGroupID>
            <ARTGs>
                <ARTG>97880</ARTG>
            </ARTGs>
            <MinimumBenefit>126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG019</BillingCode>
            <Name>Artisan Toric (Custom) T1</Name>
            <Description>AC Iris clip IOL Toric</Description>
            <Size>5.00mm Optic Diameter x 7.5 Overall</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>140</SubCategoryID>
            <GroupID>1325</GroupID>
            <SubGroupID>3888</SubGroupID>
            <Suffix>t1, ifc</Suffix>
            <ARTGs>
                <ARTG>92476</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG020</BillingCode>
            <Name>Artisan Toric (Custom) T2</Name>
            <Description>AC Iris clip IOL Toric</Description>
            <Size>5.00mm Optic Diameter x 7.5 Overall</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>140</SubCategoryID>
            <GroupID>1325</GroupID>
            <SubGroupID>3888</SubGroupID>
            <Suffix>t2, ifc</Suffix>
            <ARTGs>
                <ARTG>92476</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG012</BillingCode>
            <Name>Artisan Anterior Chamber IOL</Name>
            <Description>Phakic Intraocular Lens Myopic / Hyperopic</Description>
            <Size>5.00mm Optic Diameter x 8.5 in overall length;</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>140</SubCategoryID>
            <GroupID>1325</GroupID>
            <SubGroupID>3888</SubGroupID>
            <ARTGs>
                <ARTG>92476</ARTG>
            </ARTGs>
            <MinimumBenefit>552</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG010</BillingCode>
            <Name>Artiflex Anterior Chamber Intraocular Lens</Name>
            <Description>Optic: Hydrophobic Polysiloxane. Haptic: PMMA</Description>
            <Size>6mm optic diameter x 8.5 in overall length</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>140</SubCategoryID>
            <GroupID>1325</GroupID>
            <SubGroupID>3889</SubGroupID>
            <ARTGs>
                <ARTG>92476</ARTG>
            </ARTGs>
            <MinimumBenefit>565</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL002</BillingCode>
            <Name>Model CZ70BD</Name>
            <Description>Other:PMMA</Description>
            <Size>Range of Powers: +10.0D to +30.0D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1326</GroupID>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ016</BillingCode>
            <Name>CT ASPHINA 409M</Name>
            <Description>ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation</Description>
            <Size>6mm optic, 11mm overall diameter. Diopter range 0.0 to +32.0D (0.5D steps from 10.0 to 30.0D, 1.0D outside this range)</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ017</BillingCode>
            <Name>CT ASPHINA 509M</Name>
            <Description>ZEISS Micro Incision Aspheric (aberration correcting) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation</Description>
            <Size>6mm Optic, 11mm overall diameter. Diopter range 0.0 to +32.0D (0.5D steps from 10.0 to 30.0D, 1.0D outside this range)</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL026</BillingCode>
            <Name>Akreos AO Micro Incision Lens</Name>
            <Description>Micro Incision, posterior chamber, foldable acrylic, aphakic, anterior &amp; posterior edge modification, preloaded, with aberration control, intraocular lens</Description>
            <Size>6mm optic overall diameter 11.0mm(10D-15D), 10.7mm (15.50-22D), 10.5mm (22.50-30D)</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>270</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ028</BillingCode>
            <Name>CT ASPHINA 409MP</Name>
            <Description>Preloaded, micro incision, aspheric (aberration neutral), foldable square-edged single piece intraocular lens for capsular bag fixation.</Description>
            <Size>Diopter range: 0.0 to 32.0D; Optic size: 6.0mm; Overall length: 11.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>270</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ037</BillingCode>
            <Name>CT ASPHINA 509MP</Name>
            <Description>Preloaded, micro incision, aspheric (aberration correcting), foldable square-edged single-piece intraocular lens for capsular bag fixation</Description>
            <Size>Diopter range: 0.0 to + 32.0D; Optic Size: 6.0mm; Overall length: 11.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>134490</ARTG>
            </ARTGs>
            <MinimumBenefit>270</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG015</BillingCode>
            <Name>Rayner C-flex Advance Aspheric IOL</Name>
            <Description>Mini incision pre-loaded  aspheric IOL</Description>
            <Size>Power range +8.0 - +34.0 dioptres in 0.5 increments</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>220612</ARTG>
            </ARTGs>
            <MinimumBenefit>270</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TW012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EG016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ARTIS PL E</Name>
            <Description>Preloaded Intraocular lens</Description>
            <Size>0 to 35D</Size>
            <SupplierCode>TW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>226270</ARTG>
            </ARTGs>
            <MinimumBenefit>270</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ031</BillingCode>
            <Name>AT TORBI 709MP (Standard Range)</Name>
            <Description>Bitoric, preloaded, micro incision, aspheric (aberration neutral), foldable, square-edged, single-piece IOL for capsular bag fixation</Description>
            <Size>Diopter range: Sph -10.0 to 32.0, Cyl +1.0 to 6.5&#xD;
Optic size: 6.0mm, Overall length: 11.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>549</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TW011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EG015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ARTIS T PL</Name>
            <Description>Preloaded Toric Intraocular lens</Description>
            <Size>+18 to +25D / C +1.50D</Size>
            <SupplierCode>TW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>226270</ARTG>
            </ARTGs>
            <MinimumBenefit>549</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ020</BillingCode>
            <Name>AT TORBI 709M</Name>
            <Description>STANDARD RANGE BITORIC - ZEISS Micro Incision Aspheric (abberation neutral) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation</Description>
            <Size>6mm optic, 11mm overall diameter. Diopter range: Sph -10.0 to +32.0D, Cyl +1.0 to 6.5D (all 0.5D steps)</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>534</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ027</BillingCode>
            <Name>AT TORBI 709M</Name>
            <Description>HIGH CYLINDER BITORIC - ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable square edged, single piece IOL for capsular bag fixation</Description>
            <Size>6mm optic, 11mm overall diameter.  Diopter range: Sph -10.0 to +32.0D, +7.0 to 12.0D (all 0.5D steps)</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ040</BillingCode>
            <Name>CT SPHERIS 209M</Name>
            <Description>Micro incision, Spherical aberrated, foldable square-edged single-piece intraocular lens for capsular bag fixation.</Description>
            <Size>Diopter range :0.00 to + 32.0. Optic Size : 6mm  Overall Length  : 11mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3890</SubGroupID>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL038</BillingCode>
            <Name>Acrysof Aspheric UV-absorbing IOL</Name>
            <Description>Foldable Acrylic Single-piece Lens with UV Absorbing and Aspheric Correction</Description>
            <Size>+ 6.0 D to +30.0 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO014</BillingCode>
            <Name>TECNIS® Intraocular Lens (Z9002 &amp; ZA9003)</Name>
            <Description>Foldable Intraocular Lenses - Ultraviolet light absorbing posterior chamber intraocular lenses, Silicone/Acrylic</Description>
            <Size>5-10 dioptre in 1.0 dioptre increments; 10.5 - 30 dioptre in 0.5 increments</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>99891</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO024</BillingCode>
            <Name>Tecnis® One Piece (ZCB00)</Name>
            <Description>One piece intraocular lens with edge modification and 360 degree square edge</Description>
            <Size>+5 to +34 diopter powers in 0.5d increments. Overall diameter 13mm, Optic size 6mm</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>170331</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO043</BillingCode>
            <Name>TECNIS® Eyhance IOL</Name>
            <Description>1-piece enhanced monofocal IOL</Description>
            <Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments. Overall diamter 13mm, optic size 6mm</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>170331</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL022</BillingCode>
            <Name>SofPort Advanced Optic (AO)</Name>
            <Description>Posterior chamber, foldable silicone IOL with anterior optic-haptic square edge, posterior optic-haptic square edge, 360-degree optic square edge and asperic optic for aberration control</Description>
            <Size>0 D to 30.0 D</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL023</BillingCode>
            <Name>Akreos Advanced Optic</Name>
            <Description>Posterior chamber, foldable acrylic IOL, with anterior optic-haptic square edge, posterior optic-haptic square edge, 360 degree optic square edge and aspheric optic for aberration control</Description>
            <Size>0 D to 30.0 D</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL030</BillingCode>
            <Name>enVista</Name>
            <Description>The enVista, Model MX60, is an ultra-violet-absorbing, posterior chamber, hydrophobic acrylic one-piece foldable intraocular lens (IOL)  Has an aspheric lens optic, square posterior edge, modified C haptics and available in dioptric powers ranging from +0.0 to +34.0D.</Description>
            <Size>Overall diameter 12.5mm, optic body diameter 6.0mm in dioptric powers ranging from +0.0 to +34D&#xD;
0.0D to 10.0D in 1 Diopter increments&#xD;
11.0D to 30.0D in 0.5 Diopter increments&#xD;
31.0D to 34.0D in 1 Diopter increments</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL052</BillingCode>
            <Name>Enhanced enVista IOL</Name>
            <Description>The enhanced enVista (Model MX60E) is an ultraviolet-absorbing, posterior chamber, hydrophobic acrylic intraocular lens (IOL). They have an aspheric lens optic, square posterior edge, and modified C haptics. The lenses can be folded for insertion into the eye.</Description>
            <Size>Specification:   Optic Body Diameter 6.0   Overall Diameter 12.5 Haptic Angulations Planar Haptic   Lens Power Range +0.0 to +34.0 Diopters (0.0 to +10.0 in 1.0 Diopter increments, +10.0 to +30.0 in 0.5 Diopter increments, and +30.0 to +34.0 in 1.0 Diopter increments)</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ030</BillingCode>
            <Name>CT ASPHINA 404</Name>
            <Description>Small incision, foldable, single piece, monofocal, aspheric (aberration neutral), square-edged, hydrophilic acrylic (with hydrophobic surface properties) intraocular lens for capsular bag fixation. (Monofocal lens for powers outside standard 409MP MICS range).</Description>
            <Size>Diopter range: -10.0 to 42.0, Optic size: 6.0mm, Overall length: 11.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE492</BillingCode>
            <Name>LENTIS L-313</Name>
            <Description>Foldable one-piece monofocal acrylic plate haptic IOL</Description>
            <Size>Optic Size 6.0mm, Overall length 11.0mm. Available Diopters: +-10.0D to 36.0D (1.0D steps) +10.5D to 29.5D (0.5D steps)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE648</BillingCode>
            <Name>FEMTIS FB-313</Name>
            <Description>Foldable one-piece monofocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description>
            <Size>Optic Size 5.7mm, Overall length 10.5mm. Available Diopters: +-15.0D to 30.0D (0.5D steps)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE673</BillingCode>
            <Name>LENTIS LU-814VR</Name>
            <Description>Foldable one-piece acrylic posterior chamber aspheric IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description>
            <Size>Optic size: 6.2mm 0.0D to +23.0D, 5.5mm +23.01D to +35.0D , Overall length: 13.0mm, Available Dioptres: 0.0D to +35.0D (1.0D steps), +15.5D to +26.5D (0.5D steps).</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ013</BillingCode>
            <Name>PreciSAL 302AC</Name>
            <Description>Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and UV light filter.</Description>
            <Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to + 17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG012</BillingCode>
            <Name>Rayner "C-Flex" and Superflex" Aspheric IOL</Name>
            <Description>Aspheric Intra Ocular Lenses with Amon-Apple enhanced 360 Degree square edge, Anti-vaulting Haptics</Description>
            <Size>C-Flex -970C + 22.5D to +34D Superflex-920H - 10D to +22D</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN003</BillingCode>
            <Name>ALSAFIT</Name>
            <Description>Single piece aspheric foldable intraocular lens for implantation into the capsular bag.</Description>
            <Size>Diopter power range: 0.0 D to 32.00 D (0.50 D increments). Optic size: 6mm. Overall length: 11.0mm.</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>268033</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN008</BillingCode>
            <Name>ALSIOL</Name>
            <Description>Single piece aspheric foldable intraocular lens for implantation into the capsular bag.</Description>
            <Size>Diopter power range: 0.0 D to +32.00 D (0.50 D increments). Optic size: 6 mm. Overall length: 11.0 mm.</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>277174</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN013</BillingCode>
            <Name>Vision Pro Hydrophobic Acrylic Aspheric Intraocular Lens (RS60A)</Name>
            <Description>Hydrophobic Acrylic Aspheric Posterior Chamber Foldable IOL</Description>
            <Size>Aspheric IOL: +0 to +34 D in 0.5 D increments; Overall diameter 13mm, Optic size 6mm.</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>344091</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO074</BillingCode>
            <Name>HumanOptics Aspira</Name>
            <Description>Posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic</Description>
            <Size>-20.0 to +60.0 D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO084</BillingCode>
            <Name>Aspira-aXA</Name>
            <Description>Posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic.</Description>
            <Size>-20D to +40 D.</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO034</BillingCode>
            <Name>TECNIS® 1-Piece Pre-Loaded IOL</Name>
            <Description>1-piece IOL Posterior Chamber Intraocular lens, incorporates a proprietary wavefront-designed aspheric optic with a squared posterior optic edge designed to provide a 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects. Supplied pre-loaded in either a screw style disposable injector or in a pre-loaded cartridge.</Description>
            <Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments.  Overall diameter 13mm, Optic size 6mm</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>377171</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO048</BillingCode>
            <Name>TECNIS® Eyhance Pre-Loaded IOL</Name>
            <Description>1-piece enhanced monofocal pre-loaded IOL</Description>
            <Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments. Overall diameter 13mm, optic size 6mm</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>377170</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL040</BillingCode>
            <Name>Enhanced enVista IOL with Bausch + Lomb SimplifEYE Preloaded Delivery System</Name>
            <Description>The enVista Family of Intraocular Lenses (IOLs) are ultraviolet-absorbing, posterior chamber, hydrophobic acrylic IOLs. They have an aspheric lens optic, square posterior edge, and modified C haptics. The lenses can be folded for insertion into the eye.  The MXPLC combines the preloaded IOL with an inserter and is sold in a common package. This alternate packaging configuration allows for a simpler loading of the injector.  </Description>
            <Size>Specification  Optic Body Diameter                 6.0 ± 0.1 mm     Overall Diameter                        12.5 ± 0.2 mm        Haptic Thickness                       0.35 ± 0.04 mm     Haptic Angulations                         Planar Haptic  Lens       Power Range                    +0.0 to +34.0D                                                     (+0.0 to +9.0D in 1D increments)                                                         (+10.0 to +30.0D in 0.5D increments)    (+31.0 to +34.0D in 1D increments)  </Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL041</BillingCode>
            <Name>LuxGood Preloaded Crystal</Name>
            <Description>The LuxGood intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL and has aspheric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxGood lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: +00.00 D to +34.00 D: 6.0 mm +/- 0.1 mm  Overall Diameter: +00.00 D to +34.00 D: 11.00 mm +/- 0.2 mm  Power Range: +0.00 D to +34.00 D Label Increments: 0.1 D</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ048</BillingCode>
            <Name>CT LUCIA 621P</Name>
            <Description>One ZEISS UV light-absorbing Heparin Surface Hydrophobic Acrylic Posterior Chamber Intra-ocular Lens. This lens is intended to correct aphakia. It is made from an optically clear hydrophobic acrylic material which incorporates an UV-absorbing component and has a Heparin coating.</Description>
            <Size>Dioptre Range: 00.0 to +34.0 with increments of 0.5  Optic Size: 6.0mm  Overall Length: 13.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>389794</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV268</BillingCode>
            <Name>Hoya Vivinex iSert preloaded IOL (Model XC1)</Name>
            <Description>Preloaded injector system, micro incision, aspheric, UV filtering, single piece, hydrophobic acrylic</Description>
            <Size>+6.0 to 30.0 D (in 0.5D steps)</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>117417</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV269</BillingCode>
            <Name>HOYA iSert® 250</Name>
            <Description>Preloaded injector system, Micro-Incision, Aspheric, UV filtering, Single Piece, Hydrophobic</Description>
            <Size>+6.0D to +30.0D (in 0.5D steps)</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>112674</ARTG>
                <ARTG>117417</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ014</BillingCode>
            <Name>PreciSAL P302AC  PreciSAL PS302AC</Name>
            <Description>Preloaded Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and UV light filter.</Description>
            <Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to + 17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG017</BillingCode>
            <Name>RayOne Ashperic preloaded</Name>
            <Description>Preloaded aspheric intraocular lens, hydrophilic acrylic, UV absorbing, 360 square edge, anti-vaulting haptics</Description>
            <Size>6mm optic, range sphere -10 to +34</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>220612</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG020</BillingCode>
            <Name>RayOne Hydrophobic IOL</Name>
            <Description>Hydrophobic acrylic IOL, preloaded injector system, micro incision, aspheric, UV filtering, single piece.</Description>
            <Size>Power range: &#xD;
-10.0 D to +7.0 D (1.0 D increments, including plano)&#xD;
+8.0 D to +30.0 D (0.5 D increments)&#xD;
+31.0 D to +32.0 D (1.0 D increments) &#xD;
Shapes:&#xD;
Biconvex (positive powers), Plano, Concave (negative powers)</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN011</BillingCode>
            <Name>I-Stream Pre-Loaded Aspheric Hydrophobic</Name>
            <Description>Single piece, pre-loaded aspheric  hydrophobic acrylic IOL</Description>
            <Size>Optic diameter: 6mm&#xD;
Total diameter: 13mm&#xD;
Power range: +9.0 to +32.0D</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>307407</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN014</BillingCode>
            <Name>Vision Pro Preloaded Hydrophobic Acrylic Aspheric Intraocular Lens (PRS60A)</Name>
            <Description>Preloaded, Hydrophobic Acrylic Aspheric Posterior Chamber Foldable IOL</Description>
            <Size>Aspheric IOL: +0 to +34 D in 0.5 D increments; Overall diameter 13mm, Optic size 6mm</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>357110</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO075</BillingCode>
            <Name>HumanOptics Aspira Preloaded</Name>
            <Description>Preloaded posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic</Description>
            <Size>+10.0 to +40.0 D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO083</BillingCode>
            <Name>Aspira-aXA Preloaded</Name>
            <Description>Preloaded posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360  LEC barrier, HD optic</Description>
            <Size>0 to +30.0 D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BiFlex 877PA Preloaded Hydrophobic Acrylic Foldable Aspheric Monofocal Lens without Blue Light Filter</Name>
            <Description>Posterior Chamber IOL, special 360° sharp edge, Aspheric Aberration Balanced</Description>
            <Size>Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm  Powers available:   -0.0 - +9.0 D  ±0.25 D increment: 1.0 D  +10.0 - +25.0 D ±0.25 D increment: 0.5 D   +25.5 - +30.0 D ±0.5 D  increment: 0.5 D  +31.0 - +35.0 D ±0.5 D  increment: 1.0 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS043</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Basis Z Preloaded Hydrophylic IOL</Name>
            <Description>Hydrophylic preloaded IOL</Description>
            <Size>6mm Optic Diameter and 13mm Length</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO042</BillingCode>
            <Name>Tecnis Toric 1-Piece Pre-Loaded IOL</Name>
            <Description>1-piece IOL Posterior chamber Intraocular lens , incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects.</Description>
            <Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments. Cylinder power: 1.00 diopter, 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75 diopter, 4.00 diopter, 4.50 diopter, 5.25 diopter and 6.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm.</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>181845</ARTG>
            </ARTGs>
            <MinimumBenefit>535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL032</BillingCode>
            <Name>enVista Toric</Name>
            <Description>The enVista toric (Model MX60T) is a one-piece glistening-free hydrophobic foldable IOL. The enVista Toric, model MX60T IOL has a Toric aspheric lens optic, a square posterior edge and modified C haptics, an overall diameter of 12.5mm and an optic body of 6.0mm.  It is available in multiple spherical and cylindrical powers.</Description>
            <Size>Overall diameter is 12.5mm for the entire lens power range, with spherical equivalent powers from +6.0 to +30.0 Diopters in 0.5 Diopter steps and cylinder powers from +1D to 6D  Diopters (at the IOL plane).</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL043</BillingCode>
            <Name>Enhanced enVista Toric with Bausch + Lomb SimplifEYE preloaded delivery system</Name>
            <Description>The enVista Family of Intraocular Lenses (IOLs) are ultraviolet-absorbing, posterior chamber, hydrophobic acrylic IOLs. They have an aspheric lens optic, square posterior edge, and modified C haptics. The lenses can be folded for insertion into the eye. The MX60PTC combines the preloaded IOL with the enVista SimplifEYE Preloaded Injector System inserter and is sold in a common package. This alternate packaging configuration allows for a simpler loading of the injector.</Description>
            <Size>Specification: Optic Body Diameter 6.0 ± 0.1 mm Overall Diameter 12.5 ± 0.2 mm  Haptic Thickness 0.35 ± 0.04 mm Haptic Angulations Planar Haptic Lens Power Range +0.0 to +30.0D (in 0.5D increments) +0.90D to +5.75D (in 0.75D increments from +1.25D).</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL045</BillingCode>
            <Name>LuxGood Toric Preloaded Crystal</Name>
            <Description>The LuxGood Toric intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL and has aspheric and toric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxGood Toric lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: 6.0 mm; Overall Diameter: 11 mm Haptic Angle: 0°  Powers: +6.00 to +34.00 Diopters Cylindrical Powers: +0.75 to +6.00 Diopters  </Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG016</BillingCode>
            <Name>RayOne Toric Aspheric preloaded</Name>
            <Description>Single piece preloaded aspheric toric acrylic IOL, UV absorbing, 360 square edge, anti-vaulting haptics</Description>
            <Size>6mm optic, +8 ro +30 sphere, +1 to +6 cylinder in 0.5 steps</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>220612</ARTG>
            </ARTGs>
            <MinimumBenefit>535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU004</BillingCode>
            <Name>Medicontur Bi-Flex POB-MA Toric 877PT</Name>
            <Description>Single piece posterior chamber hydrophobic acrylic monofocal toric intraocular lens. Preloaded with biconvex aspheric optic.</Description>
            <Size>Powers: +10.0 D to +30.0 D in 0.5 diopter increments  Cylinder powers: 1.00 D, 1.50 D, 2.25 D, 3.00 D, 3.75 D, 4.50 D, 5.25 D, 6.00 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL049</BillingCode>
            <Name>Clareon AutonoMe Toric</Name>
            <Description>Clareon AutonoMe Toric consists of a Clareon Toric Aspheric Hydrophobic Acrylic Intraocular Lens (Clareon Toric IOL) pre-loaded on the AutonoMe Automated Delivery System.</Description>
            <Size>+6.0 to +30.0 diopters</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL044</BillingCode>
            <Name>LuxGood Toric Preloaded</Name>
            <Description>The LuxGood Toric intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, with blue light filtering and has aspheric and toric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxGood Toric lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: 6.0 mm; Overall Diameter: 11 mm Haptic Angle: 0°  Powers: +6.00 to +34.00 Diopters Cylindrical Powers: +0.75 to +6.00 Diopters  </Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV267</BillingCode>
            <Name>Hoya Vivinex XY1AT Toric</Name>
            <Description>Preloaded injector system, toric / corrects corneal astigmatism, micro-incision, aspheric, blue blocker, single piece hydrophobic</Description>
            <Size>IOL Power: + 10.0 to 30.0 (0.5 steps), IOL Cylinder power: 1.0D (XY1AT2), 1.50D (XY1AT3), 2.25D (XY1AT4), 3.00D (XY1AT5), 3.75D (XY1AT6), 4.50D (XY1AT7), 5.25D (XY1AT8), 6.00D (XY1AT9)</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>117417</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ020</BillingCode>
            <Name>PreciSAL Toric PT302A</Name>
            <Description>Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV and blue light filters.</Description>
            <Size>Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; Cylinder powers from 1.0D to 6.0D</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU003</BillingCode>
            <Name>Medicontur Bi-Flex POB-MA Toric 877PTY</Name>
            <Description>Single piece hydrophobic acrylic monofocal toric posterior chamber intraocular lens. Preloaded with blue light filter and with biconvex aspheric optic.</Description>
            <Size>Powers: +10.0 D to +30.0 D in 0.5 diopter increments  Cylinder powers: 1.00 D, 1.50 D, 2.25 D, 3.00 D, 3.75 D, 4.50 D, 5.25 D, 6.00 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL031</BillingCode>
            <Name>AcrySert C Model SN6CWS</Name>
            <Description>Posterior chamber, UV absorbing, foldable, acrylic, single piece lens with blue light protection and aspheric correction, in cartridge</Description>
            <Size>+6.0 to +30.0 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL039</BillingCode>
            <Name>AcrySof IQ Aspheric IOL with UltraSert pre-loaded delivery system</Name>
            <Description>Pre-loaded foladable Acrylic Single-piece Lens with Blue light protection and Aspheric correction (SN60WF)</Description>
            <Size>+6.0D to +30.0D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL044</BillingCode>
            <Name>Clareon AutonoMe</Name>
            <Description>The Clareon Aspheric Hydrophobic Acrylic Lens is an ultraviolet and blue light filtering foldable single-piece posterior chamber intraocular lens, provided in the AutonoMe Pre-loaded Delivery System.</Description>
            <Size>+6.0 to +30.0D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL037</BillingCode>
            <Name>MicroPure 123</Name>
            <Description>Preloaded, posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece hydrophobic glistening-free Intra Ocular Lens.</Description>
            <Size>Overall diameter of 10D to 24.5D: 11.00mm&#xD;
25D to 30D: 10.75mm&#xD;
&#xD;
Optic diameter of 10D to 24.5D: 6.00mm&#xD;
25D to 30 D: 5.75mm&#xD;
&#xD;
Power from 10D to 30D with 0.5 diopter increments.</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>211587</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL042</BillingCode>
            <Name>LuxGood Preloaded</Name>
            <Description>The LuxGood intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, blue light filtering and has aspheric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxGood lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: +00.00 D to +34.00 D: 6.0 mm +/- 0.1 mm   Overall Diameter: +00.00 D to +34.00 D: 11.00 mm +/- 0.2 mm   Power Range: +0.00 D to +34.00 D Label Increments: 0.1D</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ047</BillingCode>
            <Name>CT LUCIA 621PY</Name>
            <Description>One ZEISS UV light-absorbing Heparin Surface Hydrophobic Acrylic Posterior Chamber Intra-ocular Lens. This lens is intended to correct aphakia. It is made from an optically clear hydrophobic acrylic with yellow dye additive (Acrylmex Yellow) [Optically clear blue-light blocking]</Description>
            <Size>Dioptre Range: 00.0 to +34.0 with increments of 0.5   Optic Size: 6.0mm   Overall Length: 13.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>389793</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV250</BillingCode>
            <Name>Hoya-PS AF-1 (UY) PY-60AD</Name>
            <Description>Preloaded in cartridge, Aspheric, Blue blocker, Foldable, Single-Piece, Hydrophobic Acrylic</Description>
            <Size>+6.0D to +30.0D (0.5D steps)</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>117417</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV252</BillingCode>
            <Name>HOYA iSert® 251</Name>
            <Description>Preloaded injector system, Micro-incision, Aspheric, Blue-Blocker, Single Piece, Hydrophobic</Description>
            <Size>+6.0D to 30.0D (5 steps)</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>112674</ARTG>
                <ARTG>117417</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV264</BillingCode>
            <Name>Hoya Vivinex iSert  Preloaded IOL (Model XY1)</Name>
            <Description>Intra Ocular Lens</Description>
            <Size>Power +6 dioptres  - +30 dioptres</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>117417</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ016</BillingCode>
            <Name>PreciSAL P302A  PreciSAL PS302A</Name>
            <Description>Preloaded Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and blue light filter.</Description>
            <Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IW001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BL037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MicroPure 123</Name>
            <Description>Preloaded, posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece hydrophobic glistening-free Intra Ocular Lens.</Description>
            <Size>Overall diameter of 10D to 24.5D: 11.00mm  25D to 30D: 10.75mm    Optic diameter of 10D to 24.5D: 6.00mm  25D to 30 D: 5.75mm    Power from 10D to 30D with 0.5 diopter increments.</Size>
            <SupplierCode>IW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>363012</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG037</BillingCode>
            <Name>RayOne Hydrophobic Aspheric BLF IOL</Name>
            <Description>Hydrophobic acrylic IOL, preloaded injector system, micro incision, aspheric, UV filtering, single piece, with blue light filtering.</Description>
            <Size>Power range:   +0.0 D to +7.0 D (1.0 D increments)  +8.0 D to +30.0 D (0.5 D increments)  +31.0 D to +32.0 D (1.0 D increments)Shapes:  Biconvex (positive powers), Plano</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO067</BillingCode>
            <Name>HumanOptics Aspira Y Preloaded</Name>
            <Description>Preloaded posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic, Blue light filter</Description>
            <Size>+10.0 to +30.0 D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BiFlex Preloaded 877PAY Hydrophobic Acrylic Foldable Aspheric Monofocal Lens with Blue light Filter</Name>
            <Description>Posterior Chamber IOL, special 360° sharp edge, Aspheric - Aberration Balanced</Description>
            <Size>Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm Powers available: -0.0 - +9.0 D ±0.25 D increment: 1.0 D  +10.0 -+25.0  D ±0.25 D increment: 0.5 D  +25.5- +30.0 D ±0.5 D increment: 0.5 D  +31.0 - +35.0 D ±0.5 D increment: 1</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Basis Z Preloaded Hydrophobic IOL</Name>
            <Description>Hydrophobic preloaded IOLs</Description>
            <Size>6mm Optic Diameter and 13mm Length</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>292</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL045</BillingCode>
            <Name>AcrySof Aspheric UV Absorbing Toric Intraocular Lens</Name>
            <Description>AcrySof UV Absorbing Toric is a biconvex, toric, aspheric, UV-absorbing, single-piece, foldable, hydrophobic monofocal intraocular lens</Description>
            <Size>+6.0 to +34.0 diopter</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO041</BillingCode>
            <Name>Tecnis Toric 1-Piece IOL</Name>
            <Description>1-piece IOL Posterior chamber Intraocular lens , incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects.</Description>
            <Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments. Cylinder power: 1.00 diopter, 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75 diopter, 4.00 diopter, 4.50 diopter, 5.25 diopter and 6.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm.</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>181845</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO046</BillingCode>
            <Name>TECNIS® Eyhance Toric IOL</Name>
            <Description>1-piece enhanced monofocal toric IOL</Description>
            <Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments.  Overall diameter 13mm, Optic size 6mm.  Cylinder power: 1.00, 1.50, 2.25, 3.00, 3.75, 4.00, 4.50, 5.25 and 6.00 diopter (as measured at the IOL plane). </Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>181845</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL051</BillingCode>
            <Name>Enhanced enVista Toric IOL</Name>
            <Description>The enhanced enVista Toric (Model MX60ET) is an ultraviolet-absorbing, posterior chamber, hydrophobic acrylic toric intraocular lens (IOL). They have an aspheric lens optic, square posterior edge, and modified C haptics. The lenses can be folded for insertion into the eye.</Description>
            <Size>Specification:   Optic Body Diameter 6.0   Overall Diameter 12.5  Haptic Angulations Planar Haptic   Lens Power Range +6.0 Diopters to +30.0 Diopters in 0.5 Diopter increments </Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>98915</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE515</BillingCode>
            <Name>LENTIS TplusX LU-313T</Name>
            <Description>Foldable one-piece monofocal  toric IOL for capsular bag fixation</Description>
            <Size>Optic Size 6.0mm, overall length 11.0mm. Sph -10.0D to +36.0D (in 0.01D increments) Cyl +0.50 to +10.0D cyl (in 0.01D increments), sph  + cyl &lt;40.0D,  axis 1 degree scaling</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE517</BillingCode>
            <Name>LENTIS LS-313T0-T6</Name>
            <Description>Foldable one-piece monofocal toric acrylic IOL.</Description>
            <Size>Optic Size 6.0mm, Overall Length 11.00mm. Available diopters: +10.0D to +30.0D (0.5D). Cyl: (T0 +0.75D) (T1 +1.5D) (T2 +2.25D) (T3 +3.0D) (T4 + 3.75D) (T5 + 4.5D) (T6 +5.25D)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE674</BillingCode>
            <Name>LENTIS Tplus LU-814T</Name>
            <Description>Foldable one-piece acrylic posterior chamber aspheric toric IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description>
            <Size>Optic size: 6.2mm ,-10.0D to +23.0D (SEQ), 5.5mm +23.01D to +35.0D (SEQ) Overall length: 13.0mm, Available Dioptres: sph. -10.0D to +35.0D (0.01D increments), cyl. +0.25D to +12.0D (0.01D increments), axis. 1 degree increments.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG018</BillingCode>
            <Name>T-Flex Aspheric - Toric &lt;7 diopter</Name>
            <Description>Acrylic foldable posterior chamber IOLs, aspheric, toric &lt;7 diopter</Description>
            <Size>Standard -&#xD;
Spheres: +6.0 to +30.0 D (spherical equivalent)&#xD;
Cylinders: +1.0 to +6.0 D&#xD;
Made to Order -&#xD;
Spheres: -10.0 to +35.0 D (subject to spherical equivalent)&#xD;
Cylinders: +1.0 to +6.0 D</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN010</BillingCode>
            <Name>I-stream Toric Hydrophilic</Name>
            <Description>One-piece posterior chamber lens with aspherical surface for capsular bag fixation.</Description>
            <Size>Optic diameter: 6mm&#xD;
Total diameter: 11mm&#xD;
Diopter range: +15.0 to +25.0D (standard), 1.0 to 14.5D and 25.5 to 40.0D (made to order)&#xD;
Cylinder range: 0.75 to 6.0D</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>307407</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO060</BillingCode>
            <Name>HumanOptics Torica</Name>
            <Description>Toric posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic</Description>
            <Size>Sphere -20D to +59D, Cylinder 1D to 6D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medicontur BiFlex 677TA Hydrophilic Acrylic Foldable Toric Lens without Blue light Filter</Name>
            <Description>Posterior chamber IOL, 360° Special Square Edge,  Aspheric – Coma optimized – Toric</Description>
            <Size>Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm  Powers available:  -10.0  -  +30.0 D ±0.25 D increment:  0.5 D  +31.0  - +35.0 D ±0.5 D increment:  1.0 D  Cylinders available:    +1.5 D - +7.0 D increment:  0.75 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL032</BillingCode>
            <Name>AcrySof IQ Toric IOL</Name>
            <Description>Posterior chamber, UV absorbing, foldable, acrylic, toric, single piece lens with blue light protection and aspheric correction</Description>
            <Size>+6 to +30 D spherical, +31.0 to +34.0 (1.0 D increments); 1.00 to 	6.00 D cylinder.</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>528</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL056</BillingCode>
            <Name>Clareon Toric Aspheric Hydrophobic Acrylic IOL </Name>
            <Description>The Clareon Toric Aspheric Hydrophobic Acrylic IOL is a toric, UV-absorbing, blue light filtering, foldable, single-piece posterior chamber intraocular lens.</Description>
            <Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). Cylinder 1.00 – 6.00 diopters</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>528</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ019</BillingCode>
            <Name>PreciSAL Toric T302A</Name>
            <Description>Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV and blue light filters.</Description>
            <Size>Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; Cylinder powers from 1.0D to 6.0D</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>528</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN005</BillingCode>
            <Name>ALSAFIT TORIC VF</Name>
            <Description>Single piece toric aspheric foldable intraocular lens for implantation into the capsular bag. Violet filter.</Description>
            <Size>Diopter power range: Sphere: From 0.0 D to +32.00 D (0.50 D increments). Cylinder: From +0.50 D to +6.00 D (0.50 D increments).&#xD;
Optic size: 6mm. Overall length: 11.0mm.</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>268033</ARTG>
            </ARTGs>
            <MinimumBenefit>528</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO057</BillingCode>
            <Name>HumanOptics Torica Y</Name>
            <Description>Toric posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic, Blue light filter</Description>
            <Size>Sphere -20D to +59D, Cylinder 1D to 6D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>528</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medicontur BiFlex 677TAY Hydrophilic Acrylic Foldable Toric Lens with Blue light Filter</Name>
            <Description>Posterior chamber IOL, 360° Special Square Edge,  Aspheric – Coma optimized – Toric</Description>
            <Size>Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm  Powers available:  -10.0  -  +30.0 D ±0.25 D increment:  0.5 D   +31.0  - +35.0 D ±0.5 D increment:  1.0 D  Cylinders available:    +1.5 D - +7.0 D increment:  0.75 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>528</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS048</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Basis Z Hydrophilic Toric</Name>
            <Description>Foldable hydrophilic toric intraocular lens</Description>
            <Size>Available in spherical diopter powers from -10.0D to +35.0D in 0.5D steps from +10.0D to +30.0D and then 1.0D steps in the ranges of -10.0D to 9.0D and +31.0D to +35.0D. Cylinder Power range is 1.5-6.0D in 0.75D steps.</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>528</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO040</BillingCode>
            <Name>TECNIS® Toric 1-Piece IOL</Name>
            <Description>1-piece IOL Posterior chamber Intraocular lens, incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide a 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects.</Description>
            <Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments.  Cylinder power: 7.00 diopter, 8.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm.</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>181845</ARTG>
            </ARTGs>
            <MinimumBenefit>754</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO047</BillingCode>
            <Name>TECNIS® Eyhance Toric IOL</Name>
            <Description>1-piece enhanced monofocal toric IOL</Description>
            <Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments. Overall diameter 13mm, Optic size 6mm. Cylinder power: 7.00 and 8.00 diopter (as measured at the IOL plane).</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>181845</ARTG>
            </ARTGs>
            <MinimumBenefit>754</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG019</BillingCode>
            <Name>T-Flex Aspheric - Toric ≥7 diopter</Name>
            <Description>Acrylic foldable posterior chamber IOLs, aspheric, toric ≥7 diopter</Description>
            <Size>Standard&#xD;
Spheres: +6.0 to +30.0 D (spherical equivalent)&#xD;
Cylinders: +1.0 to +6.0 D&#xD;
Made to Order&#xD;
Spheres: -10.0 to +35.0 D (subject to spherical equivalent)&#xD;
Cylinders: +7.0 to +11.0 D</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>754</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO059</BillingCode>
            <Name>HumanOptics Torica</Name>
            <Description>Toric posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic</Description>
            <Size>Sphere -20D to +59D, Cylinder 7D to 30D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>754</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medicontur BiFlex 677TA Hydrophilic Acrylic Foldable Toric Lens without Blue light Filter</Name>
            <Description>Posterior chamber IOL, 360° Special Square Edge,  Aspheric – Coma optimized – Toric</Description>
            <Size>Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm  Powers available:  -10.0  -  +30.0 D ±0.25 D increment:  0.5 D   +31.0  - +35.0 D ±0.5 D increment:  1.0 D  Cylinders available:    +7.0 D - +9.0 D increment:  0.75 D  +9.0 D - +10.0 D increment:  1.0 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>754</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG027</BillingCode>
            <Name>RayOne Toric Aspheric preloaded - Premium/Made to Order</Name>
            <Description>Single piece preloaded aspheric toric acrylic IOL, UV absorbing, 360 square edge, anti-vaulting haptics</Description>
            <Size>-9.5 to +34.5 D SE (subject to sphere power)  +7 to +11 cylinder  Further pre-selected SE/cylinder combinations are available above and below the stated SE range.</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2, pl</Suffix>
            <ARTGs>
                <ARTG>220612</ARTG>
            </ARTGs>
            <MinimumBenefit>793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO058</BillingCode>
            <Name>HumanOptics Torica Y</Name>
            <Description>Toric posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic, Blue light filter</Description>
            <Size>Sphere -20D to +59D, Cylinder 7D to 30D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2, vblf</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medicontur BiFlex 677TAY Hydrophilic Acrylic Foldable Toric Lens with Blue light Filter</Name>
            <Description>Posterior chamber IOL, 360° Special Square Edge,  Aspheric – Coma optimized – Toric</Description>
            <Size>Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm  Powers available:  -10.0  -  +30.0 D ±0.25 D increment:  0.5 D  +31.0  - +35.0 D ±0.5 D increment:  1.0 D  Cylinders available:    +7.0 D - +9.0 D increment:  0.75 D  +9.0 D - +10.0 D increment:  1.0 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, t2, vblf</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL021</BillingCode>
            <Name>Alcon AcrySof SN60WF</Name>
            <Description>Foldable Acrylic Single-piece Lens with Blue Light Protection and Aspheric Correction</Description>
            <Size>+ 6.0 D to +30.0 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>256</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL057</BillingCode>
            <Name>Clareon Aspheric Hydrophobic Acrylic Intraocular Lens (Model SY60WF) </Name>
            <Description>Clareon™ Aspheric Hydrophobic Acrylic IOL Model SY60WF is an ultraviolet and blue light filtering, foldable, single-piece, monofocal intraocular lens. </Description>
            <Size>+6.0 to +30.0 diopters</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>256</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ015</BillingCode>
            <Name>PreciSAL 302A</Name>
            <Description>Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and blue light filter.</Description>
            <Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>256</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG036</BillingCode>
            <Name>Simedice Intraocular Lens</Name>
            <Description>Foldable Acrylic Single-piece Lens with Blue Light Protection and Aspheric Correction</Description>
            <Size>Spherical power: +10.0 to +30.0 D, in 0.5 increments</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>385552</ARTG>
            </ARTGs>
            <MinimumBenefit>256</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO055</BillingCode>
            <Name>HumanOptics Aspira Y</Name>
            <Description>Posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic, Blue light filter</Description>
            <Size>-20 to +60 D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>256</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG003</BillingCode>
            <Name>Rayner Standard Toric C-Flex</Name>
            <Description>Hydrophilic HEMA-MMA copolymer, foldable with injector</Description>
            <Size>5.00mm dia optic, 12.00mm dia overall, cyls 2.0D to 6.0D in 2D increments</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG004</BillingCode>
            <Name>Rayner Premium Toric C-Flex</Name>
            <Description>HEMA-MMA copolymer, foldable with injector</Description>
            <Size>5.75mm dia optic, 12.00mm dia overall, cyls 1.5D to 11.0D in 0.5D increments</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>t2</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>701</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG013</BillingCode>
            <Name>Rayner Super Premium Toric I.O.L.</Name>
            <Description>Acrylic foldable toric single piece I.O.L</Description>
            <Size>-10.0D to 0.00D Sphere: 1D to 11.00D Cylinder in 0.25 steps                                                           +31.00D to +35.00 Spit: 1D to 11.00D Cylinder in 0.25steps</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>t2</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>701</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL016</BillingCode>
            <Name>Alcon Acrysof Natural Model SN60AT</Name>
            <Description>Foldable Acrylic Single-piece Lens, asymmetric optic/consistent edge, with blue light protection</Description>
            <Size>+6 to +40D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL025</BillingCode>
            <Name>AcrySof Multipiece Models MN60MA, MN60AC</Name>
            <Description>Foldable Acrylic multi-piece Lens with Blue light Protection</Description>
            <Size>- 5 D to + 30 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <Suffix>vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL004</BillingCode>
            <Name> Acrysof Multipiece Models MA50BM, MA60AC, MA60MA</Name>
            <Description>Foldable Acrylic Multi-piece Lens</Description>
            <Size> -5 D to +30 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL011</BillingCode>
            <Name>Acrysof Model SA60AT</Name>
            <Description>Foldable Acrylic Single-piece Lens, asymmetric optic/consistent edge</Description>
            <Size>Range of Powers: +6 to +40 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO002</BillingCode>
            <Name>Sensar  AR40 Monofocal Acrylic IOL,  Sensar OptiEdge AR40e Foldable Acrylic IOL</Name>
            <Description>Soft Acrylic, Foldable, UV Absorbing, Posterior</Description>
            <Size>Range available from -10D to +30D. 6 mm Optic Diameter x 13mm in overall length.</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <ARTGs>
                <ARTG>99891</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ041</BillingCode>
            <Name>CT LUCIA 202</Name>
            <Description>Foldable, 3-piece, monofocal, square-edged, hydrophobic acrylic intraocular lens.</Description>
            <Size>Diopter size: 4.0 to 34.0 DS.  Optic size: 6mm.  Overall length: 13mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG001</BillingCode>
            <Name>Rayner C-Flex</Name>
            <Description>Hydrophilic HEMA-MMA copolymer, foldable with injector</Description>
            <Size>5.75mm dia optic, 12.00mm dia overall</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG002</BillingCode>
            <Name>Superflex</Name>
            <Description>Hydrophilic HEMA-MMA copolymer, foldable with injector</Description>
            <Size>6.25mm dia optic, 12.5mm dia overall</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3892</SubGroupID>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>225</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL052</BillingCode>
            <Name>Clareon PanOptix Trifocal UV Absorbing Intraocular Lens (Model CCWTT0) </Name>
            <Description>The Clareon PanOptix Trifocal UV Absorbing Intraocular Lens (Model CCWTT0) is a presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber, multifocal IOL </Description>
            <Size>+6.0 to +30.0 diopters</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO037</BillingCode>
            <Name>TECNIS® Symfony Extended Range of Vision (ZXR00)</Name>
            <Description>Extended Range of Vision Posterior Chamber IOL</Description>
            <Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments Overall diamter 13mm, Optic size 6mm</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>170331</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE496</BillingCode>
            <Name>LENTIS Mplus   LENTIS Comfort</Name>
            <Description>Foldable one-piece multifocal plate haptic acrylic IOL</Description>
            <Size>Overall Length 11.0mm and Optic Size 6.0mm.  Available diopters -10.0D to -1.0D (1.0D), 0.0D to +36.0D (0.5D)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE650</BillingCode>
            <Name>FEMTIS Comfort FB-313MF15</Name>
            <Description>Foldable one-piece multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description>
            <Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: +15.0D to 30.0D (0.5D steps)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE675</BillingCode>
            <Name>LENTIS Mplus LU-814MF30</Name>
            <Description>Foldable one-piece acrylic posterior chamber aspheric multifocal IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description>
            <Size>Optic size: 6.2mm , 0.0D to +23.0D,  5.5mm +23.01D to +36.0D Overall length: 13.0mm, Available Dioptres: 0.0D to +36.0D (0.5D increments).</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE764</BillingCode>
            <Name>LENTIS Comfort LU-814MF15</Name>
            <Description>Foldable one-piece acrylic posterior chamber aspheric multifocal IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description>
            <Size>Optic size: 6.2mm, Overall length: 13.0mm, Available Dioptres: 0.0D to +36.0D (0.5D increments).</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE785</BillingCode>
            <Name>FEMTIS Mplus FB-313MF30</Name>
            <Description>Foldable one-piece multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description>
            <Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: +15.0D to 30.0D (0.5Dsteps)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER281</BillingCode>
            <Name>IC-8, Hydrophobic Small Aperture Intraocular Lens</Name>
            <Description>A hydrophobic posterior chamber intraocular lens (IOL), embedded with a central circular mask, which operates under the principle of small aperture optics to reduce near vision blur and provide seamless extended range vision from distance to near.</Description>
            <Size>The overall diameter is 12.5 millimetres with a 6 millimetre diameter aspheric optic.</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>236210</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ023</BillingCode>
            <Name>PreciSAL Multifocal M302AC</Name>
            <Description>Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic edge, 360 degree optic square edge design, precision power calculation, abreration technology, pupil independent diffractive anterior surface with a near sigh correction addition of up to +3.5D, and UV Filter.</Description>
            <Size>Available in spherical dioptric powers from 0.0D to +30.0D. 1D steps: 0.0D to+10.0D; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG009</BillingCode>
            <Name>Rayner "M-Flex" Mulitfocal Foldable IOL</Name>
            <Description>Acrylic, Foldable, Single piece multi-zoned refractive aspheric multifocal with Amon-Apple 360 Degree Square edge, Anti Vaulting Haptics</Description>
            <Size>6.5mm Optic-Overall diameter 12.5mm: +3D or + 4D Addition: +14D to +25D in 1.0D increments: +8.5D to +23.5D in 0.5D increments</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO063</BillingCode>
            <Name>HumanOptics Diffractiva</Name>
            <Description>Multifocal posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic</Description>
            <Size>Sphere: +10D to +30D, Near addition +3.5D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS045</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Basis Z Progressive IOL</Name>
            <Description>Progressive Hydrophilic IOL</Description>
            <Size>Optic Diameter: 6mm  Length: 13mm</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL053</BillingCode>
            <Name>Clareon PanOptix Trifocal UV Absorbing IOL with the AutonoMe Automated Pre-loaded Delivery System</Name>
            <Description>The Clareon PanOptix Trifocal UV Absorbing IOL with the AutonoMe Automated Pre-loaded Delivery System is a presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber, multifocal IOL, pre-loaded on the AutonoMe Automated Delivery System </Description>
            <Size>+6.0 to +30.0 diopters </Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL047</BillingCode>
            <Name>LuxSmart Preloaded Crystal</Name>
            <Description>The LuxSmart intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL and has aspheric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxSmart lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: +00.00 D to +34.00 D: 6.0 mm +/- 0.1 mm Overall Diameter: +00.00 D to +34.00 D: 11.00 mm +/- 0.2 mm Power Range: +0.00 D to +34.00 D Label Increments: 0.1D</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ034</BillingCode>
            <Name>AT LISA tri 839MP</Name>
            <Description>Trifocal (aspheric) micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system.  The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description>
            <Size>Diopter range: 0.0 to +32.0D (0.5D increments). Optic size: 6.0mm. Overall Length: 11.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>134490</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ042</BillingCode>
            <Name>AT LARA 829MP</Name>
            <Description>Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system, aberration neutral aspheric optical design</Description>
            <Size>Diopter range: -10.0 D to +32.0 D, 0.5 increments&#xD;
Optic size: 6mm&#xD;
Overall length: 11mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ024</BillingCode>
            <Name>PreciSAL Mulitfocal PM302AC</Name>
            <Description>Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optichaptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV filter.</Description>
            <Size>Available in spherical dioptric powers from 0.0 to +30.0.  1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DV271</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RayOne Trifocal</Name>
            <Description>Diffractive step trifocal with smooth transition and reduced light loss</Description>
            <Size>0.0 D to +30.0D (increments 0.5D)</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>220612</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG034</BillingCode>
            <Name>RayOne EMV RAO200E Intraocular lens</Name>
            <Description>RayOne EMV Model 200E is an extended vision, non-diffractive, UV-Absorbing, single-piece, foldable, hydrophilic, posterior chamber intraocular lens.  Provided preloaded in two-step injector.</Description>
            <Size>6mm optic, Power range +10.0 to +30.0D (0.5D increments)</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>220612</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO065</BillingCode>
            <Name>HumanOptics Diffractiva Preloaded</Name>
            <Description>Preloaded Multifocal posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic</Description>
            <Size>Sphere: +10D to +30D, Near addition +3.5D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL050</BillingCode>
            <Name>LuxSmart Toric Preloaded Crystal</Name>
            <Description>The LuxSmart Toric intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, and has aspheric and toric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxSmart lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: 6.0 mm; Overall Diameter: 11 mm; Haptic Angle: 0° ; Powers: +6.00 to +34.00 Diopters; Cylindrical Powers: +0.75 to +6.00 Diopters </Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>918</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ036</BillingCode>
            <Name>AT LISA tri Toric 939MP</Name>
            <Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and + 1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision,</Description>
            <Size>Diopter range -10.00 to +28.0 and +1 to +4.0 DC Optic size: 6..00mml; Overall length: 11.mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>918</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ046</BillingCode>
            <Name>AT LARA toric 929MP</Name>
            <Description>Bitoric Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation implantable with preloaded injector system, aberration neutral aspheric optical design</Description>
            <Size>Diopter range SE: - 8.0 D to + 32.0 D in 0.5 increments&#xD;
Cylinder: + 1.0 D to + 4.0 D in 0.5 increments&#xD;
Further preselected SE/cylinder combinations are available above and below the stated SE range.&#xD;
Optic size: 6mm, total diameter: 11mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>918</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG023</BillingCode>
            <Name>RayOne Trifocal Toric</Name>
            <Description>Trifocal posterior chamber, toric, aberration-neutral technology, pre-loaded single piece acrylic IOL.</Description>
            <Size>Spherical Equivalent: +6.0 D to +30.0 D (0.5 D increments), Cylinders: +0.75 D, +1.5 D, +2.25 D, +3.0 D, +3.75 D, +4.5 D, Trifocal, diffractive, +3.5 D near add and +1.75 D intermediate add at the IOL plane</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>220612</ARTG>
            </ARTGs>
            <MinimumBenefit>918</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO081</BillingCode>
            <Name>HumanOptics ToricaDiff Preloaded</Name>
            <Description>Preloaded Toric Multifocal posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic</Description>
            <Size>Sphere +10D to +30D, Cylinder 1D to 6D, Near addition +3.5D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, t1</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>918</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL049</BillingCode>
            <Name>LuxSmart Toric Preloaded</Name>
            <Description>The LuxSmart Toric intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, with blue light filtering and has aspheric and toric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxSmart lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: 6.0 mm; Overall Diameter: 11 mm; Haptic Angle: 0° ; Powers: +6.00 to +34.00 Diopters; Cylindrical Powers: +0.75 to +6.00 Diopters </Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, t1, vlbf</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO080</BillingCode>
            <Name>HumanOptics ToricaDiff Y Preloaded</Name>
            <Description>Preloaded Toric Multifocal posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic, Blue light filter</Description>
            <Size>Sphere +10D to +30D, Cylinder 1D to 6D, Near addition +3.5D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, t1, vlbf</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL048</BillingCode>
            <Name>LuxSmart Preloaded</Name>
            <Description>The LuxSmart intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior  chamber, hydrophobic acrylic IOL, blue light filtering and has aspheric optics. The lens is  provided sterile and is designed to be folded prior to insertion into the eye. The preloaded  intraocular LuxSmart lens is supplied with an Accuject Pro Delivery System to provide a  touch-free method of delivery of the lens into the capsular bag.</Description>
            <Size>Body Diameter: +00.00 D to +34.00 D: 6.0 mm +/- 0.1 mm Overall Diameter: +00.00 D to  +34.00 D: 11.00 mm +/- 0.2 mm Power Range: +0.00 D to +34.00 D Label Increments:  0.1D</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>342175</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ025</BillingCode>
            <Name>PreciSAL Multifocal PM302A</Name>
            <Description>Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optichaptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV and blue filter powers.</Description>
            <Size>Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO066</BillingCode>
            <Name>HumanOptics Diffractiva Y Preloaded</Name>
            <Description>Preloaded Multifocal posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic, Blue light filter</Description>
            <Size>Sphere: +10D to +30D, Near addition +3.5D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medicontur BiFlex Preloaded 677PMY Hydrophilic Acrylic Foldable Multifocal Lens with Blue light Filter</Name>
            <Description>Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized</Description>
            <Size>Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm  Powers available:   -10.0 - +9.0 D ±0.25 D increment:  1.0 D  +10.0 - +25.0 D ±0.25 D increment:  0.5 D   +25.5 - +30.0 D ±0.5 D increment:  0.5 D   +31.0- +45.0 D ±0. D increment:  1.0 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, pl, vblf</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO038</BillingCode>
            <Name>TECNIS Symfony Toric Extended Range of Vision (ZXT00)</Name>
            <Description>Extended Range of Vision Toric Multifocal Posterior Chamber IOL</Description>
            <Size>+6 to +30 in 0.5d steps Available Cyl powers +1.0d, 1.5d, 2.25d, 3.00d, 3.75d, 4.5d, 5.25d, 6.00d</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>181845</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ038</BillingCode>
            <Name>AT LISA tri toric 939M low cylinder</Name>
            <Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation.  The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description>
            <Size>Diopter range: -10.00 to + 32.0 DS and +1 to +6.5DC&#xD;
Optic Size: 6.0mm. Overall Length: 11.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ045</BillingCode>
            <Name>AT LARA toric 929M low cylinder</Name>
            <Description>Bitoric Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation implantable with injector system, aberration neutral aspheric optical design</Description>
            <Size>Diopter range SE: - 4.0 D to + 32.0 D in 0.5 increments&#xD;
Cylinder: + 4.5 D to + 6.5 D increments&#xD;
Further preselected SE/cylinder combinations are available above and below the stated SE range.&#xD;
Optic size: 6mm, total diameter: 11mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE494</BillingCode>
            <Name>LENTIS Mplus Toric LU-313MFT</Name>
            <Description>Patient specific one-piece multifocal-toric plate haptic acrylic IOL</Description>
            <Size>Overall Length 11.0mm and Optic Size 6.0 + 0.0D to +36.0D inclusive in 0.01D increments. Cyl +0.50 to +12.00D inclusive in 0.01D increments  sph + cyl &lt;40.0D  axis 1 degree scaling</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE526</BillingCode>
            <Name>LENTIS Comfort Toric LS-313MF15T0-T6</Name>
            <Description>Foldable one piece multifocal toric plate haptic acrylic IOL</Description>
            <Size>Overall Length 11.0mm and Optic Size 6.0mm, SE: +10.0D to +30.0D (0.5D steps), Cyl: +0.75D to +5.25D (0.75D steps).</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE676</BillingCode>
            <Name>LENTIS Mplus toric LU-814MF30T</Name>
            <Description>Foldable one-piece acrylic posterior chamber aspheric multifocal toric IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description>
            <Size>Optic size: 6.2mm, Overall length: 13.0mm, Available Dioptres: sph. 0.0D to +36.0D (0.01D increments), cyl. +0.50D to +12.0D (0.01D increments), axis 1 deg. increments.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE718</BillingCode>
            <Name>FEMTIS Comfort Toric FB-313MF15T0-T3</Name>
            <Description>Foldable one-piece toric multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description>
            <Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: SE +15.0D to 30.0D (0.5Dsteps), cyl  T0 +0.75D | T1 +1.5D | T2 +2.25D | T3 +3.0D</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE765</BillingCode>
            <Name>LENTIS Mplus Toric LU-814MF15T</Name>
            <Description>Foldable one-piece acrylic posterior chamber aspheric multifocal toric IOL for capsular bag,sulcus and sulcus-sclera fixation</Description>
            <Size>Optic size: 6.2mm,Overall length:13.0mm, Available Dioptres: sph. 0.0D to +36.0D (0.01D increments), cyl. +0.25D to +12.0D (0.01D increments), axis 1 deg. increments</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE786</BillingCode>
            <Name>FEMTIS Mplus Toric FB313MF30T0-T3</Name>
            <Description>Foldable one-piece toric multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description>
            <Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: SE +15.0D to +30.0D (0.5Dsteps), cyl T0 +0.75D | T1 +1.5D | T2 +2.25D | T3 +3.0D</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG010</BillingCode>
            <Name>Rayner M-Flex Toric (Standard)</Name>
            <Description>Acrylic, Foldable, Single Piece, Multi-zoned Refractive Aspheric Toric Mulitfocal with Amon-Apple enhanced 360 degree Square edge, Anti Vaulting Haptics</Description>
            <Size>5.75mm / 12.0mm: 6.25mm / 12.5mm +3.00D or +4.00D Addition FAR: +14.0D to +32.00D in 0.5 STEPS: +2.00D +3.00D  +4.00D Cylinder. NEAR: +14.0D to 27.0D in 0.5 STEPS: +2.00D +3.00D  +4.00D Cylinder</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG011</BillingCode>
            <Name>Rayner "M-Flex" Toric (Non Standard)</Name>
            <Description>Acrylic, Foldable, Single Piece, Muli-Zoned Refractive, Toric Multifocal with Amon-Apple enhanced 360 Degree square edge, Anti-vaulting Haptics, Patient Specific.</Description>
            <Size>5.75/12.0mm: 6.25/12.5mm +3.00D to +4.00D Addition FAR: +14.0D to +32.0D in 0.5D Increments: NEAR: +14.0D to +27.0D in 0.50D Increments Cylinder: 1.0D to 1.5D and 2.5D to 6.00D in 0.5 increments</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL033</BillingCode>
            <Name>AcrySof IQ ReSTOR multifocal toric IOL (SND1T2-T6; SV25T2-T6)</Name>
            <Description>Posterior chamber UV absorbing foldable, acrylic, aspheric, toric single piece lens with apodised diffractive optic and blue light protection.</Description>
            <Size>+6  to +34 D spherical; 1.00 to 3.75 D cylinder</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL043</BillingCode>
            <Name>AcrySof IQ PanOptix Toric Trifocal IOL</Name>
            <Description>Trifocal posterior chamber, toric, UV absorbing, foldable, acrylic, aspheric, single piece lens with apodised diffractive trifocal optic and blue light protection.  The apodised diffractive trifocal optic (anterior) provides two diffractive focal points (+3.25D near focus and 2.17D intermediate focus).</Description>
            <Size>+6.0 to +30.0D in 0.5 Diopter increments and +31.0 to +34.0D in 1.0 Diopter increments. Cylinder: +1.0; +1.50; +2.25; +3.00 and +3.75 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL046</BillingCode>
            <Name>AcrySof IQ Vivity Toric Extended Vision Intraocular Lens</Name>
            <Description>Vivity Toric Models DFT215, DFT315, DFT415, DFT515 and DFT615 are a toric, extended vision, non-diffractive, UV-absorbing and blue light filtering, single-piece, foldable, hydrophobic, posterior chamber intraocular lens.</Description>
            <Size>+10.0 to +30.0 diopters;   Cylinder: 1.0 to 3.75 diopters</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL058</BillingCode>
            <Name>Clareon PanOptix Toric Trifocal Hydrophobic Intraocular Lens (Models CNWTT2 – CNWTT6) </Name>
            <Description>Clareon PanOptix Toric Trifocal Hydrophobic IOL is a toric, presbyopia correcting, hydrophobic, UV-absorbing, blue light filtering, foldable, single-piece, posterior chamber, multifocal IOL</Description>
            <Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopter in 1.0 diopter increments with a +2.17 diopter intermediate and a +3.25 diopter near add power; Cylinder 1.00 to 3.75 diopters.</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO045</BillingCode>
            <Name>TECNIS® Synergy Toric IOL</Name>
            <Description>1-piece continuous multifocal toric IOL</Description>
            <Size>+5.0 Diopters to +34.0 Diopters in 0.5 Diopter increments.  Overall diameter 13mm, optic size 6mm  Cylinder powers 1.00 D, 1.50 D, 2.25 D, 3.00 D, 3.75 D, 4.50 D, 5.25 D, and 6.00 D (as measured on the IOL plane).</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>181845</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL036</BillingCode>
            <Name>FineVision Toric POD FT</Name>
            <Description>Posterior chamber, toric, trifocal diffractive (aspheric), UV and blue light blocker, single piece acrylic IOL.</Description>
            <Size>An overall diameter of 11.40mm and optic diameter of 6.00mm. From 0 to +35 Diopters with 0.5 diopter increments.</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>211587</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL046</BillingCode>
            <Name>FINEVISION HP TORIC (POD FT 49P)</Name>
            <Description>The POD FT 49P (FINEVISION HP TORIC) posterior chamber intraocular lens is indicated for the replacement of the human lens to achieve the visual correction of aphakia and pre-existing corneal astigmatism in astigmatic adult patients in whom a cataractous lens has been removed by phacoemulsification who desire improved uncorrected vision, reduction of residual refractive cylinder, useful near and intermediate visual functions, and reduced spectacle dependence. The intraocular lens is intended to maintain rotational stability after placement in the capsular bag and is intended to be placed in the capsular bag. The GF-Glistening Free, material is an acrylic copolymer of medical quality which includes a UV absorbing filter. For the yellow intraocular lenses, a blue light-filtering chromophore is covalently bounded to the UV-absorbing material and the spectral transmittance through a central diopter IOL. They have biconvex optics with an aspheric anterior diffractive trifocal structure that partitions the light to give pseudo-accommodative vision and a posterior toric optic which compensates for corneal astigmatism. The add-power for near vision is + 3.5 diopters and for the intermediate vision + 1.75 diopters at IOL plane allowing the patient to benefit from near vision without a reading aid, and from increased spectacle independence for near and intermediate visions.</Description>
            <Size>Optic diameter: 6.00mm; Total diameter: 11.40mm; From 6 to +35 Diopters, with 0.5 Diopter increments; Cylinders (IOL Plane) 1.00D, 1.50D, 2.25D, 3.00D, 3.75D, 4.50D, 5.25D, 6.00D.</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>211587</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE523</BillingCode>
            <Name>LENTIS Mplus LU-313MFTY</Name>
            <Description>Patient specific one-piece multifocal toric plate haptic acrylic IOL. Violet light filter.</Description>
            <Size>Overall Length 11.0mm and Optic Size 6.0mm, +-0.0D to +36.0D inclusive in 0.01D increments. Cyl +0.50D to +12.0D inclusive in 0.01D increments, axis 1 degree increments</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE778</BillingCode>
            <Name>Acunex Vario Toric AN6VT</Name>
            <Description>Foldable one-piece acrylic EDOF C loop IOL with aspheric surface and violet blue light filter.</Description>
            <Size>Overall Length 12.5mm and Optic Size 6.0mm, SE: +10.0D to +30.0D (0.5D steps), cyl: T0 +0.75D  T1 +1.5D  T2 +2.25D  T3 +3.0D, ADD +1.5D.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE789</BillingCode>
            <Name>Acunex Variomax Toric AN6VMT</Name>
            <Description>Foldable one-piece acrylic Multifocal C loop IOL with aspheric surface and violet blue light filter.</Description>
            <Size>Overall Length 12.5mm and Optic Size 6.0mm, SE: +10.0D to +30.0D (0.5D steps), cyl: T0 +0.75D T1 +1.5D T2 +2.25D T3 +3.0D, ADD +3.0D.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IW002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BL036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>FineVision Toric POD FT</Name>
            <Description>Posterior chamber, toric, trifocal diffractive (aspheric), UV and blue light blocker, single piece acrylic IOL.</Description>
            <Size>An overall diameter of 11.40mm and optic diameter of 6.00mm. From 0 to +35 Diopters with 0.5 diopter increments.</Size>
            <SupplierCode>IW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>363012</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>677MTY</Name>
            <Description>BiFlex Single-Piece Aspheric Hydrophilic Progressive Diffractive Toric IOL with Blue filter and 360' Special Square Edge for implantation into capsular bag</Description>
            <Size>Optic diameter: 6.0 mm ±0.05 mm, Overall diameter: 13.0 mm ±0.10 mm  Powers available:   -10.0  -  +30.0 D ±0.25 D increment:  0.5 D    Cylinders available:              +1.0 D - +4.5 D increment:  0.5 D     +5.25D - +6.0 D increment:  0.75 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS047</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Basis Z Hydrophilic Toric Progressive IOL</Name>
            <Description>One piece foldable hydrophilic progressive toric intraoccular lens</Description>
            <Size>Available in spherical diopter powers from +10D to 35D in 0.5 steps  Cylindrical powers range from 1.0-6.0D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t1, vblf</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>934</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ039</BillingCode>
            <Name>AT LISA tri toric 939M high powered cylinder</Name>
            <Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description>
            <Size>Diopter range: -10.00 to + 32.0 DS and +7 to +12 DC&#xD;
Optic Size: 6.0mm. Overall Length: 11.0mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>1130</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ044</BillingCode>
            <Name>AT LARA toric 929M high cylinder</Name>
            <Description>Bitoric Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation implantable with injector system, aberration neutral aspheric optical design</Description>
            <Size>Diopter range SE: - 4.0 D to + 32.0 D in 0.5 increments&#xD;
Cylinder: + 7.0 D to + 12.0 D increments&#xD;
Further preselected SE/cylinder combinations are available above and below the stated SE range.&#xD;
Optic size: 6mm, total diameter: 11mm</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, t2</Suffix>
            <ARTGs>
                <ARTG>151348</ARTG>
            </ARTGs>
            <MinimumBenefit>1130</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL030</BillingCode>
            <Name>AcrySof IQ ReSTOR SN6AD1, SV25T0 and MN6AD1</Name>
            <Description>Posterior Chamber, UV absorbing, foldable, acrylic, single piece lens with apodised diffractive optic and blue light protection</Description>
            <Size>+6 D to + 34 D</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL040</BillingCode>
            <Name>AcrySof IQ PanOptix Trifocal IOL</Name>
            <Description>Trifocal posterior chamber, UV absorbing, foldable, acrylic, aspheric, single piece lens with apodised diffractive trifocal optic and blue light protection.  The apodised diffractive trifocal optic (anterior) provides two diffractive focal points (+3.25D near focus and 2.17D intermediate focus).</Description>
            <Size>+6.0 to +30.0D in 0.5 Diopter increments and +31.0 to +34.0D in 1.0 Diopter increments</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL050</BillingCode>
            <Name>AcrySof IQ Vivity Extended Vision Intraocular Lens</Name>
            <Description>Vivity Model DFT015 is an extended vision, non-diffractive, UV-absorbing and blue light filtering, single-piece, foldable, hydrophobic, posterior chamber intraocular lens</Description>
            <Size>+10.0 to +30.0 diopters</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL051</BillingCode>
            <Name>Clareon PanOptix Trifocal Hydrophobic Intraocular Lens (Model CNWTT0) </Name>
            <Description>The Clareon PanOptix Trifocal Hydrophobic Intraocular Lens (Model CNWTT0) is a presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber, multifocal IOL </Description>
            <Size> +6.0 to +30.0 diopters</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>92318</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO044</BillingCode>
            <Name>TECNIS Synergy IOL</Name>
            <Description>1-piece continuous multifocal IOL</Description>
            <Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments. Overall diameter 13mm, optic size 6mm</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>170331</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL034</BillingCode>
            <Name>FineVision Micro F</Name>
            <Description>Posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece lens with apodised diffractive , trifocal optic and blue light protection</Description>
            <Size>An overall diameter of 10.75mm and optic diameter of 6.15mm. From 0 to +35 dopters with 0.5 diopter increments.</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>211587</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL038</BillingCode>
            <Name>B+L FINEVISION HP (POD F GF)</Name>
            <Description>POD F GF test intraocular lens (IOL) is a foldable IOL with a quadripode “POD” open-loop design intended for capsular bag implantation. The IOL is made of the proprietary hydrophobic glistening-free (GFree®) material containing a UV-blocker and additional blue blocker. The material is a hydrophobic acrylic copolymer of medical quality which includes a UV (wavelength &lt; 400 nm) absorbing filter and a blue light-filtering chromophore which is covalently bounded to the hydrophobic material.&#xD;
The optical part of the test POD F GF lens is biconvex and aspherical partially compensating the positive spherical aberration of the cornea. The optic bears a diffractive TRIFOCAL element on its anterior side (toward patient pupil), allowing for presbyopia correction and spectacle independence for near and intermediate visions. The add-power at the IOL plane for the near vision is + 3.5 diopters and for the intermediate vision + 1.75 diopters.&#xD;
POD F GF is intended for implantation in the capsular bag after  human lens extraction after cataract. The IOL material is capable of being folded prior to insertion, allowing placement through an incision (2.0-2.2 mm) smaller than the optic diameter of the lens. After surgical insertion into the eye, the lens unfolds to ReSTOR the optical performance. The supporting haptics provide for proper positioning and fixation of the IOL optic within the eye.</Description>
            <Size>Optic diameter: 6.00mm&#xD;
Total diameter: 11.40mm&#xD;
From Ø to +35 Diopters, with 0.5 Diopter increments</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>211587</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE766</BillingCode>
            <Name>Acunex Variomax AN6VM</Name>
            <Description>Foldable one-piece acrylic multifocal C loop IOL with aspheric surface and violet blue light filter.</Description>
            <Size>Overall Length 12.5mm and Optic Size 6.0mm, SE +10.0D to +30.0D (0.5D steps), ADD +3.0D.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE774</BillingCode>
            <Name>Acunex Vario AN6V</Name>
            <Description>Foldable one-piece acrylic EDOF C loop IOL with aspheric surface and violet blue light filter.</Description>
            <Size>Overall Length 12.5mm and Optic Size 6.0mm, SE +10.0D to +30.0D (0.5D steps), ADD +1.5D.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>328681</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ022</BillingCode>
            <Name>PresiSAL Multifocal M302A</Name>
            <Description>Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation. Aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV and blue light fliters.</Description>
            <Size>Available in sperical dioptric powers from 0.0D to +30.0D. 1D steps: 0.0D to +10.0D; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>183558</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IW003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BL034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>FineVision Micro F</Name>
            <Description>Posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece lens with apodised diffractive , trifocal optic and blue light protection</Description>
            <Size>An overall diameter of 10.75mm and optic diameter of 6.15mm. From 0 to +35 dopters with 0.5 diopter increments.</Size>
            <SupplierCode>IW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>363012</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IW004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BL038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>B+L FINEVISION HP (POD F GF)</Name>
            <Description>POD F GF test intraocular lens (IOL) is a foldable IOL with a quadripode “POD” open-loop design intended for capsular bag implantation. The IOL is made of the proprietary hydrophobic glistening-free(GFree®) material containing a UV-blocker and additional blue blocker. The material is a hydrophobic acrylic copolymer of medical quality which includes a UV(wavelength less than 400 nm) absorbing filter and a blue light-filtering chromophore which is covalently bounded to the hydrophobic material.  The optical part of the test POD F GF lens is biconvex and aspherical partially compensating the positive spherical aberration of the cornea. The optic bears a diffractive TRIFOCAL element on its anterior side (toward patient pupil), allowing for presbyopia correction and spectacle independence for near and intermediate visions. The add-power at the IOL plane for the near vision is + 3.5 diopters and for the intermediate vision + 1.75 diopters. POD F GF is intended for implantation in the capsular bag after human lens extraction after cataract. The IOL material is capable of being folded prior to insertion, allowing placement through an incision (2.0-2.2 mm) smaller than the optic diameter of the lens. After surgical insertion into the eye, the lens unfolds to ReSTOR the optical performance. The supporting haptics provide for proper positioning and fixation of the IOL optic within the eye</Description>
            <Size>Optic diameter: 6.00mm  Total diameter: 11.40mm  From Ø to +35 Diopters, with 0.5 Diopter increments</Size>
            <SupplierCode>IW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>363012</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN004</BillingCode>
            <Name>ALSAFIT TRIFOCAL VF</Name>
            <Description>Single piece trifocal aspheric foldable intraocular lens for implantation into the capsular bag. Violet filter.</Description>
            <Size>Diopter power range: 0.0 D to +32.00 D (0.50 D increments).&#xD;
Optic size: 6mm. Overall length: 11.0mm.</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>268033</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO064</BillingCode>
            <Name>HumanOptics Diffractiva Y</Name>
            <Description>Multifocal posterior chamber IOL, foldable, UV absorber, Aspheric, aberration technology, 360° LEC barrier, HD optic, Blue light filter</Description>
            <Size>Sphere: +10D to +30D, Near addition +3.5D</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>227764</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medicontur BiFlex 677MY Hydrophilic Acrylic Foldable Multifocal Lens with Blue light Filter</Name>
            <Description>Posterior chamber IOL, 360° Special Square Edge, Aspheric – Coma optimized</Description>
            <Size>Optic diameter: 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm ±0.20 mm  Powers available:   -10.0 - +9.0 D ±0.25 D increment:  1.0 D  +10.0 - +25.0 D ±0.25 D increment:  0.5 D   +25.5 - +30.0 D ±0.5 D increment:  0.5 D   +31.0- +45.0 D ±0. D increment:  1.0 D</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1327</GroupID>
            <SubGroupID>3893</SubGroupID>
            <Suffix>at, vblf</Suffix>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>651</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG008</BillingCode>
            <Name>Rayner "Sulcoflex" Pseudophakic I.O.L.</Name>
            <Description>Sulcoflex Aspheric Pseudophakic I.O.L</Description>
            <Size>-5D to +5D</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3895</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG024</BillingCode>
            <Name>Rayner Sulcoflex Ashperic (Premium) I.O.L.</Name>
            <Description>Pseudophakic Supplementary I.O.L.O.L.</Description>
            <Size>-10.0D to -5.50D in 0.5D increments.                +5.50D to 10.00D in 0.5D increments</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3895</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG005</BillingCode>
            <Name>Rayner Sulcoflex Aspheric Toric Pseudophakic Secondary I.O.L - Standard</Name>
            <Description>Acrylic, Aspheric, Toric Pseudophakic Secondary IOL :  Sulcus fixated with undulating Haptics and Posterior Haptic Angulation (Standard)</Description>
            <Size>SE -3 to +3 in 0.5 D steps&#xD;
Cyl +1 to +3 in 1D steps</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3895</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>567</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG007</BillingCode>
            <Name>Rayner Sulcoflex Aspheric Toric Pseudophakic Secondary IOL (Premium)</Name>
            <Description>Acrylic, Aspheric, Toric Pseudophakic Secondary IOL: Sulcus fixated with undulating Haptics and Posterior Haptic Angulation (Premium)</Description>
            <Size>SE -7.00 to +7.00 in 0.5 D steps; Cyl +1.00 to +6.00 in 0.5D steps</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3895</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>567</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>AddOn SML</Name>
            <Description>Add-on hydrophilic lens for macular degeneration</Description>
            <Size>Central Optic Diameter - 1.5mm  Optic Diameter - 6mm  Length - 13mm</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3895</SubGroupID>
            <Suffix>hm</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>634</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS041</PriorBillingCode>
            </PriorBillingCodes>
            <Name>AddOn Toric</Name>
            <Description>Add on hydrophilic toric lens</Description>
            <Size>Optic Diameter: 6mm  Length:13mm</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3895</SubGroupID>
            <Suffix>t1</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>AddOn Spherical</Name>
            <Description>Add on hydrophilic spherical intraocular lens</Description>
            <Size>Optic Diameter: 6mm  Length: 13mm</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3895</SubGroupID>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG006</BillingCode>
            <Name>Rayner "Sulcoflex" Aspheric Multi-focal Pseudophakic Secondary IOL</Name>
            <Description>Acrylic, Aspheric Multi-focal Pseudophakic Secondary IOL: Sulcus-Fixated with Undulating Haptics and Posterior Haptic Angulation</Description>
            <Size>6.5mm / 13.5mm - 5.00D+5.00D sphere with  + 3.00 Addition</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG022</BillingCode>
            <Name>Sulcoflex Trifocal</Name>
            <Description>Acrylic, aberration-neutral, trifocal pseudophakic secondary IOL; sulcus-fixated with undulating and rounded C-loop haptics.</Description>
            <Size>Power range: -3.0 D to +3.0 D (increments 0.5 D). -1.0 D to +1.0 D (increments 0.25 D)&#xD;
Trifocal, diffractive,&#xD;
+3.5 D near add and +1.75 D intermediate add at the IOL plane</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <Suffix>at</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DV254</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Rayner Premium Sulcoflex Multifocal Toric Supplementary IOL</Name>
            <Description>653Z-Premium Multifocal Toric Supplementary IOL</Description>
            <Size>-7D to +7D (Spherical Equivalent) Cylinder 1D, 4D, 5D, 6D Addition 3.5D</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>973</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DV255</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Rayner Standard Sulcoflex Multifocal Toric Supplementary IOL</Name>
            <Description>653Z-Standard Multifocal Toric Supplementary IOL</Description>
            <Size>-3D to +3D (Spherical Equivalent) Cylinders 2D and 3D Addition 3.5D</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>100926</ARTG>
            </ARTGs>
            <MinimumBenefit>973</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS049</PriorBillingCode>
            </PriorBillingCodes>
            <Name>1stQ addon progressive toric lens</Name>
            <Description>One piece, foldable intraocular lens (IOL), biocompatible hydrophilic acrylic (25% water content), as additional IOL in combination with a Basis IOL.  Fixation is in the sulcus.</Description>
            <Size>-3.0D to +3.0D spherical equivalent in 0.5D steps and +1.0D to +4.5D cylindrical in 0.5D steps and +3.0D add</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <Suffix>at, t1</Suffix>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>973</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV272</BillingCode>
            <Name>XtraFocus 93L</Name>
            <Description>A hydrophobic pinhole sulcus implant with small aperture diaphragm designed to provide an extended depth of focus</Description>
            <Size>14mm OD, 1.3mm pinhole</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <ARTGs>
                <ARTG>288314</ARTG>
            </ARTGs>
            <MinimumBenefit>634</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Scharioth Macula Lens</Name>
            <Description>Add-on hydrophilic lens for maculopathies such as macula degeneration</Description>
            <Size>Central Optic Diameter - 1.5mm    Optic Diameter - 6mm    Length - 13mm</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <ARTGs>
                <ARTG>221834</ARTG>
            </ARTGs>
            <MinimumBenefit>634</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>AddOn Progressive</Name>
            <Description>Add on hydrophillic progressive lens</Description>
            <Size>Optic Diameter: 6mm  Length 13mm</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>141</SubCategoryID>
            <GroupID>1328</GroupID>
            <SubGroupID>3896</SubGroupID>
            <ARTGs>
                <ARTG>280510</ARTG>
            </ARTGs>
            <MinimumBenefit>634</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL005</BillingCode>
            <Name>DUOVISC VISCOELASTIC SYSTEM</Name>
            <Description>ProVisc contains sodium hyaluronate, Viscoat contains chondroitin sulfate and sodium hyaluronate</Description>
            <Size>1 unit 0.50ml Viscoat and 1 unit 0.55ml ProVisc</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <SubGroupID>3897</SubGroupID>
            <ARTGs>
                <ARTG>141482</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ019</BillingCode>
            <Name>TWINVISC Viscoelastic</Name>
            <Description>TWINVISC includes a cohesive and a dispersive viscoelastic in one syringe, separated by a valve.  Dispersive: sodium hyaluronate (2.2%).  Cohesive: sodium hyaluronate (1%)</Description>
            <Size>Total volume 1.4 ml</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <SubGroupID>3897</SubGroupID>
            <ARTGs>
                <ARTG>160685</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ043</BillingCode>
            <Name>COMBIVISC</Name>
            <Description>COMBIVISC consists of two ophthalmic viscoelastic devices. One prefilled syringe of dispersive viscoelastic 3% (0.85ml) and one prefilled syringe of cohesive viscoleastic 1.5% (1.0ml),  along with one 25 gauge Viscoflow cannula and one 27 gauge Viscoflow cannula, that can be used jointly or independently in surgical interventions to remove cataracts and implant a prosthetic lens.</Description>
            <Size>COMBIVISC dispersive 3% 0.85ml 25G cannula&#xD;
COMBIVISC cohesive 1.5% 1ml 27G cannula&#xD;
Supplied as a single unit pack, comprising a single syringe of the COMBIVISC Dispersive and a single syringe of the COMBIVISC Cohesive &#xD;
Also supplied as a multipack containing five sealed pouched units</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <SubGroupID>3897</SubGroupID>
            <ARTGs>
                <ARTG>293592</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO009</BillingCode>
            <Name>Healon 5, Intraocular Viscoelastic Fluid</Name>
            <Description>HEALON5- Sodium hyaluronate 23mg/ml .</Description>
            <Size>0.6ml</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <Suffix>hmw</Suffix>
            <ARTGs>
                <ARTG>144893</ARTG>
            </ARTGs>
            <MinimumBenefit>65</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO010</BillingCode>
            <Name>Healon GV Intraocular Viscoelastic Fluid</Name>
            <Description>Sodium Hyaluronate 14mg/mL</Description>
            <Size>0.55ml and 0.85ml</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <Suffix>hmw</Suffix>
            <ARTGs>
                <ARTG>144892</ARTG>
            </ARTGs>
            <MinimumBenefit>65</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL006</BillingCode>
            <Name>PROVISC VISCOELASTIC SOLUTION</Name>
            <Description>PROVISC contains sodium hyaluronate</Description>
            <Size>0.85mL pack</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>310195</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL007</BillingCode>
            <Name>VISCOAT Viscoelastic Fluid</Name>
            <Description>Chondroitin sulfate and sodium hyaluronate</Description>
            <Size>0.75mL</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>141142</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL015</BillingCode>
            <Name>Cellugel Ophthalmic Viscosurgical Device</Name>
            <Description>2% Hydroxypropyl Methylcellulose (HPMC)</Description>
            <Size>1ml</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>115487</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL029</BillingCode>
            <Name>DisCoVisc Ophthalmic Viscosurgical Device</Name>
            <Description>Sodium hyaluronate 17 mg/mL and chondroitin sulfate 40mg/mL</Description>
            <Size>1.0 mL</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>141141</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO008</BillingCode>
            <Name>Healon, Intraocular Viscoelastic Fluid</Name>
            <Description>Sodium Hyaluronate 10mg/ml</Description>
            <Size>Healon  0.55ml &amp; 0.85ml</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>144891</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO032</BillingCode>
            <Name>Healon Endocoat</Name>
            <Description>Viscoelastic</Description>
            <Size>0.85ml</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>198813</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL008</BillingCode>
            <Name>Ocucoat Intraocular Fluid</Name>
            <Description>20mg/mL hydroxypropylmethyl cellulose for intraocular use</Description>
            <Size>1ml and 2ml Sterile</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>140513</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL015</BillingCode>
            <Name>Amvisc Plus injection</Name>
            <Description>15mg/mL Sodium Hyaluronate for intraocular use</Description>
            <Size>0.5mL and 0.8mL</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>161187</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ012</BillingCode>
            <Name>Z-HYALIN Viscoelastic</Name>
            <Description>Cohesive Viscoelastic Solution - sodium hyaluronate 10mg/ml.  (previously called Ophthalin)</Description>
            <Size>Volume 1.0ml</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>150016</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ013</BillingCode>
            <Name>Z-HYALIN Plus Viscoelastic</Name>
            <Description>Cohesive Viscoelastic Solution - sodium hyaluronate 15mg/ml.  (previously called Opthalin Plus)</Description>
            <Size>Volume 1.0ml</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>150017</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CZ022</BillingCode>
            <Name>VISTHESIA 1.5%</Name>
            <Description>VISCOANAESTHETIC syringe contains sodium hyaluronate (NaHA, 1.5%) and lidocaine hydrochloride (1%). Also contains two topical ampoules with NaHA (0.3%) and lidocaine (2%)</Description>
            <Size>0.8ml syringe &amp; 2x0.3ml ampoules</Size>
            <SupplierCode>CZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>198088</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE787</BillingCode>
            <Name>CAPSULGel</Name>
            <Description>Isotonic, clear, viscoelastic and  sterile HPMC solution for intraocular application</Description>
            <Size>2.0ml prefilled, single-use, glass syringe.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>383098</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV273</BillingCode>
            <Name>Oasis Visco Shield HPMC Viscoelastic</Name>
            <Description>A sterile,  high molecular weight HPMC solution for use as a surgical aid in maintaining a deep anterior chamber during ophthalmic surgical procedures</Description>
            <Size>2 ml syringe</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>373573</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ002</BillingCode>
            <Name>Ocuvis and Ocumax 2% Hydroxypropylmethylcellulose</Name>
            <Description>20mg/mL hydroxypropylmethyl cellulose for intraocular use. Pre-loaded in a sterile syringe with one cannula for injection, in a sterile Tyvek pouch</Description>
            <Size>2mL sterile</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>104427</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG035</BillingCode>
            <Name>Methylvisc 2.0%</Name>
            <Description>Hydroxypropyl Methylcellulose, viscoelastic solution for intraocular application. Pre-loaded in single-use sterile syringe with single-use injection cannula.</Description>
            <Size>2mL</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>366798</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN009</BillingCode>
            <Name>Viscos HPMC</Name>
            <Description>Hydroxypropylmethylcellulose, viscoelastic solution for intraocular application. Pre-loaded in single-use sterile syringe with single-use injection cannula.</Description>
            <Size>2 mL</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>300480</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS050</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Albomed Visco HPMC 2.0%</Name>
            <Description>A superior viscoelastic solution based on hydroxylpropyl methylcellulose for intraocular use where it serves as a volume substitute for aqueous humor during intraocular surgery.</Description>
            <Size>Supplied in a 2 ml syringe</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1329</GroupID>
            <ARTGs>
                <ARTG>353332</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE775</BillingCode>
            <Name>CAPSULBlue</Name>
            <Description>Trypan blue solution for use in anterior segment ophthalmic surgery. </Description>
            <Size>0.15ml prefilled glass syringe</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1330</GroupID>
            <ARTGs>
                <ARTG>343322</ARTG>
            </ARTGs>
            <MinimumBenefit>39</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV231</BillingCode>
            <Name>Vision Blue</Name>
            <Description>Trypan blue dye for ophthalmic applications</Description>
            <Size>0.5ml syringe</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1330</GroupID>
            <ARTGs>
                <ARTG>147581</ARTG>
            </ARTGs>
            <MinimumBenefit>39</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG024</BillingCode>
            <Name>RS-Blue</Name>
            <Description>Trypan Blue for the reversible staining of human tissue during surgery</Description>
            <Size>0.7ml Syringe</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1330</GroupID>
            <ARTGs>
                <ARTG>252154</ARTG>
            </ARTGs>
            <MinimumBenefit>39</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN012</BillingCode>
            <Name>SIDA-BLUE</Name>
            <Description>A sterile solution of trypan blue, a selective tissue-staining agent used in ophthalmic surgery.</Description>
            <Size>1mL vial or 1mL glass pre-filled syringe (PFS)</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>142</SubCategoryID>
            <GroupID>1330</GroupID>
            <ARTGs>
                <ARTG>317719</ARTG>
            </ARTGs>
            <MinimumBenefit>39</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL039</BillingCode>
            <Name>Preloaded Capsular Tension Ring</Name>
            <Description>Capsular tension ring preloaded (acrylic)</Description>
            <Size>11mm</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1331</GroupID>
            <Suffix>pl</Suffix>
            <ARTGs>
                <ARTG>281831</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV029</BillingCode>
            <Name>Eyejet CTR</Name>
            <Description>Capsular tension ring made of PMMA per-load on disposable injector</Description>
            <Size>10mm, 11mm, 12mm</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1331</GroupID>
            <Suffix>pl</Suffix>
            <ARTGs>
                <ARTG>132347</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG018</BillingCode>
            <Name>RINGJECT</Name>
            <Description>Preloaded Capsular tension ring</Description>
            <Size>12/10, 13/11</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1331</GroupID>
            <Suffix>pl</Suffix>
            <ARTGs>
                <ARTG>145740</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN001</BillingCode>
            <Name>Inside CTR</Name>
            <Description>Preloaded PMMA capsular tension ring</Description>
            <Size>Type 14 (12.3mm open, 10.0mm compressed), Type 14C (13.0mm open, 11.0mm compressed), Type 14A ( 14.5mm open, 12.0mm compressed), Type 13 ( 12.3mm open, 10.0mm compressed), Type 13A ( 13.0mm open, 11.0mm compressed), Type 13B ( 14.5mm open, 12.0mm compressed), Type 19D (11.6 mm open, 10.0/9.5/9.0/8.5mm compressed), Type 10C ( 12.1mm open, 11.0mm compressed)Type 15A ( 13.0mm open, 11.0mm compressed), Type 15B ( 14.5mm open, 12.0mm compressed).</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1331</GroupID>
            <Suffix>pl</Suffix>
            <ARTGs>
                <ARTG>235092</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VU001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IS018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jetring</Name>
            <Description>Preloaded PMMA (polymethyl methacrylate) capsular tension ring.</Description>
            <Size>JETRING 11ACB Right  Overall diameter:    13.0 mm  ±0.20 mm   Compressed diameter:   11,0 mm  ±0.20 mm   Haptic:     ø0.17 mm  ±0.02 mm   Haptic design:   straight, open modified C-loop    JETRING 12ACB Right  Overall diameter:    14.5 mm  ±0.20 mm   Compressed diameter:   12,0 mm  ±0.20 mm   Haptic:     ø0,20 mm  ±0.02 mm   Haptic design:    straight, open modified C-loop</Size>
            <SupplierCode>VU</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1331</GroupID>
            <Suffix>pl</Suffix>
            <ARTGs>
                <ARTG>354770</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV009</BillingCode>
            <Name>Morcher Capsular Tension Ring</Name>
            <Description>PMMA Implant</Description>
            <Size>sizes 8 -12mm</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1331</GroupID>
            <ARTGs>
                <ARTG>132347</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG001</BillingCode>
            <Name>Capsular Tension Rings Clear</Name>
            <Description>PMMA Implant</Description>
            <Size>10/08, 12/10, 13/11mm</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1331</GroupID>
            <ARTGs>
                <ARTG>145740</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV010</BillingCode>
            <Name>Morcher Complex Capsular Tension Ring</Name>
            <Description>PMMA Implant</Description>
            <Size>9.5mm, 10mm, 11mm, 12.5mm, 13mm</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>143</SubCategoryID>
            <GroupID>1332</GroupID>
            <ARTGs>
                <ARTG>132347</ARTG>
            </ARTGs>
            <MinimumBenefit>254</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LN002</BillingCode>
            <Name>Ahmed Glaucoma Valve Model FP7</Name>
            <Description>A sterile device designed to regulate  the flow of Fluid between the anterior chamber and the space around the conjunctiva of the eye be allowing flow when the pressure in the chamber is above a pre-set value (e.g., 8 to 10 mmHg). Made of medical grade silicone</Description>
            <Size>one size</Size>
            <SupplierCode>LN</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1333</GroupID>
            <Suffix>v</Suffix>
            <ARTGs>
                <ARTG>242076</ARTG>
            </ARTGs>
            <MinimumBenefit>564</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VS001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DV230</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Molteno 3</Name>
            <Description>Drainage implant for glaucoma, made of silicon</Description>
            <Size>Small &amp; Large size</Size>
            <SupplierCode>VS</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1333</GroupID>
            <Suffix>v</Suffix>
            <ARTGs>
                <ARTG>128911</ARTG>
            </ARTGs>
            <MinimumBenefit>564</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AO012</BillingCode>
            <Name>Baerveldt Glaucoma Implant BG 101-350, Baerveldt Glaucoma Implant BG 103-425, Baerveldt Glaucoma Implant BG 103-250</Name>
            <Description>Non-valved artificial drainage device, composition silicone - smooth, tumble-polished finish</Description>
            <Size>Surface area 250, 350, 425mm2</Size>
            <SupplierCode>AO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1333</GroupID>
            <ARTGs>
                <ARTG>168768</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ067</BillingCode>
            <Name>PAUL® Glaucoma Implant        </Name>
            <Description>Micro-sized tubed aqueous shunt glaucoma drainage device</Description>
            <Size>Length 44.9mm  Width 23mm  Extraocular plate surface area of 342.1mm²</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1333</GroupID>
            <ARTGs>
                <ARTG>303466</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL037</BillingCode>
            <Name>Ex-Press Glaucoma Filtration Device</Name>
            <Description>Miniature glaucoma shunt</Description>
            <Size>50 microns; 200 microns</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1334</GroupID>
            <SubGroupID>3898</SubGroupID>
            <ARTGs>
                <ARTG>319620</ARTG>
            </ARTGs>
            <MinimumBenefit>645</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE641</BillingCode>
            <Name>ESNOPER Glaucoma Implant</Name>
            <Description>Glaucoma Drainage Implant</Description>
            <Size>3.00mm x 1.40mm x 2.85mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1334</GroupID>
            <SubGroupID>3899</SubGroupID>
            <ARTGs>
                <ARTG>290207</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER501</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OQ002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hydrus Microstent</Name>
            <Description>Intracanalicular scaffold, made from a biocompatible alloy, for the treatment of primary open angle glaucoma</Description>
            <Size>8 mm in length</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1802</GroupID>
            <SubGroupID>6441</SubGroupID>
            <Suffix>smp</Suffix>
            <ARTGs>
                <ARTG>301403</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RQ075</BillingCode>
            <Name>iStent Inject System</Name>
            <Description>The iStent Inject is a pre-loaded injection system which delivers two stents across the trabecular meshwork to provide a pathway for aqueous humor to flow from the anterior chamber. It is indicated for use in conjunction with cataract surgery for the reduction of IOP in subjects with mild to moderate open angle glaucoma currently treated with ocular hypotensive medication.</Description>
            <Size>One size</Size>
            <SupplierCode>RQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1802</GroupID>
            <SubGroupID>6441</SubGroupID>
            <Suffix>tda</Suffix>
            <ARTGs>
                <ARTG>250914</ARTG>
            </ARTGs>
            <MinimumBenefit>1444</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RQ084</BillingCode>
            <Name>Glaukos iStent inject W System </Name>
            <Description>An improved product to PLAC billing code RQ075 (product name iStent Inject) with a wider flange for better surgeon visualisation and stent confirmation. The improvement includes a delivery injection unit with 2 stents. Intended purpose per TGA submission is for implantation with or without cataract surgery and to reduce intraocular pressure in adult patients diagnosed with mild to moderate primary open-angle glaucoma (POAG) currently treated with ocular hypotensive medication. </Description>
            <Size>One Size</Size>
            <SupplierCode>RQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1802</GroupID>
            <SubGroupID>6441</SubGroupID>
            <Suffix>tda</Suffix>
            <ARTGs>
                <ARTG>321526</ARTG>
            </ARTGs>
            <MinimumBenefit>1444</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AW027</BillingCode>
            <Name>XEN Glaucoma Treatment System</Name>
            <Description>The XEN Glaucoma Treatment System consists of an injector device that is preloaded with a XEN Gel Implant. The XEN Gel Implant creates a new subconjunctival outflow pathway to reduce intraocular pressure in patients with mild to advanced primary open-angle glaucoma where previous treatments have failed.</Description>
            <Size>XEN Gel Implant is 6mm long, 150µm outside diameter and 45µm inside diameter.</Size>
            <SupplierCode>AW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1802</GroupID>
            <SubGroupID>6442</SubGroupID>
            <ARTGs>
                <ARTG>297899</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RQ085</BillingCode>
            <Name>PRESERFLO™ MicroShunt &amp; 3mm Scleral Marker</Name>
            <Description>The MicroShunt is made of a flexible SIBS [poly (Styrene-block-IsoButylene-block-Styrene)] polymer with triangular fins that prevent migration of the tube into the AC. It is designed to be implanted under the subconjunctival/Tenon space and intended for reduction of intraocular pressure in eyes of patients with primary open angle glaucoma where IOP remains uncontrollable while on maximum tolerated medical therapy and/or where glaucoma progression warrants surgery</Description>
            <Size>1 size ( 8.5 mm length; 70 µm internal lumen; 350 μm outer diameter; 1.1 mm wingspan)</Size>
            <SupplierCode>RQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>144</SubCategoryID>
            <GroupID>1802</GroupID>
            <SubGroupID>6442</SubGroupID>
            <ARTGs>
                <ARTG>367151</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO017</BillingCode>
            <Name>FCI Ptose-up</Name>
            <Description>Expanded PTFE</Description>
            <Size>15cm long x 2 or 3mm wide x 0.35mm thick</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1335</GroupID>
            <ARTGs>
                <ARTG>146261</ARTG>
            </ARTGs>
            <MinimumBenefit>314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE581</BillingCode>
            <Name>ALOS Eyelid Implants - Gold</Name>
            <Description>Gold Eyelid implants</Description>
            <Size>0.6, 0.8, 1.0, 1.2, 1.4, 1.6 grams</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3900</SubGroupID>
            <ARTGs>
                <ARTG>290117</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV260</BillingCode>
            <Name>Meddev Eyelid Weight, Implantable</Name>
            <Description>Thin Profile eyelid implants for patients with facial palsy</Description>
            <Size>Gold Thin 0.6, 0.8, 1.0, 1.2, 1.4, 1.6g</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3900</SubGroupID>
            <ARTGs>
                <ARTG>205794</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG032</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE183</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Lid Load Gold Eyelid Weights;</Name>
            <Description>Gold</Description>
            <Size>0.6, 0.8, 1.0, 1.2, 1.4, 1.6 grams</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3900</SubGroupID>
            <ARTGs>
                <ARTG>337652</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO047</BillingCode>
            <Name>Meddev Eyelid Weight, Implantable</Name>
            <Description>Thin Profile eyelid implants for patients with facial palsy</Description>
            <Size>Gold Thin 0.6, 0.8, 1.0, 1.2, 1.4, 1.6g</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3900</SubGroupID>
            <ARTGs>
                <ARTG>212173</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE583</BillingCode>
            <Name>ALOS Eyelid Implant - Gold 1.8</Name>
            <Description>Gold Eyelid Implant</Description>
            <Size>1.8 grams</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3901</SubGroupID>
            <ARTGs>
                <ARTG>290117</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV259</BillingCode>
            <Name>Meddev Eyelid Weight, Implantable</Name>
            <Description>Contour eyelid implants for patients with facial palsy.</Description>
            <Size>Contour Gold 1.8, 2.0, 2.2, 2.4, 2.6, 2.8g</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3901</SubGroupID>
            <ARTGs>
                <ARTG>205794</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG033</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE182</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Lid Load Gold Eyelid Weights;</Name>
            <Description>Gold</Description>
            <Size>1.8, 2.0, 2.2, 2.4, 2.6, 2.8 grams</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3901</SubGroupID>
            <ARTGs>
                <ARTG>337652</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO046</BillingCode>
            <Name>Meddev Eyelid Weight, Implantable</Name>
            <Description>Contour eyelid implants for patients with facial palsy.</Description>
            <Size>Contour Gold 1.8, 2.0, 2.2, 2.4, 2.6, 2.8g</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3901</SubGroupID>
            <ARTGs>
                <ARTG>212173</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE584</BillingCode>
            <Name>ALOS Eyelid Implants - Platinum</Name>
            <Description>Platinum Eyelid Implants</Description>
            <Size>0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8 grams</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3902</SubGroupID>
            <ARTGs>
                <ARTG>290117</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV261</BillingCode>
            <Name>Meddev Eyelid Weight, Implantable Platinum</Name>
            <Description>Platinum Contour and Thin Profile eyelid implants for patients with facial palsy</Description>
            <Size>Platinum Thin 0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8g&#xD;
Contour Platinum 1.8, 2.0, 2.2, 2.4, 2.6, 2.8g</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3902</SubGroupID>
            <ARTGs>
                <ARTG>205794</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC001</BillingCode>
            <Name>LIDCHAIN Platinum Eyelid Implant</Name>
            <Description>Platinum</Description>
            <Size>Weights - 0.8, 1.0, 1.2, 1.4, 1.6, 1.8 grams</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3902</SubGroupID>
            <ARTGs>
                <ARTG>182945</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO048</BillingCode>
            <Name>Meddev Eyelid Weight, Implantable Platinum</Name>
            <Description>Platinum Contour and Thin Profile eyelid implants for patients with facial palsy</Description>
            <Size>Platinum Thin 0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8g  Contour Platinum 1.8, 2.0, 2.2, 2.4, 2.6, 2.8g</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>145</SubCategoryID>
            <GroupID>1336</GroupID>
            <SubGroupID>3902</SubGroupID>
            <ARTGs>
                <ARTG>212173</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO044</BillingCode>
            <Name>FCI Mono-Canalicular Lacrimal Intubation Set</Name>
            <Description>Silicone tubing with plug swaged, imbedded into or around malleable or flexible stainless steel probes or guides. PEEK thread. Introducer.</Description>
            <Size>Probes: 40mm to 120mm x 0.7mm to 1.2mm.  Tube: 0.64mm to 1.18mm x 30mm to 350mm.  PEEK Thread: 0.2mm to 0.4mm x 500mm.  Plug Collar: 2mm to 4mm.</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <Suffix>mc</Suffix>
            <ARTGs>
                <ARTG>143177</ARTG>
            </ARTGs>
            <MinimumBenefit>162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO049</BillingCode>
            <Name>FCI Masterka</Name>
            <Description>Self-retaining monocanalicular nasal intubation WITHOUT nasal retrieval</Description>
            <Size>30mm to 40mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <Suffix>mc/sr</Suffix>
            <ARTGs>
                <ARTG>143177</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO086</BillingCode>
            <Name>Lacrijet</Name>
            <Description>Self retaining mono-canalicular stent without nasal retrieval that is pre-loaded into a handpiece.</Description>
            <Size>15mm to 50mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <Suffix>mc/sr</Suffix>
            <ARTGs>
                <ARTG>143177</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO050</BillingCode>
            <Name>FCI Nunchaku</Name>
            <Description>Self-retaining bicanalicular nasal intubation WITHOUT nasal retrieval</Description>
            <Size>90mm to 105mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <Suffix>sr</Suffix>
            <ARTGs>
                <ARTG>143177</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE191</BillingCode>
            <Name>Canaliculus Intubation Sets </Name>
            <Description>Silicone, SS &amp; Nylon</Description>
            <Size>17.7 x .064 x 29cm, 15.5 x .051 x 33cm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>182623</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE278</BillingCode>
            <Name>BD Visitec Lacrimal Intubation Sets</Name>
            <Description>Stainless steel probes with solid silicone rods or silicone tubing - packaged sterile</Description>
            <Size>1. Probes 0.90mm x 4.5cm, rod 40cm x 0.80mm. 2. Probes 0.40mm x 11cm, tubing 35cm x 0.64mm. Probes 0.60mm x 11mm, tubing 35cm x 0.30mm.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>125073</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE799</BillingCode>
            <Name>Olie Medical (Sidapharm) Lacrimal Intubation Set</Name>
            <Description>This disposable device consists of two stainless steel malleable probes (with or without olive tip) attached to a silicon tube.</Description>
            <Size>23G, 17.5 cm, Straight tip    23G, 11.0 cm, Olive tip</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>370527</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV022</BillingCode>
            <Name>Eyetec DCR Tubes</Name>
            <Description>Stainless steel, silicone tubing, Bodkin lacrimal intubation set</Description>
            <Size>30cm</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>117458</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV241</BillingCode>
            <Name>Eyetec DCR Tubes</Name>
            <Description>Crawford and Cannaliculus Intubation Sets</Description>
            <Size>N/A</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>117458</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV256</BillingCode>
            <Name>LIS 052 "StenTube"</Name>
            <Description>Large Diameter Lachrymal Intubation Set</Description>
            <Size>1.32mm Tube diameter</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>117460</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO021</BillingCode>
            <Name>FCI Lacrimal Intubation Set</Name>
            <Description>PVP Coated Silicone Tubing/PVP Coated Silicone Plug/Metal Probes/Polypropylene Thread</Description>
            <Size>PVP Bika: 0.64mm O.D. Tube/80 x 0.8mm probes, PVP Differential Bika: 0.64 &amp; 1.18mm O.D. Tube/40 x 1.2mm probes, PVP Bika for DCR: 0.94mm O.D. Tube/50 x 0.8mm probes, PVP Infant Bika 0.64mm O.D. Tube/55 x 0.7mm probes, PVP Infant Bika II: 0.64mm O.D. Tube/</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>143177</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO043</BillingCode>
            <Name>FCI Bi-Canalicular Lacrimal Intubation Set</Name>
            <Description>Silicone tubing swaged, imbedded into or around malleable and flexible stainless steel probes. PEEK thread.</Description>
            <Size>Probes: 40mm to 120mm x 0.7mm to 1.2mm.  Tube: 0.64mm to 1.18mm x 25mm to 400mm.  PEEK Thread: 0.2mm to 0.4mm x 500mm.</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1337</GroupID>
            <ARTGs>
                <ARTG>143177</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV257</BillingCode>
            <Name>Lacricath Lachrymal Duct Balloon Catheter</Name>
            <Description>Bilateral Lachrymal Duct Balloon Catheter System including inflation device.</Description>
            <Size>2mm, 3mm, 5mm and 9mm</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1803</GroupID>
            <Suffix>bilateral</Suffix>
            <ARTGs>
                <ARTG>117460</ARTG>
            </ARTGs>
            <MinimumBenefit>793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO069</BillingCode>
            <Name>Ophtacath Lacrimal Duct Balloon Catheter – Bilateral system</Name>
            <Description>Bilateral balloon catheter kit containing balloon catheter &amp; inflation device</Description>
            <Size>2mm and 3mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1803</GroupID>
            <Suffix>bilateral</Suffix>
            <ARTGs>
                <ARTG>212425</ARTG>
            </ARTGs>
            <MinimumBenefit>793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV258</BillingCode>
            <Name>Lacricath Unilateral Lachrymal Duct Balloon Catheter</Name>
            <Description>Unilateral Lachrymal Duct Balloon Catheter system including inflation device</Description>
            <Size>2mm, 3mm, 5mm and 9mm</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1803</GroupID>
            <ARTGs>
                <ARTG>117460</ARTG>
            </ARTGs>
            <MinimumBenefit>438</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO070</BillingCode>
            <Name>Ophtacath Lacrimal Duct Balloon Catheter – Unilateral system</Name>
            <Description>Unilateral balloon catheter kit containing balloon catheter &amp; inflation device</Description>
            <Size>2mm and 3mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>146</SubCategoryID>
            <GroupID>1803</GroupID>
            <ARTGs>
                <ARTG>212425</ARTG>
            </ARTGs>
            <MinimumBenefit>438</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO040</BillingCode>
            <Name>FCI Orbital Implants</Name>
            <Description>Silicone - Sterile</Description>
            <Size>12mm to 22mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1339</GroupID>
            <ARTGs>
                <ARTG>143210</ARTG>
            </ARTGs>
            <MinimumBenefit>49</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE585</BillingCode>
            <Name>OCULFIT Orbital Implant</Name>
            <Description>Porous polyethylene spherical orbital implant</Description>
            <Size>14, 16, 18, 19, 20, 21, 22, 23 mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1340</GroupID>
            <SubGroupID>3903</SubGroupID>
            <Suffix>vp</Suffix>
            <ARTGs>
                <ARTG>290198</ARTG>
            </ARTGs>
            <MinimumBenefit>1741</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO006</BillingCode>
            <Name>FCI Orbital Implants</Name>
            <Description>Orbital Implant, Bioceramic (Aluminium Oxide)/Hydroxyapatite (Synthetic)</Description>
            <Size>Bioceramic diameter, 12, 14, 16, 18, 20, 21, 22mm; Synthetic Diameter, 10, 12, 14, 16, 18, 20, 22mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1340</GroupID>
            <SubGroupID>3903</SubGroupID>
            <Suffix>vp</Suffix>
            <ARTGs>
                <ARTG>143210</ARTG>
            </ARTGs>
            <MinimumBenefit>1741</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO007</BillingCode>
            <Name>FCI Orbital Implants</Name>
            <Description>Mesh wrapped orbital implant: mesh wrapped bioceramic (aluminium oxide), mesh wrapped hydroxyapatite (synthetic), mesh wrap (polyglycolic acid)</Description>
            <Size>Bioceramic diameter: 16, 18, 20, 22mm; Synthetic Hydroxyapatite diameter: 16, 18, 20, 22mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1340</GroupID>
            <SubGroupID>3903</SubGroupID>
            <Suffix>vp</Suffix>
            <ARTGs>
                <ARTG>143210</ARTG>
            </ARTGs>
            <MinimumBenefit>1741</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO085</BillingCode>
            <Name>Ezypor</Name>
            <Description>High density porous polyethylene orbital implant</Description>
            <Size>12mm to 22mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1340</GroupID>
            <SubGroupID>3903</SubGroupID>
            <Suffix>vp</Suffix>
            <ARTGs>
                <ARTG>143210</ARTG>
            </ARTGs>
            <MinimumBenefit>1741</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Sphere</Name>
            <Description>An implantable device made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in sizes to meet the patient's specific needs.  Used for orbital reconstruction following enucleation and evisceration procedure.</Description>
            <Size>14mm, 16mm, 18mm, 20mm, 22mm, 24mm (diameter)</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1340</GroupID>
            <SubGroupID>3903</SubGroupID>
            <Suffix>vp</Suffix>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>1741</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK521</BillingCode>
            <Name>Sphere</Name>
            <Description>Orbital Sphere Models 6316, 6326, 6327, 6317 and 6322 8702-8704. COI implant, models 7222, 7223 &amp; 80026. MCOI implant, models 7207 - 7209 Quad Motility Implants 9866 - 9868 &amp; 80022</Description>
            <Size>Orbital Sphere Models 6316: 14mm, 6326: 16mm, 6327: 18mm, 6317: 20mm, 6322: 22mm, 8702: 19mm, 8703: 21mm, 8704: 23mm, COI Implants 7222: Approx 4ml, 7223: Approx 5ml, 80026: Approx 6ml, MCOI 7207: Approx 3ml, 7208: Approx 4.2ml,  7209: Approx 5.6ml, QUAD Motility Small 16ml, Medium: 18ml, Large: 20ml, Extra Large: 22ml.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1340</GroupID>
            <SubGroupID>3903</SubGroupID>
            <ARTGs>
                <ARTG>189074</ARTG>
                <ARTG>189075</ARTG>
                <ARTG>257435</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE277</BillingCode>
            <Name>Frontalis Suspension Set</Name>
            <Description>Stainless steel needles with solid silicone rods and silicone tubing - packaged sterile</Description>
            <Size>needles 0.90mm x 6.5cm, rod 40cm - 0.80mm, sleeve 10 x 2mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1341</GroupID>
            <ARTGs>
                <ARTG>125073</ARTG>
            </ARTGs>
            <MinimumBenefit>284</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO045</BillingCode>
            <Name>FCI Ptosis Probes</Name>
            <Description>Stainless steel needle probes swaged with silicone tubing.</Description>
            <Size>80mm x 0.8mm needle probes, 280mm 0.64mm tubing.</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>147</SubCategoryID>
            <GroupID>1341</GroupID>
            <ARTGs>
                <ARTG>146261</ARTG>
            </ARTGs>
            <MinimumBenefit>284</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AP002</BillingCode>
            <Name>Mira: Scleral Implants</Name>
            <Description>Silicone Sponge- Retinal Implant Used in Scleral Buckling (Silicone Elastomer Sponge)</Description>
            <Size>Sponge- Mira 502 Cylinder 2mm, Mira 5025 Cylinder 2.5mm, Mira 503 Cylinder 3mm, Mira 504 Cylinder 4mm, Mira 505 Cylinder 5mm, Mira 505G Grooved cylinder 5mm, Mira 505T Packer tunnel cylinder 5mm, Mira 510 Half cylinder 5mm, Mira 515 Brucker two-thirds cylinder 5mm, Mira 501 Masciulli oval 2.5mm by 4mm, Mira 506 Vaiser oval 3mm by 5mm, Mira 506G Vaiser grooved oval 3mm by 5mm, Mira 507 oval 5.5mm by 7.5mm, Mira 507G Grooved oval 5.5mm by 7.5mm, Mira 507T Packer tunnel oval 5.5mm by 7.5mm, Mira 511 Half oval 7.5mm, Mira 517 Brucker two-thirds oval 7.5mm, Mira 509 Fuller flat oval 3.5mm by 7.5mm, Mira 509G Fuller grooved flat oval 3.5mm by 7.5mm, Mira 518 Frederick grooved flat oval 2.5mm by 12mm, Mira 508 Frederick flat oval 4mm by 12mm, Mira 508G Frederick grooved flat oval 4mm by 12mm, Mira 513 Snyder 3+ meridional 7mm by 4mm, Mira 514 Snyder 4+ meridional 8mm by 5mm, Mira 516G Tapered groove 6.4mm, Mira 519G Tapered groove 7.5mm by 3.2mm.</Size>
            <SupplierCode>AP</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <SubGroupID>3905</SubGroupID>
            <ARTGs>
                <ARTG>143682</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG031</BillingCode>
            <Name>Labtician Retinal Implants - Sponges</Name>
            <Description>Silicone Sponge- Retinal Implant Used in Scleral Buckling (Silicone Elastomer Sponge)</Description>
            <Size>S 1981-4 Oval Sponge,  S 1981-5 Oval Sponge,  S 1981-7 Oval Sponge,  S 1981-7.5 Oval Sponge,  S 1982-1.5 Round Sponge 1.5mm,  S 1982-2 Round Sponge 2mm,  S 1982-2.5 Round Sponge 2.5mm,  S 1982-3 Round Sponge 3mm,  S 1982-4 Round Sponge 4mm,  S 1982-5 Round Sponge 5mm,  S 1982-5T Round Tunnel Sponge 5mm,  S 1982-7 Round Sponge 7mm,  S 1982-7.5 Round Sponge 7.5mm x 50mm,  S 1983-2.3 Grooved Sponge,  S 1983-2.5 Grooved Part Thickness Sponge,  S 1983-2.8 Grooved Part Thickness Sponge,  S 1983-3 Grooved Sponge,  S 1983-3.2 Grooved Sponge,  S 1983-3.5 Grooved Sponge,  S 1983-4 Grooved Sponge,  S 1983-5 Grooved Sponge,  S 1983-7.5 Grooved Sponge,  S 1984-2.5 Part Thickness Sponge,  S 1984-3 Partial Thickness Sponge,  S 1984-3.3 Partial Thickness Sponge,  S 1984-5 Partial Thickness Sponge,  S 1984-7.5 Partial Thickness Sponge,  S 1986-3.5 Oblong Sponge,  S 1986-4 Oblong Sponge,  S 1987-7 Accessory Sponge,  S 1987-8 Accessory Sponge</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <SubGroupID>3905</SubGroupID>
            <ARTGs>
                <ARTG>337137</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO012</BillingCode>
            <Name>FCI Scleral Buckling Devices</Name>
            <Description>Sponge/Cord: Silicone</Description>
            <Size>Cord: 1.0 to 5.0mm O.D. x 150mm length; Half Cord: 3.0mm to width x1.5mm to 2.5mm height x150mm; Circular Sponge: 3 to 5mm; Oval Sponge: 2 to 5.5mm x 4 to 12mm; Half Sponge: 2 to 3.1mm x 4 to 7.5mm; Grooved Sponge: 3 to 5mm x 5 to  12mm; Gain Sponge: 6 x </Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <SubGroupID>3905</SubGroupID>
            <ARTGs>
                <ARTG>143211</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AP003</BillingCode>
            <Name>Mira: Scleral Implants</Name>
            <Description>Solid Silicone-Tire/Meridional/Wedge/Pad. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer)</Description>
            <Size>Tires-Mira 286 Wendel Symmetrical Oval Tire 6mm, Mira Symmetrical Oval Tire 7mm, Mira 287WG Murray wide (3.5mm) grooved symmetrical tire, 10mm wide, Mira 288 ross symmetrical grooved tire, low profile 10mm wide by 2.5mm, Mira 289 Symmetrical oval tire 10mm, Mira 277Symmetrical tire 7mm, Mira 279 Symmetrical tire 9mm, Mira 78G Grooved symmetrical tire 10mm, Mira 281 Symmetrical tire 12.5mm, Mira 275 Munsen Asymmetrical tire 6mm, Mira 276 Asymmetrical tire 7mm, Mira 278 Brockhurst asymmetrical tire 8.5mm, Mira 280LG Large grooved asymmetrical tire 10mm, Mira 77G Grooved hemisphere 26mm. Meridional- Mira 106 Meridional Implant 6mm by 10.5mm, Mira 112 Curved Meridional implant 12mm by 12mm, Mira 103 Meridional implant 4mm by 15mm. Wedge- Mira 135 Pruett maxi wedge 14mm, Mira Pruett midi wedge 12mm, Mira 190 Spencer sub-implant 5mm by 10mm. Pad- Mira 80 Pad 4mm by 8mm, Mira 22 Button 5mm by 5mm</Size>
            <SupplierCode>AP</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>143682</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AP004</BillingCode>
            <Name>Mira: Scleral Implants</Name>
            <Description>Solid Silicone-Sleeve. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer)</Description>
            <Size>Sleeves-Mira 70 Sleeve 1mm I.D., Mira 71 Sleeve 1mm I.D., Mira 72 McNutt Sleeve 1.57mm I.D., Mira 270 Sleeve 0.76mm I.D.</Size>
            <SupplierCode>AP</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>143682</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AP006</BillingCode>
            <Name>Mira: Scleral Implants</Name>
            <Description>Solid Silicone-Band/Strip/Boat/Clip. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer)</Description>
            <Size>Bands-Mira 40 Circling Band 2mm, Mira 240 Circling Band 2.5mm. Strips-Mira 41 Strip 3.5mm, Mira 42 Strip 4mm, Mira 20 Strip 4mm, Mira 219 Strip 4.5mm, Mira 31 Strip 4.5mm, Mira 32 Strip 5mm, Mira 225 Oval Strip 5mm, Mira 220 Strip 6mm. Boats-Mira 60 Boat 2mm, Mira 260 Boat 2.5mm. Clips-Mira 50 Double Tantalum Clip 2mm, Mira 250 Double Tantalum Clip 2.5mm, Mira 51 Singla Tantalum Clip 3.5mm, Mira 52 Joondeph Single Tantalum Clip 4mm</Size>
            <SupplierCode>AP</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>143682</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG028</BillingCode>
            <Name>Labtician - Retinal Implants</Name>
            <Description>Solid Silicone- Tire/Meridional/ Wedge/Pad. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer)</Description>
            <Size>S 2965 Silicone Strip , S 2967 Silicone Strip , S 2968 Silicone Strip, S 2970 Silicone Strip , S 2971 Silicone Strip , S 2976 Silicone Button , S 2977 Silicone Tire 10mm , S 2986 Silicone Tire 7mm, S 2991 Silicone Tire 9mm, S 2994 Silicone Tire 6.0mm , S 2995 Silicone Tire 8.5mm , S 2996 Silicone Tire 10mm , S 2996 L Silicone Tire 10mm LG , S 2997 Silicone Tire 12.5mm, S 2999 Silicone Tire 7.0mm , S 2999 L Silicone Tire Wide Groove , S 3004 Silicone Tire 9mm , S 3010 Silicone Tire 6mm, S 3014 Silicone Tire 7mm , S 3014 L Silicone Tire 7mm WG , S 3016 Silicone Tire 10mm , S 3017 Silicone Tire , S 3018 Silicone Sleeve , S 3019 Silicone Sleeve, S 3025 Wong Meridional Implant , S 3071 Silicone Sleeve, S 5020 Silicone Lace™ 2mm , S 5025 Silicone Lace™ 2.5mm.</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>337137</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG029</BillingCode>
            <Name>Labtician Retinal Implants</Name>
            <Description>Band/Strip: solid silicone</Description>
            <Size>S 2950 Circling Band, S 2969 Circling Band, S 2978 Meridional Implant - Flat, S 2987 Circling Band, S 2988 Meridional Implant, S 2989 Boat, S 2992 Silicone Strip, S 2993 Pad, S 2998 Silicone Strip, S 3012 Boat, S 3013 Silicone Strip, S 3020 Meridional Implant, S 3021 Wedge, S 3022 Wedge, S 3083 Labtician Oval Sleeve, S 3084 Labtician Oval Sleeve, S 3093 Labtician Buckling Sleeve, S 3094 Labtician Buckling Sleeve, S 4050 Silicone Strip, S 4055 Silicone Strip, S 4060 Silicone Strip, S 4065 Silicone Strip</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>337137</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO009</BillingCode>
            <Name>FCI Scleral Buckling Devices</Name>
            <Description>Band/strip: solid silicone</Description>
            <Size>Band - 2.0 x 0.75mm Type 40, 3.5 x 0.75mm Type 41, 4.0 x 1.25mm Type 42, 2.5 x 0.6mm Type 240, Morin 3.5 x 0.6mm
Strip - 5.7mm Type 20, 7.2mm Type 31, 9.2mm Type 32, 6mm Type 219, 7.5mm Type 220, 8mm Type 225</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>143211</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO011</BillingCode>
            <Name>FCI Scleral Buckling Devices</Name>
            <Description>Tire: Solid Silicone</Description>
            <Size>Symmetrical: (2.5 mm Groove, 7 to 9mm wide), Biconvex: (2.5mm Groove, 7 to 10mm wide), Asymetrical: (2.5mm Groove, 7 to 10mm wide)</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>143211</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO013</BillingCode>
            <Name>FCI Scleral Buckling Devices</Name>
            <Description>Strip: Solid Silicone</Description>
            <Size>Strip: 1.4 x 4.4 x 100mm, Morin Strip: 7mm wide x 100mm long, Caputo Zip Strip: 7 to 9mm wide x 120mm long, Korobelnik Oval Strip: 2 x 5mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1342</GroupID>
            <ARTGs>
                <ARTG>143211</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO010</BillingCode>
            <Name>FCI Scleral Buckling Devices</Name>
            <Description>Fixation Sleeve: Solid silicone</Description>
            <Size>O.D: 1.65 to 2.41mm, Length 30mm</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1344</GroupID>
            <ARTGs>
                <ARTG>143211</ARTG>
            </ARTGs>
            <MinimumBenefit>23</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL035</BillingCode>
            <Name>ISPAN Retinal Gases for Constellation® Vision System</Name>
            <Description>Tamponade gases for retinal surgery C3F8 and SF6</Description>
            <Size>125g cylinder, dispensed in single dose syringe</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1345</GroupID>
            <ARTGs>
                <ARTG>115487</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL036</BillingCode>
            <Name>ISPAN retinal gases</Name>
            <Description>Tamponade gases for retinal surgery C3F8 and SF6</Description>
            <Size>125 g cylinder, dispensed in single dose syringe</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1345</GroupID>
            <ARTGs>
                <ARTG>115487</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE284</BillingCode>
            <Name>Single Dose Ophthalmic Gases</Name>
            <Description>Single dose tamponading gas for retinal surgery</Description>
            <Size>30ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1345</GroupID>
            <ARTGs>
                <ARTG>99568</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE795</BillingCode>
            <Name>Micromed Microgas</Name>
            <Description>Single dose high molecular weight gases for replacement of vitreous humor during retinal surgery  </Description>
            <Size>50cc aluminium canister with dispenser</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1345</GroupID>
            <ARTGs>
                <ARTG>382032</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV270</BillingCode>
            <Name>OcuGas </Name>
            <Description>Tamponade gas for retinal surgery</Description>
            <Size>OCUGAS SF6 (15 ml) is supplied in a non pressurized and sterile primary container.  OCUGAS C2F6 (12 ml) is supplied in a non pressurized and sterile primary container.  OCUGAS C3F8 (9 ml) is supplied in a non pressurized and sterile primary container.</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1345</GroupID>
            <ARTGs>
                <ARTG>292815</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG021</BillingCode>
            <Name>GOT Multi</Name>
            <Description>Tamponade gas for retinal surgery</Description>
            <Size>75ml</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1345</GroupID>
            <ARTGs>
                <ARTG>297730</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ012</BillingCode>
            <Name>EasyGas</Name>
            <Description>Endotamponade Gases for Retinal Surgery, EasyGas SF6, C2F6 or C3F8, each supplied in a 60ml syringe, sterile</Description>
            <Size>60ml dispensed in a single dose, sterile syringe</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1345</GroupID>
            <ARTGs>
                <ARTG>197089</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL013</BillingCode>
            <Name>Perfluoron Kits</Name>
            <Description>Perfluoro-n-octane for use as a retinal surgery additive</Description>
            <Size>5mL</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>327862</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AL014</BillingCode>
            <Name>Perfluoron Kits</Name>
            <Description>Perfluoro-n-octane for use as a retinal surgery additive</Description>
            <Size>7mL</Size>
            <SupplierCode>AL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>327862</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL017</BillingCode>
            <Name>Perfluo-octane (Oktaline) Okta-Line</Name>
            <Description>Perfluorocarbon Liquid  for use as a retinal surgery additive</Description>
            <Size>5mL</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>108429</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL018</BillingCode>
            <Name>DK Line 100% purified perfluorodecalin</Name>
            <Description>Perfluorodecalin</Description>
            <Size>7ml</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>108429</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE204</BillingCode>
            <Name>Arcaline (Perfluorodecaline)</Name>
            <Description>Liquid perfluorocarbon aid for retinal surgery, operative device for retinal surgery, in particular retinal detachment (RD), RD with giant tear etc.</Description>
            <Size>3ml, 5ml, 7ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>140539</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE205</BillingCode>
            <Name>Arcotane (Perfloro-N-Octane)</Name>
            <Description>Liquid perfluoro-N-Octane aid for retinal surgery, pre-operative device for retinal surgery, in particular retinal detachment (RD), RD with giant tear, RD with proliferative vitreal retinopathy (PVR) etc.</Description>
            <Size>5ml, 7ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>140539</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV244</BillingCode>
            <Name>D.O.R.C. Eftiar</Name>
            <Description>Eftiar Decaline and Octane 5ml</Description>
            <Size>5ml, 7ml</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>148699</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG022</BillingCode>
            <Name>Perfluorocarbons</Name>
            <Description>HPF8 Perfluoro-n-octane and HPF10 Perfluorodecalin</Description>
            <Size>5ml and 7ml</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>252153</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ008</BillingCode>
            <Name>Octane &amp; Decalin</Name>
            <Description>Perfluorocarbon retinal tamponade medium, intraoperative</Description>
            <Size>5ml &amp; 7ml, Sterile</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>152235</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO054</BillingCode>
            <Name>FCI - DECA, FCI - OCTA</Name>
            <Description>FCI - DECA: Purified perflurodecalin, FCI - OCTA: Purified perfluoro-N-Octane</Description>
            <Size>5ml / 7ml</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1346</GroupID>
            <ARTGs>
                <ARTG>143212</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ005</BillingCode>
            <Name>Densiron</Name>
            <Description>Heavy Tamponade Liquid Medium, Postoperative</Description>
            <Size>10 ml, Sterile</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <Suffix>HO</Suffix>
            <ARTGs>
                <ARTG>152234</ARTG>
            </ARTGs>
            <MinimumBenefit>217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL016</BillingCode>
            <Name>Oxane LMWC Fractioned Silicone Oil</Name>
            <Description>Purified fractioned silicone oil</Description>
            <Size>10mL</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>108429</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BL024</BillingCode>
            <Name>Oxane HD</Name>
            <Description>Silicone oil - RMN3 mixture</Description>
            <Size>10ml</Size>
            <SupplierCode>BL</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>108429</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE701</BillingCode>
            <Name>ARCIOLANE 5500</Name>
            <Description>Silicone Oil for Vitreoretinal Surgery</Description>
            <Size>10ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>140539</ARTG>
                <ARTG>171840</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE702</BillingCode>
            <Name>ARCIOLANE 1300</Name>
            <Description>Silicone Oil for Vitreoretinal Surgery</Description>
            <Size>10ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>140539</ARTG>
                <ARTG>171840</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DV243</BillingCode>
            <Name>D.O.R.C. Silicon Oil</Name>
            <Description>D.O.R.C. Silicon Oil 1000/2000/5000CS</Description>
            <Size>10ml</Size>
            <SupplierCode>DV</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>193027</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG023</BillingCode>
            <Name>RS-OIL</Name>
            <Description>Highly purified Silicone Oil</Description>
            <Size>10ml</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>297730</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IQ006</BillingCode>
            <Name>Siluron 1000 &amp; Siluron 5000</Name>
            <Description>Silicone Oils</Description>
            <Size>10 ml, Sterile</Size>
            <SupplierCode>IQ</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>152234</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG030</BillingCode>
            <Name>LSO Silicone Oil</Name>
            <Description>Highly purified, sterile, transparent, silicone oil available in both a 1,000 cP and a 5,000 cP viscosity.</Description>
            <Size>10mL vial, 10mL syringe</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>337138</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO022</BillingCode>
            <Name>FCI Purified Silicone Oil (Solvent Free)</Name>
            <Description>Viscosity: 1000 cst/5000 cst: solvent free purified silicone oil</Description>
            <Size>10ml</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>148</SubCategoryID>
            <GroupID>1347</GroupID>
            <ARTGs>
                <ARTG>143212</ARTG>
            </ARTGs>
            <MinimumBenefit>176</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SO076</BillingCode>
            <Name>HumanOptics Artificial Iris</Name>
            <Description>One sterile, foldable Artificial Iris made of silicone, with or without fibre and custom made specific to the patient.</Description>
            <Size>Custom made</Size>
            <SupplierCode>SO</SupplierCode>
            <CategoryID>1</CategoryID>
            <SubCategoryID>262</SubCategoryID>
            <GroupID>1822</GroupID>
            <ARTGs>
                <ARTG>225976</ARTG>
            </ARTGs>
            <MinimumBenefit>5607</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD020</BillingCode>
            <Name>HiRes90K Advantage Cochlear Implant with HiFocus 1j Electrode</Name>
            <Description>The HiRes90K Advantage Cochlear Implant  with HiFocus 1j Electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus 1j Electrode array</Description>
            <Size>Implant Size: 56mm (L) x 28mm (w x5.7mm (thickness). Electrode size: Active length 17mm, Tip diameter 0.4mm, Basal diameter 0.8mm. Total length of electrode array 25mm</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>220306</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD022</BillingCode>
            <Name>HiRes90K Advantage Cochlear Implant with the HiFocus Mid-Scala Electrode</Name>
            <Description>The HiRES90K Advantage Cochlear Implant with HiFocus Mid-Scala electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlea. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus Mid-Scala Electrode array</Description>
            <Size>Implant Size: 56mm (L) x 28mm (w) x 5.7mm (thickness. Electrode size: Active length 15mm, Tip diameter 0.5mm, Basal diameter 0.7mm. Total length of electrode array 23.7mm</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>220306</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BD024</PriorBillingCode>
                <PriorBillingCode>BD026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HiRes Ultra Cochlear Implant</Name>
            <Description>The HiRes Ultra Cochlear Implant  with HiFocus is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and either HiFocus Mid-Scala Electrode array or HiFocus SlimJ electrode array</Description>
            <Size>Implant Size: 56.2mm (L) x 28.5mm (w) x 4.5mm (thickness).     HiFocus Mid-Scala Electrode: Active length 15mm, Tip diameter 0.5mm, Basal diameter 0.7mm. Total length of electrode array 23.7mm.  HiFocus SlimJ Electrode: Electrode size: Active length 20mm, Tip diameter 0.26mm, Basal electrode diameter 0.56mm. Total length of electrode array 23.7mm</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>295250</ARTG>
                <ARTG>301320</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD030</BillingCode>
            <Name>HiRes Ultra 3D Cochlear Implant</Name>
            <Description>The HiRes Ultra 3D Cochlear Implant is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and two electrode variations HiFocus MidScala or HiFocus SlimJ Electrode array</Description>
            <Size>Implant Size: 56.2mm (L) x 28.5mm (w) x 4.5mm (thickness).   HiFocus MidScala Electrode: Active length 15mm, Tip diameter 0.5mm, Basal diameter 0.7mm. Total length of electrode array 23.7mm  HiFocus SlimJ Electrode: Electrode size: Active length 20mm, Tip diameter 0.26mm, Basal electrode diameter 0.56mm. Total length of electrode array 23.7mm</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>375483</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO021</BillingCode>
            <Name>Nucleus Freedom Implant with Contour Advance Electrode</Name>
            <Description>Model C124RE (CA), Generation 4 Cochlear implant with perimodiolar electrode array.  Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable silicone seal</Description>
            <Size>one size only</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>117025</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO024</BillingCode>
            <Name>Nucleus Freedom Implant with Straight Electrode</Name>
            <Description>Model CI24RE (ST), Generation 4 Cochlear Implant with straight array electrode</Description>
            <Size>One size only</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>117025</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO046</BillingCode>
            <Name>Cochlear™ Nucleus® CI512 Cochlear Implants with Contour Advance Electrode</Name>
            <Description>Model CI512, 5th generation cochlear implant with perimodiloar electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable silicone seal.</Description>
            <Size>One Size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>165361</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO057</BillingCode>
            <Name>Cochlear™ Nucleus® CI422 cochlear implant with Straight Electrode</Name>
            <Description>Model CI422, 4th generation cochlear implant with straight array.  Titanium casing, removable magnet.  22 half banded platinum intracochlear electrodes moulded with a silicone elastomer carrier and spaced over a 20mm active array.  The electrode diameter is 0.6mm at the badal end, tapering to 0.3mm at the apical electrode band.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>192676</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO074</BillingCode>
            <Name>Cochlear Nucleus CI522 Cochlear Implant with Slim Straight Electrode</Name>
            <Description>Model CI522, 5th generation cochlear implant with straight electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>232917</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO078</BillingCode>
            <Name>Cochlear™ Nucleus® CI532 Cochlear Implant with Slim Modiolar Electrode</Name>
            <Description>Model CI532, 5th generation cochlear implant with slim modiolar electrode array. Sheath, titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal. Compatible with 1.5T static magnetic field.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>286928</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO083</BillingCode>
            <Name>Cochlear™ Nucleus® Profile Plus Series (CI632) Cochlear Implant with Slim Modiolar Electrode</Name>
            <Description>Profile Plus Series CI632, 6th generation cochlear implant with Slim Modiolar electrode array. Sheath, titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal, compatible with 1.5T and 3T static magnetic field.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>322143</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO084</BillingCode>
            <Name>Cochlear™ Nucleus® Plus Series (CI612) Cochlear Implant with Contour Advance Electrode</Name>
            <Description>Profile Plus Series CI612, 6th generation cochlear implant with Contour Advance electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal, compatible with 1.5T and 3T static magnetic field.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>322141</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO085</BillingCode>
            <Name>Cochlear™ Nucleus® Profile Plus Series (CI622) Cochlear Implant with Slim Straight Electrode</Name>
            <Description>Profile Plus Series CI622, 6th generation cochlear implant with Slim Straight electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal, compatible with 1.5T and 3T static magnetic field.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>322142</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI035</BillingCode>
            <Name>Neuro Zti Cochlear Implant</Name>
            <Description>The Neuro Zti is a multi-channel cochlear implant. It is designed to be surgically implanted and consists of the receiver/stimulator implanted under the skin on the temporal aspect of the skull and a multichannel electrode designed to be inserted within the Scala Tympani of the cochlea. These electrodes will provide electrical stimulation to the auditory nerve, leading to activation of user’s auditory pathway, and perception of sound percept.</Description>
            <Size>Two variants exist for the Neuro Zti:&#xD;
EVO (atraumatic) Insertion length 25mm &#xD;
CLA (classic) Insertion length 26mm</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>284148</ARTG>
                <ARTG>284150</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US012</BillingCode>
            <Name>Mi1200 SYNCHRONY Cochlear Implant / Mi1200 SYNCHRONY PIN Cochlear Implant</Name>
            <Description>Ultra small titanium implant with flexible atraumatic electrode arrays provide complete cochlea coverage. Removable and self-aligning magnet is MRI safe at 3.0 Tesla (without magnet removal)</Description>
            <Size>Stimulator Housing: L 17.3mm, W 25.4mm, Thin 4.5mm, Weight 7.6g.  Electrode: Standard (26.4mm), Compressed (12.1mm), Medium (20.9mm), FLEX24 (20.9mm), FLEX26 (20.9mm), FLEXsoft (26.4mm), FLEX28 (23.1mm), FORM19 (14.3mm), FORM24 (18.7mm), FLEX20 (15.4mm)</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>389012</ARTG>
                <ARTG>389013</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US028</BillingCode>
            <Name>Mi1250 SYNCHRONY 2 Cochlear Implant /   Mi1250 SYNCHRONY 2 PIN Cochlear Implant</Name>
            <Description>Ultra small titanium implant with symmetrical central and flexible atraumatic electrode arrays provide complete cochlea coverage.  Removable and self-aligning magnet is conditionally MRI  safe for 3.0 Tesla MRI scans (without magnet removal).</Description>
            <Size>Stimulator Housing: L 47.3 mm, W 24 mm, Thin 4.5 mm, Weight 7.7g    Electrode: Standard (26.4mm), Medium (20.9mm), Compressed (12.1mm), FLEXsoft (26.4mm), FLEX28 (23.1mm),  FLEX26 (20.9mm), FLEX24 (20.9mm), FLEX20 (15.4mm), FORM24 (18.7mm), FORM19 (14.3mm)</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1526</GroupID>
            <ARTGs>
                <ARTG>389051</ARTG>
                <ARTG>389052</ARTG>
            </ARTGs>
            <MinimumBenefit>12892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD023</BillingCode>
            <Name>Naida CI Q90 Sound Processor (Initial Order)</Name>
            <Description>The Naida CI Q90 Sound processor is a BTE Sound Processor to communicates with the internally implanted HiRes Family implants. It facilitates electro-acoustic stimulation of the cochlea, as well as being compatible with a range of wireless devices.</Description>
            <Size>There is one size of the sound processor unit with 4 battery options/sizes.</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>282255</ARTG>
            </ARTGs>
            <MinimumBenefit>11392</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO069</BillingCode>
            <Name>Cochlear ™ Nucleus® CP910 Sound Processor (Initial)</Name>
            <Description>The Cochlear Nucleus CP910 Sound Processor is a behind-the-ear sound processor two built-in directional microphones</Description>
            <Size>There is only one size of the processing unit and coil.  There are two sizes for battery holder and cover.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216062</ARTG>
            </ARTGs>
            <MinimumBenefit>11392</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO071</BillingCode>
            <Name>Cochlear ™ Nucleus® CP920 Sound Processor (Initial)</Name>
            <Description>The Cochlear Nucleus CP920 Sound Processor is a behind-the-ear sound processor with two built-in directional micophones.</Description>
            <Size>There is only one size of the processing unit and coil.  There are two sizes for battery holder and cover.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216063</ARTG>
            </ARTGs>
            <MinimumBenefit>11392</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO080</BillingCode>
            <Name>Kanso®, Cochlear™ Nucleus® CP950 Sound Processor (Initial)</Name>
            <Description>An off-the-ear sound processor with two built-in directional microphones, wireless connectivity, and equivalent functionality to the Cochlear N6 behind-the-ear sound processor in a fully integrated single unit, enclosing radiofrequency (RF) coil, supplying power, and signals to internal implant.</Description>
            <Size>One size (40.9 mm x 35.2 mm x 11.4 mm)</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>282194</ARTG>
            </ARTGs>
            <MinimumBenefit>11392</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO088</BillingCode>
            <Name>Kanso® 2, Cochlear™ Nucleus® CP1150 Sound Processor (Initial)</Name>
            <Description>The CP1150 Sound Processor (Kanso 2) is Cochlear’s next generation off-the-ear (OTE) style sound processor. Kanso 2 has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear™ Nucleus® 7  (N7). Compared to Kanso 1, Kanso 2 provides improved hearing performance in noise due to Spatial NR, and improved hearing experience and reduced user cost through buttonless interface, iOs and Android smartphone direct streaming and a rechargeable battery.  The initial Kanso 2 Kit provides multiple magnet strengths and range of battery charging options.</Description>
            <Size>One size, multiple magnet strengths and range of battery charging options</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>351996</ARTG>
            </ARTGs>
            <MinimumBenefit>11392</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US032</BillingCode>
            <Name>RONDO 3 Audio Processor (initial)</Name>
            <Description>A Single Unit off-the-ear (OTE) audio processor for the MED-EL CI System, integrating two omni-directional microphones, coil, indicator LED, magnet &amp; electronics package, held in place over the implant by magnetic attraction. It features an integrated wirelessly rechargeable battery providing up to 24hr battery life, link monitoring, increased water resistance (IP68), datalogging, Adaptive Intelligence, Automatic Sound Management, wireless connectivity to assistive listening devices.</Description>
            <Size>One size - L 44.8 mm, W 35.7 mm, H 11.6 mm  (with 5 magnet strengths and 2 cover options)  </Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>355351</ARTG>
            </ARTGs>
            <MinimumBenefit>11392</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US014</BillingCode>
            <Name>SONNET EAS Audio Processor (initial)</Name>
            <Description>Audio processor worn behind the ear with dual omnidirectional microphone, water-resistance, datalogging, Automatic Sound Management, wireless connectivity to assistive listening devices, electric and electric acoustic stimulation modes</Description>
            <Size>One size</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>Electroacoustic</Suffix>
            <ARTGs>
                <ARTG>232487</ARTG>
            </ARTGs>
            <MinimumBenefit>12303</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD027</BillingCode>
            <Name>Naida CI Electric Acoustic Solution</Name>
            <Description>The Naida CI Q90 sound processor is one part of a cochlear implant system that enables hearing. The other necessary parts of the system are the  implantable Cochlear Stimulator (ICS), headpiece and headpiece cable. The sound processor consists of two parts: the sound processor and battery power source. The Naida CI Q90 is compatible with the Naida CI Acoustic Earhook, supplying both electric and acoustic stimulation.</Description>
            <Size>The Naida CI Sound Processor comes in one size. The Naida CI Acoustic Earhook comes in 5 length options, and is available for left and right ear (10 configurations).</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>282255</ARTG>
                <ARTG>300028</ARTG>
            </ARTGs>
            <MinimumBenefit>12796</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO064</BillingCode>
            <Name>Cochlear ™ Nucleus® CP910 Sound Processor Hybrid™ Mode (Initial)</Name>
            <Description>The Cochlear Nucleus CP910 Sound processor in "Hybrid Mode" facilitates electroacoustic stimulation of the cochlea</Description>
            <Size>There is only one size of the processing unit and coil.  There are two sizes for the battery holder and cover.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216062</ARTG>
            </ARTGs>
            <MinimumBenefit>12796</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO066</BillingCode>
            <Name>Cochlear™ Nucleus® CP920 Sound Processor - Hybrid™ Mode (Initial)</Name>
            <Description>The Cochlear Nucleus CP920 Sound Processor in "Hybrid Mode" facilitates electroacoustic stimulation of the cochlea</Description>
            <Size>There is only one size of the processing unit and coil. There are two sizes for battery holder and cover.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216063</ARTG>
            </ARTGs>
            <MinimumBenefit>12796</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO081</BillingCode>
            <Name>Cochlear™ Nucleus® CP1000 Sound Processor - Hybrid™ Mode (initial)</Name>
            <Description>The CP1000 (Nucleus 7, N7) - Hybrid Mode is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the CP900 series (CP910/920) (Nucleus 6, N6) sound processor but with new architectural design, which provides improved battery life and MFi wireless connectivity directly with iOS devices via Smart App. The CP1000 in hybrid mode facilitates acoustic stimulation in the cochlea.</Description>
            <Size>There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>292000</ARTG>
            </ARTGs>
            <MinimumBenefit>12796</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US025</BillingCode>
            <Name>SONNET 2 EAS Audio Processor</Name>
            <Description>Audio processor with electric and electric acoustic stimulation modes, worn behind the ear with dual omnidirectional microphone, water-resistance, enhanced datalogging and signal processing, Adaptive Intelligence, Automatic Sound Management, wireless connectivity to assistive listening devices</Description>
            <Size>one size with 3 battery options and various magnet strengths</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>319472</ARTG>
            </ARTGs>
            <MinimumBenefit>12796</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI036</BillingCode>
            <Name>Neuro 2 Sound Processor</Name>
            <Description>The behind the ear Neuro 2 sound processor performs with the Neuro Zti cochlear implants. It consists of two microphones allowing for 3 automatic adaptive directionality modes, voice tracker and wind noise reduction features.   Its benefits include: smaller and more cosmetically appealing design and rechargeable batteries.    The processor is placed on the auricle of the either one of the patient's ears and an external antenna transmits the acoustic signal processed by the processor, by means of electromagnetic induction, to the internal component implanted beneath the skin and secured onto the mastoid.</Description>
            <Size>One size</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <ARTGs>
                <ARTG>316140</ARTG>
            </ARTGs>
            <MinimumBenefit>8740</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US022</BillingCode>
            <Name>RONDO 2 Audio Processor</Name>
            <Description>A Single Unit audio processor for the MED-EL Cochlear Implant System, integrating microphone, telecoil, coil cable, indicator LED, magnet &amp; electronics package worn off the ear and held in place by magnetic attraction.  It features an integrated wirelessly rechargeable battery, link-check function and water resistance (IP54).</Description>
            <Size>one size - L 45.5 mm, W 35.7 mm, H 11.7 mm</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4145</SubGroupID>
            <ARTGs>
                <ARTG>307121</ARTG>
            </ARTGs>
            <MinimumBenefit>8740</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD025</BillingCode>
            <Name>Naida CI Q90 Sound Processor (Replacement Order)</Name>
            <Description>The Naida CI Q90 sound processor is one part of a cochlear implant system that enables hearing. The other necessary parts of the system are the Implantable Cochlear Stimulator (ICS), headpiece and headpiece cable. The sound processor consists of two parts: the sound processor and battery power source. There are four battery options, including four sizes of Lithium Ion rechargeable PowerCel™ batteries. This facilitates electro-acoustic stimulation to the cochlear and wireless capability.</Description>
            <Size>There is only one size of the sound processing unitl.  There are four sizes of the battery.</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>282255</ARTG>
                <ARTG>300028</ARTG>
            </ARTGs>
            <MinimumBenefit>8114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO070</BillingCode>
            <Name>Cochlear ™ Nucleus® CP910 Sound Processor (Replacement)</Name>
            <Description>The Cochlear Nucleus CP910 Sound Processor is a behind-the-ear sound processor with two built-in directional microphones</Description>
            <Size>CO049</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216062</ARTG>
            </ARTGs>
            <MinimumBenefit>8114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO072</BillingCode>
            <Name>Cochlear ™ Nucleus® CP920 Sound Processor (Replacement)</Name>
            <Description>The Cochlear Nucleus CP920 Sound Processor  is a behind-the-ear sound processor with two built-in directional microphones. It has no accessory port for cables.</Description>
            <Size>There is only one size of the processing unit and coil.  There are two sizes for battery holder and cover.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216063</ARTG>
            </ARTGs>
            <MinimumBenefit>8114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO079</BillingCode>
            <Name>Kanso®, Cochlear ™ Nucleus® CP950 Sound Processor (Replacement)</Name>
            <Description>An off-the-ear sound processor with two built-in directional microphones, wireless connectivity, and equivalent functionality to the Cochlear N6 behind-the-ear sound processor in a fully integrated single unit, enclosing radiofrequency (RF) coil, supplying power, and signals to internal implant.</Description>
            <Size>One size (40.9 mm x 35.2 mm x 11.4 mm)</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>282194</ARTG>
            </ARTGs>
            <MinimumBenefit>8114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO086</BillingCode>
            <Name>Kanso® 2, Cochlear™ Nucleus® CP1150 Sound Processor (Replacement)</Name>
            <Description>The CP1150 Sound Processor (Kanso 2) is Cochlear’s next generation off-the-ear (OTE) style sound processor. Kanso 2 has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear™ Nucleus® 7. Compared to Kanso 1, Kanso 2 provides improved hearing performance in noise due to Spatial NR, and improved hearing experience and reduced user cost through buttonless interface, iOs and Android smartphone direct streaming and a rechargeable battery. The Replacement Kanso 2 Kit provides a single magnet and battery charging option.</Description>
            <Size>One size, single magnet and battery charging option  </Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>351996</ARTG>
            </ARTGs>
            <MinimumBenefit>8114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US031</BillingCode>
            <Name>RONDO 3 Audio Processor (Replacement)</Name>
            <Description>A Single Unit off-the-ear (OTE) audio processor for the MED-EL CI System, integrating two omni-directional microphones, coil, indicator LED, magnet &amp; electronics package, held in place over the implant by magnetic attraction. It features an integrated wirelessly rechargeable battery providing up to 24hr battery life, link monitoring, increased water  resistance (IP68), datalogging, Adaptive Intelligence, Automatic Sound Management, wireless connectivity to assistive listening devices.</Description>
            <Size>One size - L 44.8 mm, W 35.7 mm, H 11.6 mm (with 5 magnet strengths and 2 cover options)</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>355351</ARTG>
            </ARTGs>
            <MinimumBenefit>8114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US016</BillingCode>
            <Name>SONNET EAS Audio Processor (replacement)</Name>
            <Description>Audio processor worn behind the ear with dual omnidirectional microphones, water-resistance, data logging, Automatic Sound Management, wireless connectivity to assistive listening devices, electric and electric acoustic stimulation modes</Description>
            <Size>One size</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Electroacoustic</Suffix>
            <ARTGs>
                <ARTG>232487</ARTG>
            </ARTGs>
            <MinimumBenefit>8612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD028</BillingCode>
            <Name>Naida CI Electric Acoustic Solution</Name>
            <Description>The Naida CI Q90 sound processor is one part of a cochlear implant system that enables  hearing. The other necessary parts of the system are the implantable Cochlear Stimulator  (ICS), headpiece and headpiece cable. The sound processor consists of two parts: the  sound processor and battery power source. The Naida CI Q90 is compatible with the Naida CI Acoustic Earhook, supplying both electric and acoustic stimulation.</Description>
            <Size>The Naida CI Sound Processor comes in one size. The Naida CI Acoustic Earhook comes  in 5 length options, and is available for left and right ear (10 configurations).</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>282255</ARTG>
                <ARTG>300028</ARTG>
            </ARTGs>
            <MinimumBenefit>9078</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO065</BillingCode>
            <Name>Cochlear™ Nucleus CP910 Sound Processor Hybrid™ Mode (Replacement)</Name>
            <Description>The Cochlear Nucleus CP910 Sound Processor in "Hybrid Mode" facilitates electroacoustic stimulation to the cochlea</Description>
            <Size>There is only one size of the processing unit and coil.  There are two sizes for the battery holder.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216062</ARTG>
            </ARTGs>
            <MinimumBenefit>9078</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO067</BillingCode>
            <Name>Cochlear™ Nucleus® CP920 sound Processor - Hybrid™ Mode (Replacement)</Name>
            <Description>The Cochlear Nucleus CP920 Sound Processor in "Hybrid Mode" facilatates electroacoustic stimulation of the cochlea.</Description>
            <Size>There is only one size of the processing unit and coil. There are two sizes for battery holder and cover.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>216063</ARTG>
            </ARTGs>
            <MinimumBenefit>9078</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO082</BillingCode>
            <Name>Cochlear™ Nucleus® CP1000 Sound Processor - Hybrid™ Mode (replacement)</Name>
            <Description>The CP1000 (Nucleus 7, N7) - Hybrid Model is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the CP900 series (CP910/920) (Nucleus 6, N6) sound processor but with new architectural design, which provides improved battery life and MFi wireless connectivity directly with iOS devices via Smart App. The CP1000 in hybrid mode facilitates acoustic stimulation in the cochlea.</Description>
            <Size>There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>292000</ARTG>
            </ARTGs>
            <MinimumBenefit>9078</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US024</BillingCode>
            <Name>SONNET 2 EAS Audio Processor (replacement)</Name>
            <Description>Audio processor with electric and electric acoustic stimulation modes, worn behind the ear with dual omnidirectional microphone, water-resistance, enhanced datalogging and signal processing, Adaptive Intelligence, Automatic Sound Management, wireless connectivity to assistive listening devices</Description>
            <Size>one size with 3 battery options and various magnet strengths</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix>
            <ARTGs>
                <ARTG>319472</ARTG>
            </ARTGs>
            <MinimumBenefit>9078</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BD015</BillingCode>
            <Name>Neptune Sound Processor replacement part is the external part of the cochlear implant system. Also includes Neptune Connect</Name>
            <Description>The Neptune Processor is an external component of the HiRes Bionic Ear System. The processor is intended to deliver HiResolution sound to a cochlear implant. Also includes Neptune Connect.</Description>
            <Size>One size. &#xD;
Processor: H x W X D: 26 x 18 x 60mm&#xD;
Neptune Connect Size:  H x W x D: 17 x 18 x 58mm</Size>
            <SupplierCode>BD</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Generation 4</Suffix>
            <ARTGs>
                <ARTG>198825</ARTG>
            </ARTGs>
            <MinimumBenefit>7648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI037</BillingCode>
            <Name>Neuro 2 Sound Processor Replacement</Name>
            <Description>The behind the ear Neuro 2 sound processor performs with the Neuro Zti cochlear implants. It consists of two microphones allowing for three automatic adaptive directionality modes, voice tracker and wind noise reduction features.     Its benefits include: smaller and more cosmetically appealing design and rechargeable batteries.    The processor is placed on the auricle of the either one of the patient's ears and an external antenna transmits the acoustic signal processed by the processor, by means of electromagnetic induction, to the internal component implanted beneath the skin and secured onto the mastoid.</Description>
            <Size>One size</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Generation 4</Suffix>
            <ARTGs>
                <ARTG>316140</ARTG>
            </ARTGs>
            <MinimumBenefit>7648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US015</BillingCode>
            <Name>SONNET Audio Processor (Replacement)</Name>
            <Description>Audio processor worn behind the ear with dual omnidirectional microphones, water-resistance, data logging, Automatic Sound Management, wireless connectivity to assistive listening devices</Description>
            <Size>One size</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Generation 4</Suffix>
            <ARTGs>
                <ARTG>232486</ARTG>
            </ARTGs>
            <MinimumBenefit>7648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US023</BillingCode>
            <Name>RONDO 2 Audio Processor - Replacement</Name>
            <Description>A Single Unit audio processor for the MED-EL Cochlear Implant System, integrating microphone, telecoil, coil cable, indicator LED, magnet &amp; electronics package worn off the ear and held in place by magnetic attraction. It features an integrated wirelessly rechargeable battery, link-check function and water resistance (IP54).</Description>
            <Size>one size - L 45.5 mm, W 35.7 mm, H 11.7 mm</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1528</GroupID>
            <SubGroupID>4147</SubGroupID>
            <Suffix>Generation 4</Suffix>
            <ARTGs>
                <ARTG>307121</ARTG>
            </ARTGs>
            <MinimumBenefit>7648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO075</BillingCode>
            <Name>Cochlear Baha 5 Sound Processor</Name>
            <Description>The Cochlear Baha 5 Sound Processor (26,mm x 19mm x12mm) is a wireless-enabled smartphone compatible fully programmable head-word digital sound processor for the Baha Implantable Bone Conduction Hearing System</Description>
            <Size>One size (26mm x 19 mm x 12 mm)</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>123987</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO076</BillingCode>
            <Name>Cochlear Baha 5 SuperPower Sound Processor</Name>
            <Description>The Cochlear Baha 5 SuperPower sound processor is a powerful (up to 65dB HL) wireless-enabled, smartphone compatible, fully programmable, digital sound processor for the Baha Implantable Bone Conduction Hearing System. It is intended to be fitted as a head worn split system - it comprises a behind-the-ear (BTE) Sound Processing Unit, an Actuator unit, and a Cable between the BTE and the Actuator unit.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>123987</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO077</BillingCode>
            <Name>Cochlear Baha 5 Power Sound Processor</Name>
            <Description>The Cochlear Baha 5 Power sound processor is a powerful (up to 55dB HL), wireless-enabled, smartphone compatible, fully programmable, digital sound processor for the Cochlear Baha 'Connect' and 'Attract' Implantable Bone Conduction Hearing Systems.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>123987</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO087</BillingCode>
            <Name>Cochlear™ Baha® 6 Max Sound Processor </Name>
            <Description>The Baha 6 Max is Cochlear’s next generation off-the-ear (OTE) sound processor for use with Cochlear Baha 'Connect' and 'Attract' Implantable Bone Conduction Hearing Systems with a fitting range up to 55dB HL. Baha 6 Max has broader bandwidth at higher frequencies, iOS and Android smartphone direct streaming and smaller, lighter and more discreet OTE technology.</Description>
            <Size>1 x SP size with 2 options of the snap coupling sizes</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>123987</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI032</BillingCode>
            <Name>Ponto 3 Sound Processor</Name>
            <Description>A wireless enabled - fully programmable head worn sound processor for bone conduction hearing systems with full smart phone capabilities. Optional Superpower model, delivering higher output across the entire bandwidth.</Description>
            <Size>Ponto 3: 34x21x11mm&#xD;
Ponto 3 Power: 34x21x14mm&#xD;
Ponto 3 SuperPower: 34x21x14mm</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>198104</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI038</BillingCode>
            <Name>Ponto 4 </Name>
            <Description>A wireless enabled - fully programmable head worn sound processor for bone conduction hearing systems with directionality paradigm offering analysis, balancing &amp; noise removal, IFTTT; together with programmable &amp; direct to smart phone capacity.</Description>
            <Size>One size (26 x 19 x 11 mm)</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>198860</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI039</BillingCode>
            <Name>Ponto 5 Mini &amp; SuperPower</Name>
            <Description>A wireless enabled - fully programmable head worn sound processor for bone conduction hearing systems with directionality paradigm offering analysis, balancing &amp; noise removal, IFTTT; together with programmable &amp; direct to smart phone capacity and remote care possibilities. Has the ability to detect, and prevent feedback from occurring. Ponto 5 Mini &amp; Ponto 5 SuperPower have the ability to be programmed using DSL (Desired Sensation Level) which is particularly beneficial to the paediatric population.  </Description>
            <Size>26 x 19 x 11 mm - Ponto 5 Mini  31 x 21 x 15 mm - Ponto 5 SuperPower</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>198860</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US017</BillingCode>
            <Name>Bonebridge Samba BB Audio Processor</Name>
            <Description>The Samba BB is a wireless enabled audio processor and the externally worn component of the Bonebridge System.  It connects to the implant through magnetic attraction. Fitting the Samba BB audio processor activates the Bonebridge.</Description>
            <Size>left and right versions, length = 35mm, width = 30mm, height = 10mm, weight &lt;9g (inc battery)</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled</Suffix>
            <ARTGs>
                <ARTG>270912</ARTG>
            </ARTGs>
            <MinimumBenefit>6484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US030</BillingCode>
            <Name>SAMBA 2 BB Audio Processor</Name>
            <Description>Single Unit audio processor for the Bonebridge System, worn off the ear it is held in place by magnetic attraction over the implant. Designed to function similarly as the SAMBA BB audio processor with improved battery life, noise reduction, ingress protection  and Intelligent Sound Adapter 2.0</Description>
            <Size>One Size - left/right versions with various magnet strengths, length = 36.4mm, width = 30.4mm, height = 10.2mm, weight 9.3g (inc battery)</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4150</SubGroupID>
            <Suffix>Programmable, Wireless-enabled, Autoscan</Suffix>
            <ARTGs>
                <ARTG>353072</ARTG>
            </ARTGs>
            <MinimumBenefit>6808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO050</BillingCode>
            <Name>Baha BA210 Abutment</Name>
            <Description>Titanium abutments compatible with hexagonal coupling Baha implants</Description>
            <Size>5.5mm and 8.5mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI025</BillingCode>
            <Name>Ponto Abutment</Name>
            <Description>Bone anchor abutment with connection screw</Description>
            <Size>Length: 6 - 14mm&#xD;
Straight and angled</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment</Suffix>
            <ARTGs>
                <ARTG>198759</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO052</BillingCode>
            <Name>Baha BA300 abutment.</Name>
            <Description>Titanium abutment of the Baha BI300 implant system.</Description>
            <Size>6 mm and 9 mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment &amp; Concave</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO032</BillingCode>
            <Name>Flange fixture - self tapping fixture with pre-mounted abutment</Name>
            <Description>Self tapping titanium flange fixture with abutment in two sizes:  3mm and 4mm</Description>
            <Size>Self Tapping 4mm and 3mm with BAHA Abutment</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment &amp; Fixture</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>1833</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI194</BillingCode>
            <Name>Sophono Alpha Bone Conduction Hearing System, Implant</Name>
            <Description>Alpha Implant</Description>
            <Size>-</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment &amp; Fixture</Suffix>
            <ARTGs>
                <ARTG>272642</ARTG>
            </ARTGs>
            <MinimumBenefit>1833</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI026</BillingCode>
            <Name>Ponto Abutment and Implant</Name>
            <Description>Bone anchor implant and abutment with connection screw</Description>
            <Size>Diameter: 3.75 - 4.5mm&#xD;
Length: Fixture 3 - 4mm, Abutment 6 -14mm</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment &amp; Fixture</Suffix>
            <ARTGs>
                <ARTG>198759</ARTG>
            </ARTGs>
            <MinimumBenefit>1833</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO063</BillingCode>
            <Name>Cochlear ™ Baha® BIA400 Implant with Abutment</Name>
            <Description>Pre-mounted self-tapping titanium implant with TiOblast™ surface and coated Abutment with hydroxyapatite (HA) coating for Baha FAST surgery</Description>
            <Size>4mm implant with pre-mounted 6mm, 8mm, 10mm, or 12mm , or 14mm abutment</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment &amp; Fixture, HA</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO053</BillingCode>
            <Name>Baha BIA300 implants with abutments</Name>
            <Description>Self tapping titanium implant with pre-mounted abutment of the Baha 3  system, for the Baha FAST surgery.</Description>
            <Size>3mm implant with 6mm abutment, 4mm implant with 6mm abutment, 4mm implant with 9mm abutment.</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment, Fixture &amp; Concave</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>1916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI031</BillingCode>
            <Name>Ponto BHX Implant and Abutment</Name>
            <Description>A laser-ablated titanium surface implant using Biohelix™ (BHX) and abutment&#xD;
with connection screw.</Description>
            <Size>Diameter: 3.75 - 4.5mm&#xD;
Length: Fixture 3 - 4mm&#xD;
Abutment: 6 -14mm</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Abutment, Fixture &amp; Concave</Suffix>
            <ARTGs>
                <ARTG>198759</ARTG>
            </ARTGs>
            <MinimumBenefit>1916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI024</BillingCode>
            <Name>Ponto Implant</Name>
            <Description>Bone anchor implant</Description>
            <Size>Diameter: 3.75 - 4.5mm&#xD;
Length: 3 - 4mm</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Fixture</Suffix>
            <ARTGs>
                <ARTG>198759</ARTG>
            </ARTGs>
            <MinimumBenefit>983</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO051</BillingCode>
            <Name>Baha® BI300 Implant</Name>
            <Description>Titanium self-tapping implant with TiOblast surface of the Baha 3 system</Description>
            <Size>3mm and 4 mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Fixture &amp; Concave</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>1028</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI030</BillingCode>
            <Name>Ponto BHX Implant</Name>
            <Description>A laser-ablated titanium surface implant using Biohelix™ (BHX).</Description>
            <Size>Length: 3mm, 4mm</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Fixture &amp; Concave</Suffix>
            <ARTGs>
                <ARTG>198759</ARTG>
            </ARTGs>
            <MinimumBenefit>1028</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO062</BillingCode>
            <Name>Cochlear™ Baha®  BA400 DermaLock™ Abutment</Name>
            <Description>Titanium abutment with hydroxyapatite (HA) coating</Description>
            <Size>6mm, 8mm, 10mm, 12mm, 14mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>HA</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>1059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US027</BillingCode>
            <Name>BCI 602 Implant</Name>
            <Description>Active transcutaneous bone conduction implant consisting of attachment magnet, receiver coil, Bone Conduction-Floating Mass Transducer (BC-FMT) with electronics, bendable transition to FMT, implanted under intact skin</Description>
            <Size>one size - 28.3 (w) x 64.3 (l) x 8.6 (h) mm</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Implanted Transducer, Magnetic Coupler</Suffix>
            <ARTGs>
                <ARTG>329050</ARTG>
            </ARTGs>
            <MinimumBenefit>2222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US026</BillingCode>
            <Name>BCI 602 Lifts (1mm)</Name>
            <Description>BCI 602 Lifts (1mm) can be implanted together with the Bonebridge BCI 602, attached to the fixation wings of the BCI 602, serving as a spacer to increase distance between the fixation wings and the skull bone.</Description>
            <Size>1mm</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Lifts</Suffix>
            <ARTGs>
                <ARTG>329049</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO068</BillingCode>
            <Name>Cochlear™ Baha® BIM400 Implant Magnet</Name>
            <Description>The Cochlear Baha BIM400 is an implantable magnet that lies completely under the skin</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4151</SubGroupID>
            <Suffix>Magnetic Coupling</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>1059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO028</BillingCode>
            <Name>BAHA - Cover screw unigrip</Name>
            <Description>Titanium cover screws, individually packaged and delivered sterile.  The cover screws are used to prevent bone overgrowth of the implant.</Description>
            <Size>One size only</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4152</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO054</BillingCode>
            <Name>Baha Cover Screw conical</Name>
            <Description>Titanium cover screw of the Baha BI300 implant system used in the two-stage surgery.</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4152</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI027</BillingCode>
            <Name>Ponto Healing Cap</Name>
            <Description>Cover screw</Description>
            <Size>One size only</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4152</SubGroupID>
            <ARTGs>
                <ARTG>198868</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OI028</BillingCode>
            <Name>Ponto Cover Screw</Name>
            <Description>Cover screw</Description>
            <Size>One size only</Size>
            <SupplierCode>OI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1560</GroupID>
            <SubGroupID>4152</SubGroupID>
            <ARTGs>
                <ARTG>198759</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET072</BillingCode>
            <Name>Eclipse Piston</Name>
            <Description>Stapes: Nitinol, Fluroplastic</Description>
            <Size>Diameter 0.4mm: 3.75mm - 6.00mm; Diameter 0.5mm: 3.75mm - 6.00mm;  Diameter 0.6mm: 3.75mm - 6.00mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>170281</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC918</BillingCode>
            <Name>The Big Easy Piston</Name>
            <Description>Big Easy Range - MRI Safe, Triple Width Platinum Band, Double Width Platinum Shaft with Offset Versions</Description>
            <Size>0.4 - 1.17mm x 0.9 - 4.0mm x 4.0 x 10.2mm; 4.0 - 4.75mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>125831</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI079</BillingCode>
            <Name>Middle ear prostheses</Name>
            <Description>Stapes</Description>
            <Size>0.4-1.17mm x 0.9-4.0 x 4.0 x4.0-10.2mm; 4.0 - 4.75mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>125831</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL012</BillingCode>
            <Name>Canal Wall Prosthesis</Name>
            <Description>Grote, HA</Description>
            <Size>Small - Large</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL014</BillingCode>
            <Name>Ossicular Prosthesis</Name>
            <Description>Attic Defect Plate, HA</Description>
            <Size>7-14mm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL089</BillingCode>
            <Name>Stapes</Name>
            <Description>De La Cruz&#xD;
House-Type&#xD;
Lippy Modified&#xD;
Classic&#xD;
Richards Bucket Handle</Description>
            <Size>Various</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL091</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OL018</PriorBillingCode>
                <PriorBillingCode>OL022</PriorBillingCode>
                <PriorBillingCode>OL023</PriorBillingCode>
                <PriorBillingCode>OL024</PriorBillingCode>
                <PriorBillingCode>OL025</PriorBillingCode>
                <PriorBillingCode>OL075</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stapes</Name>
            <Description>Causse Pistons,&#xD;
Cawthorne Pistons,&#xD;
Fisch-Type Pistons,&#xD;
Fluoroplastic Pistons,&#xD;
McGee Pistons,&#xD;
Richards Platinum Fluoroplastic Pistons,&#xD;
Schuknecht Pistons,&#xD;
Schuknecht Malleus Attached Pistons&#xD;
SMart Pistons,&#xD;
SMart 360 Pistons&#xD;
SMart Malleus</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UP003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM332</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stapes</Name>
            <Description>a) NiTiBOND   b) Soft CliP   c) K-Piston   d) Angular Piston   e) CliP Piston aWengen   f) CliP Piston MVP  g) Lenticle Cup</Description>
            <Size>a) Diameter - 0.4 or 0.6mm in lengths - 3.5 to 5.5mm   b)  Diameter - 0.4 or 0.6mm in lengths 3.5 to 5.5mm   c) Diameter - 0.4 or 0.6mm in lengths 3.5 to 10mm   d) Diameter 0.4 or 0.6mm in lengths 4.25, 4.5, 4.75mm   e) Diameter - 0.4mm or 0.6mm in lengths 3.5 to 5.5mm   f) Diameter 0.4 or 0.6mm in lengths - 5 to 6.25mm  g) lengths - 3 to 4.5mm</Size>
            <SupplierCode>UP</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4154</SubGroupID>
            <ARTGs>
                <ARTG>119746</ARTG>
            </ARTGs>
            <MinimumBenefit>94</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC919</BillingCode>
            <Name>Middle Ear Prosthesis</Name>
            <Description>Malleus</Description>
            <Size>0.6 - 4.0mm x 2.7 - 5.0mm x 1.5 - 10.0mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4155</SubGroupID>
            <ARTGs>
                <ARTG>125831</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET073</BillingCode>
            <Name>Eclipse Malleus Piston</Name>
            <Description>Malleus &amp; Stapes: Nitinol, Fluoroplastic</Description>
            <Size>Diamater 0.6mm: 5.5mm-8.00mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>170281</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI076</BillingCode>
            <Name>Middle Ear Prostheses</Name>
            <Description>Partial Ossicular Reconstruction Implant - malleus + incus</Description>
            <Size>0.6-2.5 x 2.2-8.8 x 3.5 -10mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>125831</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL088</BillingCode>
            <Name>Ossicular Prosthesis - PORP</Name>
            <Description>Shea&#xD;
Micron Monolithic</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL094</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OL016</PriorBillingCode>
                <PriorBillingCode>OL017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ossicular Prosthesis - PORP</Name>
            <Description>Drum-to-Stapes&#xD;
Goldenberg Malleable &#xD;
Modified&#xD;
Off-Centered&#xD;
Sheehy Modified</Description>
            <Size>Various</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC010</BillingCode>
            <Name>Stapes Prosheses</Name>
            <Description>For reconstruction of the sound conduction chain between middle ear and inner ear through replacement of the stapes. The body of the implant consists of a columella (which in some product versions can be shortened) and a flat band. The columella is inserted in the opened Vestibulum auris through the trepanated stapes foot-plate. The flat band is placed around the long process of the incus. The implants are available in various versions and materials:&#xD;
• Titanium: Columella and flat band made of titanium;&#xD;
• Platinum/PTFE: Columella made of polytetrafluoroethylene (PTFE), flat band made of platinum (Pt);&#xD;
• Nitinol/PTFE: Columella made of polytetrafluoroethylene (PTFE), flat band made of nitinol.</Description>
            <Size>Stapes Prostheses Nitinol/PTFE, 1 piece, sterile, Wire diam: 0.2 mm, PTFE shaft diam: 0.4 &amp; 0.6 mm, Incus diam. small standard, large; length 5.25, 5.50, 5.75, 7.00 (shortenable)&#xD;
Stapes Prostheses Platinum/PTFE, 1 piece, sterile; piston diam. 0.4 &amp; 0.6 mm; length 5.25, 5.50, 5.75, 7.00 (shortenable), 10.00 (shortenable)&#xD;
Stapes Prostheses Titanium, 1 piece, sterile; piston diam. 0.4 &amp; 0.6 mm; length 5.25, 5.50, 5.75, 8.00 (shortenable)</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>290802</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC012</BillingCode>
            <Name>PORP - Partial Ossicular Replacement Prosthesis</Name>
            <Description>Partial implant made of titanium, for reconstructing a (partially) destroyed middle ear ossicular chain (chain of sound transmission) between the stapes and the tympanic membrane level in fixed and variable lengths. &#xD;
Fixed - The implant body is a single piece and was made from a single part only, i.e. it has no susceptible material bonding points such as weld seams. The implant can be subdivided into three areas: 1.) the implant bell that is offered in 2 embodiments: Unslitted and slitted; 2.) the implant shaft; 3.) the perforated implant plate. The implant plate can be arranged centrically (round) towards the implant shaft or eccentrically (oval). In the eccentric version (oval), an additional groove has been worked into the plate to improve receiving the malleus handle. &#xD;
Variable - The implant body consists of two parts, a shortenable shaft that is firmly bound to the prosthesis bell, and a prosthesis plate that has been provided with a borehole in its underside. The borehole has been dimensionally designed in such a way that it can receive the shaft after the latter has been adapted lengthwise to the respective situation in the middle ear. &#xD;
The surface of the predefined contact point (upper side of implant plate and inner side of the bell) is roughened in order to facilitate better bonding to the eardrum resp. the stapes head.</Description>
            <Size>Central Head with slitted Bell - shaft diam. 0.3mm, Length 0.5 - 3.5mm&#xD;
Offset Head with slitted Bell - shaft diam. 0.3mm, Length 0.5 - 3.5mm&#xD;
Central Head with Complete Bell - shaft diam. 0.3mm, Length 0.5 - 3.5mm&#xD;
Partial Titanium Implant with Separate Head, shaft 0 0.3 mm, Length 5.5-2.5mm (variable)&#xD;
Partial Titanium Implant with Separate Head, shaft 0 0.3 mm, Length 5.5-2.0mm (variable)</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>290802</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UP002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM329</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Partial Ossicle Replacement</Name>
            <Description>a) TTP Tuebingen Type bell   b) CliP Dresden Type   c) Malleus   d) Angular Plester   e) Angular CliP   f) TTP - Vario Bell TTP - Variac System, Partial  g) CliP Partial FlexBAL  h) Duesseldorf Type Partial</Description>
            <Size>a) length 1.75 to 3.5mm  b) length 1.75 to 3.5mm   c) length 1.75 to 3.5mm   d) length 2.25 or 3.25mm   e) length 2.25 or 3.25mm   f) one size  g) length 1.75 to 3.5mm  h) length 1.75 to 4.5mm</Size>
            <SupplierCode>UP</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>119746</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UP004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM338</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stapes</Name>
            <Description>Stapes Prosthesis</Description>
            <Size>Ø 0.4mm, Ø 0.5mm &amp; Ø 0.6mm  Lengths 3.50mm - 5.50mm</Size>
            <SupplierCode>UP</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4156</SubGroupID>
            <ARTGs>
                <ARTG>119746</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KG014</BillingCode>
            <Name>ALTO Prosthesis</Name>
            <Description>Adjustable Length Titanium Ossicular Chain Reconstruction Prosthesis</Description>
            <Size>Head Size: 1.5mm x 2.5mm / 2mm x 2.5mm / 2mm x 3.3mm / 2.5mm x 3.5mm / 4mm x 3.25mm.  Length: 0.75mm -  8.6mm.  Distal Diameter: 0.4mm - 1.45mm.</Size>
            <SupplierCode>KG</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4157</SubGroupID>
            <ARTGs>
                <ARTG>170281</ARTG>
            </ARTGs>
            <MinimumBenefit>347</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI075</BillingCode>
            <Name>Middle Ear Prostheses</Name>
            <Description>Total Ossicular Reconstruction Implants</Description>
            <Size>0.6-0.8mm x 3.0-4.0mm x 7.0-8.0mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4157</SubGroupID>
            <ARTGs>
                <ARTG>125831</ARTG>
            </ARTGs>
            <MinimumBenefit>347</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL073</BillingCode>
            <Name>Dornhoffer Prostheses</Name>
            <Description>Hydroxyapetite head/HAPEX shaft PORP and TORP</Description>
            <Size>0.8mm Shaft Dia TORP, 1.3mm Shaft Diameter PORP</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4157</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>347</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL092</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OL019</PriorBillingCode>
                <PriorBillingCode>OL020</PriorBillingCode>
                <PriorBillingCode>OL021</PriorBillingCode>
                <PriorBillingCode>OL074</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ossicular Prosthesis - TORP</Name>
            <Description>Black Spanner Strut&#xD;
Black Oval-Top PORP/Universal/TORP&#xD;
Micron Adjustable Titanium PORP/TORP&#xD;
Causse Modified TORP&#xD;
Fisch-Type TORP&#xD;
Shea TORP &#xD;
Sheehy Modified TORP</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4157</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>347</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL093</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OL013</PriorBillingCode>
                <PriorBillingCode>OL015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ossicular Prosthesis - Incus/Stapes</Name>
            <Description>a) Applebaum Incudostapedial Joint&#xD;
b) Goldenberg Incus&#xD;
c) Wehrs Incus (Single &amp; Double Notch)&#xD;
d) Wehrs II Incus-Stapes (Single Notch)&#xD;
e) Kartush Incus-Stapes Strut&#xD;
f) Goldenberg Incus-Stapes</Description>
            <Size>a) small - large&#xD;
b) one size only&#xD;
c) short, average, medium&#xD;
d) short, average, medium, long&#xD;
e) short, medium, long&#xD;
f) one size only</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4157</SubGroupID>
            <ARTGs>
                <ARTG>123372</ARTG>
            </ARTGs>
            <MinimumBenefit>347</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC011</BillingCode>
            <Name>TORP - Total Ossicular Replacement Prosthesis</Name>
            <Description>Total implant made of titanium, for reconstructing a destroyed middle-air ossicular chain (chain of sound transmission) between the footplate of the stirrup bone and the plane of the eardrum.&#xD;
The implants are available in fixed length and adjustable versions for shortening. The implant can be subdivided into three areas: 1.) the implant shoe; 2.) the implant shaft; 3.) the perforated implant plate. The implant plate can be arranged centrically (round) towards the implant shaft or eccentrically (oval). In the eccentric version (oval, fixed length only), an additional groove has been worked into the plate to improve receiving the malleus handle. The surface of the predefined contact points (upper side of implant plate and implant shoe) is roughened in order to facilitate better bonding to the eardrum resp. the stapes footplate. To improve the adaptation of the implant plate to the plane of the eardrum, the angle between the implant plate and shaft can be optimally adapted because the shaft below the implant plate tapers off (onwards from a total length of 3.5 mm). The product is available in different lengths. The length information is stated both on the outer package as well as on the product’s sterile packaging.</Description>
            <Size>Fixed Length&#xD;
Central Head shaft diam. 0.3 mm Length 3.00 mm&#xD;
Central Head shaft diam. 0.3 mm Length 3.50 mm&#xD;
Central Head shaft diam. 0.3 mm Length 4.00 mm&#xD;
Central Head shaft diam. 0.3 mm Length 4.25 mm&#xD;
Central Head shaft diam. 0.3 mm Length 4.50 mm&#xD;
Central Head shaft diam. 0.3 mm Length 4.75 mm&#xD;
Central Head shaft diam. 0.3 mm Length 5.00 mm&#xD;
Central Head shaft diam. 0.3 mm Length 5.50 mm&#xD;
Central Head shaft diam. 0.3 mm Length 6.00 mm&#xD;
Central Head shaft diam. 0.3 mm Length 6.50 mm&#xD;
Central Head shaft diam. 0.3 mm Length 7.00 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 3.00 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 3.50 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 4.00 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 4.25 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 4.50 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 4.75 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 5.00 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 5.50 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 6.00 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 6.50 mm&#xD;
Offset Head shaft diam. 0.3 mm Length 7.00 mm&#xD;
Shortenable&#xD;
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-2.8 &#xD;
mm&#xD;
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-2.3 &#xD;
mm&#xD;
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-3.5 &#xD;
mm&#xD;
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-3.0 &#xD;
mm&#xD;
Adjustable Titanium Implant with Separate Shoe, shaft diam. 0.4 mm Length 7.8-2.8 mm&#xD;
Adjustable Titanium Implant with Separate Shoe, shaft diam. 0.4 mm Length 7.8-2.3 mm</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4157</SubGroupID>
            <ARTGs>
                <ARTG>290802</ARTG>
            </ARTGs>
            <MinimumBenefit>347</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UP001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM328</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Total Ossicle Replacement</Name>
            <Description>a) TTP Tuebingen Type Aerial Type   b) TTB-Vario Aerial    c) TTP Variac System Total   d) Malleus Notch Prosthesis   e) Regensburg Type Total Prosthesis  f) Malleus Replacement  g) Duesseldorf Type Total  h) Omega Connector</Description>
            <Size>a) Length - 3 to to 7mm   b) one size only  c) one size only   d) Length - 3 to 7mm   e) Length - 4 to 5mm  f) one size only  g) lengths - 3 to 7mm  h) length - 0.5mm</Size>
            <SupplierCode>UP</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>4157</SubGroupID>
            <ARTGs>
                <ARTG>119747</ARTG>
            </ARTGs>
            <MinimumBenefit>347</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US019</BillingCode>
            <Name>Vibrant Soundbridge System - Vibroplasty Couplers</Name>
            <Description>Middle ear prostheses used with the Vibrant Soundbridge System VORP implant.  Facilitate coupling between the FMT and a vibratory structure of the middle ear.</Description>
            <Size>Functional length:  Vibroplasty-OW-Coupler - 2.50, 3.00, 3.50, 4.00mm  Vibroplasty-CliP-Coupler - 0.20, 0.50, 1.00, 1.50mm  Vibroplasty-Bell-Coupler - 0.20, 0.50, 1.00, 1.50mm  Vibroplasty-RW-Coupler - 0.85mm  Incus-Symphonix-Coupler - Left and Right (2.5 x 3.3mm)  Incus-LP-Coupler - Left and Right (2.8 x 3.8mm)   Incus-SP-Coupler (2.9 x 4.4mm)  RW-Soft-Coupler (1 x 1.5mm)  Stapes-SH-Coupler (3.5 x 4.1mm)</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>6521</SubGroupID>
            <Suffix>Coupler</Suffix>
            <ARTGs>
                <ARTG>185533</ARTG>
            </ARTGs>
            <MinimumBenefit>350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US029</BillingCode>
            <Name>SAMBA 2 Audio Processor</Name>
            <Description>Single Unit audio processor for the Vibrant Soundbridge System, worn off the ear it is held in place by magnetic attraction over the implant. Designed to function similarly as the SAMBA audio processor but with improved battery life, noise reduction, ingress protection and Intelligent Sound Adapter 2.0</Description>
            <Size>One Size - Lo/Hi, left/right versions with various magnet strengths, length = 36.4mm, width = 30.4mm, height = 10.2mm, weight 9.3g (inc battery)</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>6521</SubGroupID>
            <Suffix>Programmable, Wireless-enabled, Autoscan</Suffix>
            <ARTGs>
                <ARTG>353970</ARTG>
            </ARTGs>
            <MinimumBenefit>7166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US020</BillingCode>
            <Name>Vibrant Soundbridge System - Samba Audio Processor</Name>
            <Description>Middle ear implant audio processor.   The Samba audio processor is the externally worn component of the Vibrant Soundbridge System and connects to the implant through magnetic attraction.  Fitting the Samba audio processor activates the Soundbridge.</Description>
            <Size>Samba Lo, Samba Hi left and right versions, length = 35mm, width = 30mm, height = 10mm, weight &lt;9g (inc battery</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>6521</SubGroupID>
            <Suffix>Programmable, wireless - enabled</Suffix>
            <ARTGs>
                <ARTG>271112</ARTG>
            </ARTGs>
            <MinimumBenefit>6825</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>US021</BillingCode>
            <Name>Vibrant Soundbridge System - Vibrating Ossicular Prosthesis VORP503</Name>
            <Description>Part of the Vibrant Soundbridge System, VORP503 is an active implant, which is implanted into the temporal bone under the skin. The VORP 503 consists of the Floating Mass Transducer (FMT), a conductor link, the electronics (demodulator), fixation wings and a magnet surrounded by a receiver coil.</Description>
            <Size>One size (left and right) Length: 118mm, Width: 28mm, Thickness: 4.4mm, Weight: 10.1g</Size>
            <SupplierCode>US</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1565</GroupID>
            <SubGroupID>6521</SubGroupID>
            <ARTGs>
                <ARTG>389014</ARTG>
            </ARTGs>
            <MinimumBenefit>7470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC269</BillingCode>
            <Name>Medtronic Vent Tubes</Name>
            <Description>Activent Antimicrobial Ventilation Tube</Description>
            <Size>1.02 - 1.27mm x 0.9 - 2.4mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <Suffix>Antibiotic</Suffix>
            <ARTGs>
                <ARTG>126695</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI077</BillingCode>
            <Name>Medtronic  Ventilation Tube</Name>
            <Description>Medium to long term, antimicrobial vent tube</Description>
            <Size>1.02 - 1.52mm x 1.3-12.0mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <Suffix>Antibiotic</Suffix>
            <ARTGs>
                <ARTG>126695</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL086</BillingCode>
            <Name>Ventilation Tube</Name>
            <Description>Ultrasil Silicon Ventilation tube</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <Suffix>Antibiotic</Suffix>
            <ARTGs>
                <ARTG>146612</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL087</BillingCode>
            <Name>Ventilation tube</Name>
            <Description>PacifiC Ventilation tube</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <Suffix>Antibiotic</Suffix>
            <ARTGs>
                <ARTG>146612</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL090</BillingCode>
            <Name>Ventilation tube</Name>
            <Description>HydroxylVent tube</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <Suffix>Antibiotic</Suffix>
            <ARTGs>
                <ARTG>146612</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BQ004</BillingCode>
            <Name>Ventilation Tubes / Grommet</Name>
            <Description>a) Tubingen Gold Type &#xD;
b) Tubingen Titanium Type &#xD;
c) T Tube &#xD;
d) Reuter Bobbin Type &#xD;
e) Paparella Type&#xD;
f) Collar Button Type &#xD;
g) Star Tube &#xD;
h) Bevel Buttton Tube&#xD;
i) Straight Tube &#xD;
j) Armstrong Type &#xD;
k) Shepard Type &#xD;
l) Donaldson Type&#xD;
m) Angular Type&#xD;
n) Myringotomy Tube with Trocar&#xD;
o) Ventilation Tubes with Eyelets&#xD;
p) Minimal Type</Description>
            <Size>a) I.D.  1.25mm w/w, I.D.1.25mm wo/w, I.D. 1.5mm wo/w &#xD;
b) one size only &#xD;
c) L- 6, 7.5, 12 &#xD;
d) I.F.O.D 2.5mm, 2.7mm &#xD;
e) one size only  &#xD;
f) one side only &#xD;
g) one size only &#xD;
h) one size only &#xD;
i) i.d.-0.9mm,1.1mm,1.15mm &#xD;
j) L-3.8mm, 3.7mm, 10mm &#xD;
k) L- 2.2mm w/t, 2.2mm wo/t,2.4mm w/t &#xD;
l) S- one size only, F one size only&#xD;
m) one size only&#xD;
n) Silver or Titanium&#xD;
o) one or two&#xD;
p) one size only</Size>
            <SupplierCode>BQ</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>120972</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK005</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains -  Reuter Bobbin </Name>
            <Description>Without hole, teflon</Description>
            <Size>1.14 mm lumen dia x 2.54 mm inner flange dia x 2.54 mm outer flange dia x 0.76 inter flange. 1.52mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK006</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains -  Collar Button</Name>
            <Description>Teflon </Description>
            <Size>1.14 mm lumen dia x 2.24 mm inner flange dia x 2.24 mm outer flange dia x 1.27 inter flange. 1.78 mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK007</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains  -  Collar Button</Name>
            <Description>Teflon </Description>
            <Size>1.14 mm lumen dia x 3.0 mm inner flange dia x 3.0 mm outer flange dia x 1.27 inter flange. 1.78 mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK008</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains  -  Collar Button</Name>
            <Description>Teflon </Description>
            <Size>1.4 mm lumen dia x 2.55 mm inner flange dia x 2.55 mm outer flange dia x 0.85 inter flange. 1.35 mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK009</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains - Collar Button </Name>
            <Description>Teflon </Description>
            <Size>1.75 mm lumen dia x 2.85 mm inner flange dia x 2.85 mm outer flange dia x 0.95 inter flange. 1.46 mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK010</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains - Shepards Drain</Name>
            <Description>Teflon Shephards Drain</Description>
            <Size>1.14 mm lumen dia x 2.36 mm inner flange dia x 2.36 mm outer flange dia x 1.42 inter flange. 2.41 mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK011</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains - Teflon Shephards Drain with wire grasping feature</Name>
            <Description>Teflon Shephards Drain with wire</Description>
            <Size>0.97 mm lumen dia x 2.08 mm inner flange dia x 2.08 mm outer flange dia x 1.42 inter flange. 2.41 mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK012</BillingCode>
            <Name>Exmoor Plastics Ear Vent Drains - Donaldson Grommet</Name>
            <Description>With tab, silicone rubber</Description>
            <Size>1.1 mm lumen dia x 2.25 mm inner flange dia x 2.25 mm outer flange dia x 0.76 inter flange. 2.25 mm total length</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>133977</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE719</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Micromedics Ventilation Tubes</Name>
            <Description>Silicone and fluroplastic ventilation tubes</Description>
            <Size>Lumen size: 0.76mm, 1.0mm, 1.14mm, 1.27mm, 1.42mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>199400</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET076</BillingCode>
            <Name>Triune Vent Tube</Name>
            <Description>A tympanostomy (myringotomy) tube</Description>
            <Size>Lumen size 0.76mm - 1.35mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>170820</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC268</BillingCode>
            <Name>Medtronic Vent Tubes</Name>
            <Description>Fluoroplastic</Description>
            <Size>0.76 - 1.52mm x 2.1 - 9.5mm x 1.0 - 12.0mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>126695</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC927</BillingCode>
            <Name>Medtronic Vent Tube</Name>
            <Description>.</Description>
            <Size>1.02 - 1.52mm x 1.3 - 12.0mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>126695</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI078</BillingCode>
            <Name>Medtronic Ventilation Tubes</Name>
            <Description>Medium to Long term vent tube</Description>
            <Size>0.76-1.52mm x0.9-12.0mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>126695</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS057</BillingCode>
            <Name>NeoZoline Otological Ventilation Tubes</Name>
            <Description>Armstrong, Collar Button, Shepard, Reuter, Donaldson, Paparella, Shah</Description>
            <Size>1.10mm, 1.14mm, 1.27mm, 1.40mm, 0.76mm</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>173906</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL082</BillingCode>
            <Name>Ventilation tubes</Name>
            <Description>Fluoroplastics Ventilation tubes</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>146612</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL083</BillingCode>
            <Name>Ventilation tubes</Name>
            <Description>Titanium ventilation tubes</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>146612</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL084</BillingCode>
            <Name>Ventilation Tube</Name>
            <Description>Stainless Steel Ventilation tube</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>146612</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL085</BillingCode>
            <Name>Ventilation tubes</Name>
            <Description>Silicon Ventilation tubes</Description>
            <Size>Various sizes</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>146612</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC002</BillingCode>
            <Name>Ventilation tube</Name>
            <Description>Ventilation tube - Silicone - T-tube, T-tube grommet</Description>
            <Size>1.1mm; 1.27mm lumen</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>182921</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC003</BillingCode>
            <Name>Ventilation Tubes - Collar Button</Name>
            <Description>Teflon, w/o wire</Description>
            <Size>1.10mm, 1.25mm, 1.50mm lumen</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>182921</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC004</BillingCode>
            <Name>Ventilation Tubes - Collar Button</Name>
            <Description>Teflon w/wire, and titanium w/o wire</Description>
            <Size>0.76mm, 1.00mm, 1.25mm, 1.50mm lumen</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>182921</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC006</BillingCode>
            <Name>Ventilation Tubes - Shepherd</Name>
            <Description>Teflon, w or w/o wire</Description>
            <Size>1.15mm lumen</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>182921</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC007</BillingCode>
            <Name>Ventilation Tubes - Shepherd</Name>
            <Description>Titanium, w/o wire</Description>
            <Size>1.00mm, 1.25mm lumen</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>182921</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC009</BillingCode>
            <Name>Ventilation Tubes - Silicone</Name>
            <Description>Armstrong Grommet, Donaldson w &amp; w/o Tab, Paparella 1 and Paparella 2 (1.5mm)</Description>
            <Size>1.1mm &amp; 1.5mm lumen</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>1566</GroupID>
            <ARTGs>
                <ARTG>182921</ARTG>
            </ARTGs>
            <MinimumBenefit>18</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA007</BillingCode>
            <Name>Biodesign Otologic Repair Graft (small)</Name>
            <Description>Implantable biologic graft intended for use in otologic procedures.</Description>
            <Size>2 discs with diameters of 0.4 and 0.6cm or 0.6 and 0.9 cm.&#xD;
2.5X2.5cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>2521</GroupID>
            <SubGroupID>6742</SubGroupID>
            <Suffix>Porcine</Suffix>
            <ARTGs>
                <ARTG>300314</ARTG>
            </ARTGs>
            <MinimumBenefit>325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA006</BillingCode>
            <Name>Biodesign Otologic Repair Graft</Name>
            <Description>Implantable biologic graft intended for use in otologic procedures.</Description>
            <Size>5.0x5.0cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>2521</GroupID>
            <SubGroupID>6743</SubGroupID>
            <Suffix>Porcine</Suffix>
            <ARTGs>
                <ARTG>300314</ARTG>
            </ARTGs>
            <MinimumBenefit>492</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO089</BillingCode>
            <Name>Osia System</Name>
            <Description>Piezoelectric bone conduction implant system consisting of: the Osia implant with piezoelectric transducer, osseointegrated titanium self-tapping BI300, the Osia sound processor with 2-way digital link, surgical components and software, for hearing loss up to 55dB.</Description>
            <Size>Osia implant: One size  BI300: 3mm and 4mm  Osia sound processor: One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>196</SubCategoryID>
            <GroupID>2960</GroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
                <ARTG>124177</ARTG>
                <ARTG>304387</ARTG>
                <ARTG>305019</ARTG>
                <ARTG>305024</ARTG>
                <ARTG>355711</ARTG>
                <ARTG>358293</ARTG>
                <ARTG>375450</ARTG>
                <ARTG>375451</ARTG>
                <ARTG>389472</ARTG>
            </ARTGs>
            <MinimumBenefit>15125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC264</BillingCode>
            <Name>Septal Button </Name>
            <Description>Silicone</Description>
            <Size>3cm </Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>197</SubCategoryID>
            <GroupID>1568</GroupID>
            <ARTGs>
                <ARTG>169825</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL026</BillingCode>
            <Name>Septal Button</Name>
            <Description>Plastipore</Description>
            <Size>One size only</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>197</SubCategoryID>
            <GroupID>1568</GroupID>
            <ARTGs>
                <ARTG>143266</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RC013</BillingCode>
            <Name>Septal Button, silicone, sterile</Name>
            <Description>For non-surgical closure of septal perforation  · Silicone prevents adhesion  · Soft material for easy insertion and removal  · No scabbing, epistaxis or other septal perforation symptoms  · Surface with Lotus leaf effect prevents adhesion of secretions / tissue</Description>
            <Size>3.2cm - 1mm thick, one-piece  3.2cm - 1mm thick , two-piece</Size>
            <SupplierCode>RC</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>197</SubCategoryID>
            <GroupID>1568</GroupID>
            <ARTGs>
                <ARTG>338464</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI151</BillingCode>
            <Name>ALAR Nasal Valve Stent</Name>
            <Description>Nasal valve stent for repair of nasal vestibular stenosis and nasal valve collapse.</Description>
            <Size>20mm long x 16mm wide</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>197</SubCategoryID>
            <GroupID>1817</GroupID>
            <ARTGs>
                <ARTG>218121</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BQ007</BillingCode>
            <Name>ProTrach DualCare Set</Name>
            <Description>ProTrach DualCare is attached to a tracheostomy tube and is designed to eliminate the necessity of finger occlusion, enabling the tracheostomised patient to speak easily and more clearly. It combines a speaking valve with an HME, and this way both enabling hands-free speech and helping to keep the lungs healthy by providing the important humidification of the inhaled air. The Set includes: 180pc HME Regular, 1pc Speaking Valve, 1pc ProTrach HME DigiTop, 1 Removal Aid and 1 connection strap.</Description>
            <Size>15mm  22mm</Size>
            <SupplierCode>BQ</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1569</GroupID>
            <ARTGs>
                <ARTG>275618</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BQ008</BillingCode>
            <Name>ProTrach DualCare Speaking Valve</Name>
            <Description>ProTrach DualCare System is attached to a tracheostomy tube and is designed to eliminate the necessity of finger occlusion, enabling the tracheostomised patient to speak easily and more clearly. It combines a speaking valve with a HME and in this way enabling speaking and supporing your lungs with important heating and moisturising. The Set includes: 1pc Speaking Valve, 1pc ProTrach HME DigiTop, 1 Removal Aid and 1 connection strap.ProTrach DualCare Speaking Valve, 1 HME DigiTop, 1 removal aid and 1pc Connection Strap</Description>
            <Size>15mm&#xD;
22mm</Size>
            <SupplierCode>BQ</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1569</GroupID>
            <ARTGs>
                <ARTG>275618</ARTG>
            </ARTGs>
            <MinimumBenefit>92</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BQ010</BillingCode>
            <Name>Tracheal Speaking Valve</Name>
            <Description>Provox a) Two b) Vega c) Vega Puncture Set</Description>
            <Size>a) 4.5, 6, 8, 10, 12.5, 15mm&#xD;
b) 17, 20, 22.5fr in 4, 6, 8, 10, 12.5, 15mm&#xD;
c) 17, 20, 22.5fr in 4, 6, 8, 10, 12.5, 15mm</Size>
            <SupplierCode>BQ</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1569</GroupID>
            <ARTGs>
                <ARTG>120197</ARTG>
                <ARTG>236026</ARTG>
            </ARTGs>
            <MinimumBenefit>92</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PT001</BillingCode>
            <Name>Blom-Singer® Dual Valve and Advantage Voice Prosthesis</Name>
            <Description>A range of valved silicone voice prostheses with specific anti-fungal and anti-leakage attributes, that are placed into a tracheoesophageal puncture at the time of surgery. The Prosthesis resides between the back wall of the trachea into the esophageal wall to enable tracheosophageal speech.</Description>
            <Size>Dual Valve: 16 French and 20 French diameters 4-14mm length &#xD;
Advantage: 20 French diameter 6-14mm length&#xD;
(2mm increments)</Size>
            <SupplierCode>PT</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1569</GroupID>
            <ARTGs>
                <ARTG>278705</ARTG>
            </ARTGs>
            <MinimumBenefit>92</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PT002</BillingCode>
            <Name>Blom-Singer® Classic, Rapid Response Indwelling Voice Prostheses</Name>
            <Description>A range of valved silicone voice prostheses that are placed into a tracheoesophageal puncture at the time of surgery. The Prosthesis resides between the back wall of the trachea into the esophageal wall to enable tracheosophageal speech.&#xD;
&#xD;
Benefit: Voice is produced by temporarily blocking the stoma so that exhaled pulmonary air can be directed from the trachea, through the prosthesis into the oesophagus, producing voice in the TEP segment. Fluent, conversational speech may be acquired within just a few days.&#xD;
&#xD;
Blom-Singer Rapid Response VP’s are available with extended tracheal and oesophageal flanges to overcome peripheral valve leakage. In addition, valve weighting can be adjusted to manage reflux and central valve leakage. This range of valves is also available in special lengths.</Description>
            <Size>16 French and 20 French diameters, 4-20mm length (2mm increments)</Size>
            <SupplierCode>PT</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1569</GroupID>
            <ARTGs>
                <ARTG>278705</ARTG>
            </ARTGs>
            <MinimumBenefit>92</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PT003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BQ009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tracheal Speaking Valve</Name>
            <Description>Passy Muir Tracheal Speaking Valve</Description>
            <Size>one size</Size>
            <SupplierCode>PT</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1569</GroupID>
            <ARTGs>
                <ARTG>279056</ARTG>
            </ARTGs>
            <MinimumBenefit>92</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL071</BillingCode>
            <Name>Vocal Cord Medialisation Implant</Name>
            <Description>Vocom Larynx Medial Implant - Hydroxylapatite</Description>
            <Size>3 - 7mm Head</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1570</GroupID>
            <ARTGs>
                <ARTG>143279</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL072</BillingCode>
            <Name>Vocal Cord Medialisation Implant</Name>
            <Description>Vocom Shim for Medial Implant - Hydroxylapatite</Description>
            <Size>1mm - 3mm Offset</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1570</GroupID>
            <ARTGs>
                <ARTG>143279</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PT004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BQ001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vocal Chord Medialisation Implant</Name>
            <Description>Montgomery Laryngeal Keel</Description>
            <Size>12, 14, 16 - Clear and Radiopaque</Size>
            <SupplierCode>PT</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1570</GroupID>
            <ARTGs>
                <ARTG>119029</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JI007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH595</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aerstent</Name>
            <Description>Self Expandable Tracheal and Bronchial Stent</Description>
            <Size>Straight or Y, (10-24) mm diameter</Size>
            <SupplierCode>JI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1571</GroupID>
            <Suffix>Nitinol</Suffix>
            <ARTGs>
                <ARTG>297568</ARTG>
            </ARTGs>
            <MinimumBenefit>2029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JI008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH574</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GSS &amp; Dumon</Name>
            <Description>Silicone tracheal and bronchial stents</Description>
            <Size>10 - 20mm diameter, 20 - 110mm length</Size>
            <SupplierCode>JI</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1571</GroupID>
            <Suffix>Silicone</Suffix>
            <ARTGs>
                <ARTG>143612</ARTG>
            </ARTGs>
            <MinimumBenefit>903</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PT007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BQ005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Thyroplasty</Name>
            <Description>Montgomery Thyroplasty Implant System</Description>
            <Size>male - 8,9,10,11,12,13  female - 6,7,8,9,10</Size>
            <SupplierCode>PT</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1573</GroupID>
            <ARTGs>
                <ARTG>117683</ARTG>
            </ARTGs>
            <MinimumBenefit>1057</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PT006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BQ006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Extra-tracheal Cannula</Name>
            <Description>a) Montgomery Short-Term Cannula   b) Montgomery Long-Term Cannula</Description>
            <Size>a) 4, 6, 8, 10 b) 4, 6, 8, 10 for Stoma Sizes 17-25, 25-33, 33-41, 41-49, 49-57, 57-65mm</Size>
            <SupplierCode>PT</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1574</GroupID>
            <Suffix>Extra-tracheal</Suffix>
            <ARTGs>
                <ARTG>119737</ARTG>
            </ARTGs>
            <MinimumBenefit>269</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PT005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BQ003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Intra-tracheal Cannula</Name>
            <Description>Montgomery Safe-T-Tubes Clear and Radiopaque except c)   a) Paediatric   b) Standard   c) Hebeler    d) Thoracic    e) Extra-Long    f) Tapered   g) Montgomery Salivary Bypass Tube   h) Har-el Pharyngeal Tube   i) Montgomery Esophageal Tube  j) Trachael Fenestrator  k) Moore Trache</Description>
            <Size>a) 6, 7, 8, 9   b) 10, 11, 12, 13, 14. 15, 16  c) 12, 15, 18   d) 10, 11, 12, 13, 14, 15, 16   e) 10, 11, 12, 13, 14, 15, 16   f) 8/10, 10/13   g) 8, 10, 12, 14, 16, 18, 20   h) one size only   i) one size only  j) size 6, 8 and 10  k) size 6 and 8</Size>
            <SupplierCode>PT</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1574</GroupID>
            <Suffix>Intra-tracheal</Suffix>
            <ARTGs>
                <ARTG>119737</ARTG>
                <ARTG>119736</ARTG>
            </ARTGs>
            <MinimumBenefit>425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET040</BillingCode>
            <Name>Vox Implants</Name>
            <Description>Vox Implants are solid, irregularly textured, medical grade Polydimethylsiloxane Elastomer implants suspended in a hydrogel carrier</Description>
            <Size>One size only</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>22</CategoryID>
            <SubCategoryID>198</SubCategoryID>
            <GroupID>1576</GroupID>
            <ARTGs>
                <ARTG>146733</ARTG>
            </ARTGs>
            <MinimumBenefit>7401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VX001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SE001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SIR-Spheres including Delivery Apparatus</Name>
            <Description>Biocompatible microspheres 20-60mm (microns) in diameter containing yttrium-90. Delivery apparatus is PVC tubing, ABS stopcocks, acrylic holders and stainless steel needles with PE hubs</Description>
            <Size>One size only</Size>
            <SupplierCode>VX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1520</GroupID>
            <ARTGs>
                <ARTG>149332</ARTG>
                <ARTG>149343</ARTG>
            </ARTGs>
            <MinimumBenefit>8091</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA252</BillingCode>
            <Name>BrachySource® I-125 Implant</Name>
            <Description>BrachySource® Seeds supplied either loose, in Cartridges or needles or as a calibration source.  Up to 120 seeds per patient.</Description>
            <Size>Seeds are a 4.5mm x 0.8mm welded titanium capsule.</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4162</SubGroupID>
            <ARTGs>
                <ARTG>225229</ARTG>
                <ARTG>225230</ARTG>
                <ARTG>225231</ARTG>
                <ARTG>225237</ARTG>
                <ARTG>225238</ARTG>
            </ARTGs>
            <MinimumBenefit>5767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA253</BillingCode>
            <Name>ReadyLink® Implant</Name>
            <Description>BrachySource® Seed Implants in the ReadyLink® Delivery System.  Up to 120 seeds per patient.</Description>
            <Size>Seeds are 4.5mm x 0.8mm welded titanium capsule preconnected in user defined trains.</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4162</SubGroupID>
            <ARTGs>
                <ARTG>225229</ARTG>
                <ARTG>225230</ARTG>
                <ARTG>225231</ARTG>
                <ARTG>225237</ARTG>
                <ARTG>225238</ARTG>
            </ARTGs>
            <MinimumBenefit>5767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CL001</BillingCode>
            <Name>Advantage I-125 Pre-load</Name>
            <Description>Advantage I-125 Pre-load consists of stranded Advantage I-125 seeds pre-loaded on prescription into brachytherapy needles specifically for treatment of an individual patient.  They arrive sterile and pre-packaged ready for use in theatre</Description>
            <Size>Stranded seeds are pre-loaded in brachytherapy needles in a prescribed configuration; up to 120 seeds</Size>
            <SupplierCode>CL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4162</SubGroupID>
            <ARTGs>
                <ARTG>175081</ARTG>
            </ARTGs>
            <MinimumBenefit>5767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CL002</BillingCode>
            <Name>Advantage I-125 Seed</Name>
            <Description>Advantage I-125 seeds are sealed radioactive sources containing Iodine-125 for interstitial brachytherapy</Description>
            <Size>3mm x 0.5mm silver rod within 4.5 x 0.8mm sealed titanium capsule, up to 120 seeds</Size>
            <SupplierCode>CL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4162</SubGroupID>
            <ARTGs>
                <ARTG>154457</ARTG>
            </ARTGs>
            <MinimumBenefit>5767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RQ078</BillingCode>
            <Name>TheraStrand Rx with AgX100 Brachytherapy Kit</Name>
            <Description>The TheraStrand RX brachytherapy kit is prescription-loaded and supplied sterile.  The prescription generally comprises 25 needles containing the brachytherapy I-125 sources (80-100 seeds) sequenced per the physician's treatment plan.  All sources are of the same activity/strength.</Description>
            <Size>The seed includes a silver rod with I 125 contained in a sealed titanium capsule of 4.5 mm length and 0.8 mm in diameter.</Size>
            <SupplierCode>RQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4162</SubGroupID>
            <ARTGs>
                <ARTG>205063</ARTG>
            </ARTGs>
            <MinimumBenefit>5767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RQ079</BillingCode>
            <Name>I-Seed AgX100 Cartridge Brachytherapy Kit</Name>
            <Description>The I-Seed AgX100 Cartridge brachytherapy kit comprises 8 or fewer cartridges (max. 20 seed) in a vertical seed magazine, VSM20. The kit is supplied sterile and is compatible with the Mick applicator.</Description>
            <Size>The I-Seed AgX100 Cartridge Brachytherapy Kit generally contains 8 or fewer cartridges, each a max. 20 seeds, a total of 80-100 seeds. Each seed comprises a silver rod with the source within 4.5 x 0.8mm sealed titanium capsule.</Size>
            <SupplierCode>RQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4162</SubGroupID>
            <ARTGs>
                <ARTG>205023</ARTG>
            </ARTGs>
            <MinimumBenefit>5767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA251</BillingCode>
            <Name>BrachySource® I-125 seeds</Name>
            <Description>Single BrachySource® Seeds supplied either loose, in Cartridges or needles or as a calibration source.  To be used only if more than 120 seeds are used per patient.</Description>
            <Size>Seeds are a 4.5mm x 0.8mm welded titanium capsule.</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4163</SubGroupID>
            <ARTGs>
                <ARTG>225229</ARTG>
                <ARTG>225230</ARTG>
                <ARTG>225231</ARTG>
                <ARTG>225237</ARTG>
                <ARTG>225238</ARTG>
            </ARTGs>
            <MinimumBenefit>73</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CL003</BillingCode>
            <Name>Advantage I-125 Seed</Name>
            <Description>The Advantage I-125 seed is a sealed radioactive source containing Iodine-125 for interstitial brachytherapy</Description>
            <Size>3mm x 0.5mm silver rod within 4.5 x 0.8mm sealed titanium capsule</Size>
            <SupplierCode>CL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4163</SubGroupID>
            <ARTGs>
                <ARTG>154457</ARTG>
            </ARTGs>
            <MinimumBenefit>73</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RQ076</BillingCode>
            <Name>Theragenics C20 IsoLoader Magazines in TPSII Individual - 20 seeds per magazine - sterile</Name>
            <Description>The C20 IsoLoader cartridge is a shielded cartridge holding up to 20 I125 seeds, supplied in accordance with the surgeon's requirements.  Benefit is per seed.</Description>
            <Size>1 representation in a delivery magazine with a loading of up to 20 seeds</Size>
            <SupplierCode>RQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4163</SubGroupID>
            <ARTGs>
                <ARTG>271520</ARTG>
            </ARTGs>
            <MinimumBenefit>73</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RQ077</BillingCode>
            <Name>TheraStrand RX with I-Seed AgX100 I125 implants</Name>
            <Description>AgX100 I-125 Seeds pre-loaded. The billing code is to be applied only if more than 100 seeds are used per patient. Benefit is per seed.</Description>
            <Size>One representation with a loading of more than 100 seeds. The seed includes a silver rod with I 125 contained in a sealed titanium capsule of 4.5 mm length and 0.8 mm in diameter</Size>
            <SupplierCode>RQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1521</GroupID>
            <SubGroupID>4163</SubGroupID>
            <ARTGs>
                <ARTG>205063</ARTG>
            </ARTGs>
            <MinimumBenefit>73</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS370</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MB025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TraceIT Gel System</Name>
            <Description>TraceIT System is intended to create a temporary space within soft tissue during radiation therapy.</Description>
            <Size>3mL</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1792</GroupID>
            <SubGroupID>6061</SubGroupID>
            <ARTGs>
                <ARTG>268092</ARTG>
            </ARTGs>
            <MinimumBenefit>844</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RW003</BillingCode>
            <Name>Barrigel</Name>
            <Description>Biodegrable gel of hyaluronic acid supplied in a 3ml syringe</Description>
            <Size>3ml</Size>
            <SupplierCode>RW</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1792</GroupID>
            <SubGroupID>6061</SubGroupID>
            <ARTGs>
                <ARTG>339926</ARTG>
            </ARTGs>
            <MinimumBenefit>844</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS368</BillingCode>
            <Name>SpaceOAR System</Name>
            <Description>The SpaceOAR System consists of components for preparation of a synthetic, absorbable hydrogel spacer and a delivery mechanism packaged in a single kit. The hydrogel spacer creates a temporary space between the prostate and rectum during radiation therapy.</Description>
            <Size>10CC</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1792</GroupID>
            <SubGroupID>6281</SubGroupID>
            <ARTGs>
                <ARTG>354010</ARTG>
            </ARTGs>
            <MinimumBenefit>1731</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS369</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MB024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TraceIT Gel System</Name>
            <Description>TraceIT System is intended to create a temporary space within soft tissue during radiation therapy.</Description>
            <Size>10mL</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1792</GroupID>
            <SubGroupID>6281</SubGroupID>
            <ARTGs>
                <ARTG>268092</ARTG>
            </ARTGs>
            <MinimumBenefit>1731</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS388</BillingCode>
            <Name>SpaceOAR VUE System</Name>
            <Description>The SpaceOAR VUE System is a radiotherapy protection spacer consisting of components for preparation of synthetic absorbable hydrogel spacer and a delivery mechanism packaged in a single kit. The hydrogel spacer creates a temporary space between the prostate and rectum during radiation therapy. The hydrogel is radiopaque for visibility under computed tomography (CT) and cone beam CT.</Description>
            <Size>10CC</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1792</GroupID>
            <SubGroupID>6281</SubGroupID>
            <ARTGs>
                <ARTG>373630</ARTG>
            </ARTGs>
            <MinimumBenefit>1731</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RW004</BillingCode>
            <Name>Barrigel</Name>
            <Description>Biodegradable gel of 9ml hyaluronic acid supplied in a kit of three 3 ml syringes</Description>
            <Size>One size only</Size>
            <SupplierCode>RW</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>187</SubCategoryID>
            <GroupID>1792</GroupID>
            <SubGroupID>6281</SubGroupID>
            <ARTGs>
                <ARTG>339926</ARTG>
            </ARTGs>
            <MinimumBenefit>1731</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB086</BillingCode>
            <Name>Celsite Epoxy Peritoneal Port</Name>
            <Description>Epoxy/titanium</Description>
            <Size>32x27x13mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1522</GroupID>
            <SubGroupID>4164</SubGroupID>
            <ARTGs>
                <ARTG>133738</ARTG>
            </ARTGs>
            <MinimumBenefit>424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB385</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BB082</PriorBillingCode>
                <PriorBillingCode>BB084</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Celsite Access Port</Name>
            <Description>Single Access Port</Description>
            <Size>Standard, Small, Baby</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1522</GroupID>
            <SubGroupID>4164</SubGroupID>
            <ARTGs>
                <ARTG>133738</ARTG>
                <ARTG>137735</ARTG>
            </ARTGs>
            <MinimumBenefit>424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB083</BillingCode>
            <Name>Celsite Epoxy Dual Access Port</Name>
            <Description>Dual lumen power injectable implanted port</Description>
            <Size>Standard/small/baby</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1522</GroupID>
            <SubGroupID>4437</SubGroupID>
            <ARTGs>
                <ARTG>133738</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS371</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE275</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DC Bead</Name>
            <Description>Drug delivery embolisation system</Description>
            <Size>70-150, 100-300, 300-500, 500-700, 700-900 (microns)</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1542</GroupID>
            <SubGroupID>4195</SubGroupID>
            <ARTGs>
                <ARTG>131473</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS372</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE580</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DC Bead M1</Name>
            <Description>Drug delivery embolization system</Description>
            <Size>70-150um</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1542</GroupID>
            <SubGroupID>4195</SubGroupID>
            <ARTGs>
                <ARTG>187101</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS373</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE647</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DC Bead LUMI</Name>
            <Description>Drug delivery embolisation system</Description>
            <Size>70-150 microns (black)  100-300 microns (yellow)</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1542</GroupID>
            <SubGroupID>4195</SubGroupID>
            <ARTGs>
                <ARTG>307152</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW001</BillingCode>
            <Name>Hepasphere</Name>
            <Description>Expanding microspheres designed for chemic0-embolisation with chemotherapeutic agents such as Ethiodil, Cisplatin, Epirubicin, Mitomycin, etc.</Description>
            <Size>30 – 200 micron, 25mg or 50mg of microspheres</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1542</GroupID>
            <SubGroupID>4195</SubGroupID>
            <ARTGs>
                <ARTG>276029</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VN001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BS315</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Embozene Tandem Microspheres</Name>
            <Description>Embozene TANDEM Microspheres are spherical tightly calibrated, biocompatible, non-resorbable, hydrogel microspheres with an inorganic polyzene-F coating, colour coded to indicate microsphere size. Each 20mL syringe is filled with 2 ml of product suspended in a non-pyrogenic physiological slaine transport solution. Embozene TANDEM Microspheres may be loaded with Doxirubican-HCl and Irinotecan-HCl up to 50mg/ml which can elute local, controlled, sustained doses of drugs to targeted tumour sites after embolisation.</Description>
            <Size>Tandem 2ml 40 ± 10 µm  Tandem 2ml 75 ± 15 µm  Tandem 2ml 100  ± 25 µm</Size>
            <SupplierCode>VN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1542</GroupID>
            <SubGroupID>4195</SubGroupID>
            <ARTGs>
                <ARTG>315383</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VN002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BS316</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Embozene Tandem Microspheres</Name>
            <Description>Embozene TANDEM Microspheres are spherical tightly calibrated, biocompatible, non-resorbable, hydrogel microspheres with an inorganic polyzene-F coating,  colour coded to indicate microsphere size. Each 20 mL syringe is prefilled with 3 mL of product suspended in a non-pyrogenic physiological saline transport solution. Embozene TANDEM microspheres may be loaded with Doxorubican-HCI  and Irinotecan-HCI up to 50 mg/ml which can elute local, controlled, sustained doses of the drugs to targeted tumour sites after embolisation.</Description>
            <Size>Tandem 3ml 40 ± 10 μm  Tandem 3ml 75 ± 15 μm   Tandem 3ml 100 ± 25 μm</Size>
            <SupplierCode>VN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1542</GroupID>
            <SubGroupID>4195</SubGroupID>
            <ARTGs>
                <ARTG>315383</ARTG>
            </ARTGs>
            <MinimumBenefit>2234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA009</BillingCode>
            <Name>Bioring Gastric Band</Name>
            <Description>Adjustable gastric banding kit</Description>
            <Size>Small, Large and Extra Large</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>160524</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA010</BillingCode>
            <Name>Adhesix Bioring Gastric Band</Name>
            <Description>Adjustable gastric band system with mesh fixation of port</Description>
            <Size>Small, Large and Extra Large</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>181215</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER219</BillingCode>
            <Name>Lap-Band AP with RapidPort EZ</Name>
            <Description>LAP-BAND AP RapidPort EZ System</Description>
            <Size>11.6mm x 30.5mm x 14mm&#xD;
11.6mm x 30.5mm x 16.5mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>226688</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET042</BillingCode>
            <Name>Soft Gastric Banding System</Name>
            <Description>Sterile long term implant for the treatment of obesity.  Supplied in kit format with catheter, port and huber needles</Description>
            <Size>One size only</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>96737</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GQ003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RS002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MiniMizer gastric band.</Name>
            <Description>Adjustable Silicone band which is placed around the upper part of the stomach to reduce the volume and speed of intake of food.</Description>
            <Size>The gastric band comes in two sizes: Regular and Large</Size>
            <SupplierCode>GQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>203396</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GQ009</BillingCode>
            <Name>MiniMizer gastric band.</Name>
            <Description>Adjustable Silicone band which is placed around the upper part of the stomach to reduce  the volume and speed of intake of food.</Description>
            <Size>Regular, large and extra large</Size>
            <SupplierCode>GQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>379010</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ831</BillingCode>
            <Name>Ethicon Endo-Surgery curved adjustable gastric band with sutureless port and applier</Name>
            <Description>Silicone</Description>
            <Size>One size only</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>94766</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ832</BillingCode>
            <Name>Swedish Adjustable Gastric Band</Name>
            <Description>Silicone</Description>
            <Size>One size only</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>94766</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH003</BillingCode>
            <Name>Adjustable Peri Gastric Belt-Midband</Name>
            <Description>Silicon moulded peri gastric band and implantable chamber</Description>
            <Size>Peri gastric band - 2.2 x 17.5 x 0.8cm, Implantable chamber - one size only</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1548</GroupID>
            <ARTGs>
                <ARTG>145372</ARTG>
            </ARTGs>
            <MinimumBenefit>2830</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET081</BillingCode>
            <Name>A.M.I. B-Band</Name>
            <Description>Adjustable gastric banding implant for stabilising the gastroenterostomy stoma. The A.M.I B-Band is a soft gastric bypass band which serves as a restrictive component in gastric bypass surgery. Restriction is achieved by placing the device around the remaining stomach pouch in order to prevent long term dilation of the gastrojejunostomy and to ensure a controlled emptying of the stomach pouch.</Description>
            <Size>Adjustable band length: 4.0cm - 7.5cm. Band height: 10mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1781</GroupID>
            <ARTGs>
                <ARTG>96737</ARTG>
            </ARTGs>
            <MinimumBenefit>2102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GQ001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RS001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Minimizer Ring</Name>
            <Description>Adjustable Gastric Ring</Description>
            <Size>One size ranging from 6.5cm to a 8.0cm diameter</Size>
            <SupplierCode>GQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1781</GroupID>
            <ARTGs>
                <ARTG>203396</ARTG>
            </ARTGs>
            <MinimumBenefit>2102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GQ008</BillingCode>
            <Name>Minimizer Ring</Name>
            <Description>Adjustable Gastric Ring</Description>
            <Size>One size ranging from 6.5cm to a 8.0cm diameter</Size>
            <SupplierCode>GQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1781</GroupID>
            <ARTGs>
                <ARTG>379010</ARTG>
            </ARTGs>
            <MinimumBenefit>2102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH527</BillingCode>
            <Name>MIDCAL Ring</Name>
            <Description>Adjustable Gastric Ring</Description>
            <Size>65-80 mm circumference</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1781</GroupID>
            <ARTGs>
                <ARTG>229709</ARTG>
            </ARTGs>
            <MinimumBenefit>2102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA008</BillingCode>
            <Name>Bioring Gastric Band Replacement Port</Name>
            <Description>Bioring gastric band access port with catheter and connector</Description>
            <Size>Diameter 34mm; height 10.4mm</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1779</GroupID>
            <ARTGs>
                <ARTG>163167</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER220</BillingCode>
            <Name>RapidPort EZ Access Port Kit (replacement port)</Name>
            <Description>Access Port Kit for LAP-BAND RapidPort EZ system</Description>
            <Size>11.6mm x 30.5mm x 14mm&#xD;
11.6mm x 30.5mm x 16.5mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1779</GroupID>
            <ARTGs>
                <ARTG>226686</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET056</BillingCode>
            <Name>Soft Basket Band. INFUSION PORT.</Name>
            <Description>TITANIUM PORT</Description>
            <Size>9.8CMS/13.3CMS</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1779</GroupID>
            <ARTGs>
                <ARTG>148776</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GQ002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RS003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MiniMizer gastric band (injection port)</Name>
            <Description>Adjustable Silicone band which is placed around the upper part of the stomach to reduce the volume and speed of intake of food. The injection port is used to inflate or deflate the gastric band therefore adjusting the diameter of the band.</Description>
            <Size>Small or medium sized port.</Size>
            <SupplierCode>GQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1779</GroupID>
            <ARTGs>
                <ARTG>205914</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ444</BillingCode>
            <Name>Ethicon Endo-Surgery Gastric band sutureless port and applier</Name>
            <Description>Implantable infusion port &amp; locking connector for adjustable gastric band. Replacement port &amp; locking connector for use with adjustable gastric band.</Description>
            <Size>One size only</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1779</GroupID>
            <ARTGs>
                <ARTG>94734</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH413</BillingCode>
            <Name>Miband Access Port (replacement)</Name>
            <Description>A device, metallic or non- metallic, implanted in a patient for a short or long-term delivery of fluid or medications to the vascular system  or other anatomical region. The device consists of a housing, self-sealing septum and a catheter connection mechanism. The device may be implanted in a variety of anatomical locations.</Description>
            <Size>Port Size - 10.6mm High, 24.7mm Base width- One Size only</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>190</SubCategoryID>
            <GroupID>1779</GroupID>
            <ARTGs>
                <ARTG>153863</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS054</BillingCode>
            <Name>Flexima Biliary Stent</Name>
            <Description>Polyurethane Biliary Stent</Description>
            <Size>Diameters up to 12Fr &amp; lengths up to 15cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>127387</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS055</BillingCode>
            <Name>RX Biliary Stent</Name>
            <Description>Polyurethane Biliary Stent</Description>
            <Size>Diameters up to 12Fr &amp; lengths up to 15cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>127387</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS173</BillingCode>
            <Name>Advanix Plastic Stent with Naviflex Delivery System</Name>
            <Description>Plastic stent manufactured pre loaded on a delivery catheter</Description>
            <Size>5-18cm length, 7-10 FR diameter</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>127387</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC013</BillingCode>
            <Name>Zimmon Biliary Stent Set</Name>
            <Description>Double pigtail plastic biliary stent with delivery system</Description>
            <Size>5 - 11.5Fr, Length 2 - 18cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>139771</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC017</BillingCode>
            <Name>Cotton-Leung Biliary Stent Set</Name>
            <Description>Set includes stent, positioning sleeve to collapse the duodenal flap, 170cm pushing catheter and 320cm guiding catheter. 7Fr stents do not include guiding catheter.</Description>
            <Size>7 - 11.5Fr, Length 5 - 18cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>139771</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC078</BillingCode>
            <Name>Cook Biliary Stents</Name>
            <Description>Composition Plastic, includes Stent, Wireguide &amp; Positioner</Description>
            <Size>French 7.0, length 4cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>139197</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC106</BillingCode>
            <Name>Cotton-Leung Biliary Stent Set</Name>
            <Description>Polyethylene Stent preloaded on an Oasis Introduction System</Description>
            <Size>Diameter 7 - 11.5 FR,  length 5 - 15cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>139771</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC108</BillingCode>
            <Name>Geenan Pancreatic Stent Set</Name>
            <Description>Radiopaque Polyethylene Stent with or without ductal flaps - includes pushing catheter</Description>
            <Size>Diameter 3 - 11.5 FR, Length 2 - 15cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>142999</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC166</BillingCode>
            <Name>Solus Biliary Stent  Set</Name>
            <Description>Double Pigtail with OASIS introducer. Sof-flex material - with radiopaque bands.</Description>
            <Size>Diameter 10 FR, Length:1 - 15 cm Between pigtails</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>139771</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC228</BillingCode>
            <Name>Tannenbaum Biliary Stent Set preloaded on the OASIS Introduction System</Name>
            <Description>Plastic Biliary Stent</Description>
            <Size>8.5 - 11.5 Fr,   5 - 15 cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <Suffix>Delivery System</Suffix>
            <ARTGs>
                <ARTG>139771</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS066</BillingCode>
            <Name>Biliary Drainage Stent, Amsterdam Biliary Stent</Name>
            <Description>C-Flex or Polyurethane Biliary Stent</Description>
            <Size>Diameters up to 12Fr &amp; lengths up to 15cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>127387</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS184</BillingCode>
            <Name>Advanix Plastic Stent</Name>
            <Description>Plastic stent manufactured individually</Description>
            <Size>5-18cm length, 7-10 FR diameter</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>127387</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL003</BillingCode>
            <Name>Bile Duct Stent</Name>
            <Description>Polyethylene Stents</Description>
            <Size>7FR - 12FR 3cm - 15cm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>145851</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL008</BillingCode>
            <Name>Olympus Biliary Stent Set</Name>
            <Description>Radio-opaque Polyethglare Stent Set</Description>
            <Size>7Fr 3cm - 15cm, 8Fr 3cm - 15cm, 10Fr 3cm - 15cm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>145856</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA003</BillingCode>
            <Name>Compass BDS Biliary Stent</Name>
            <Description>Plastic biliary stent</Description>
            <Size>7 Fr, Length: 5-15cm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>133255</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC006</BillingCode>
            <Name>Cotton-Leung Biliary Stent Only</Name>
            <Description>.</Description>
            <Size>6 - 11.5Fr, Length 3 - 20cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>139770</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC008</BillingCode>
            <Name>Cotton-Huibregste Biliary Stent Only</Name>
            <Description>.</Description>
            <Size>7 - 11.5Fr, Length 5 - 21cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>139770</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC012</BillingCode>
            <Name>Zimmon Biliary Stent Only</Name>
            <Description>.</Description>
            <Size>5 - 11.5Fr, Length 3 - 18cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>139770</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC064</BillingCode>
            <Name>Tannenbaum Biliary Stent only</Name>
            <Description>Plastic biliary stent with proximal and distal flaps</Description>
            <Size>Diameter: 8.5,10,11.5 FR. Length Between Flaps: 5 --&gt;15 cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>139770</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC267</BillingCode>
            <Name>Cotton-Leung Sof-Flex Biliary Stent</Name>
            <Description>Cotton-Leung Sof-Flex Biliary Stent</Description>
            <Size>6 - 11.5 Fr; Length 3 - 20cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4218</SubGroupID>
            <ARTGs>
                <ARTG>139770</ARTG>
            </ARTGs>
            <MinimumBenefit>74</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS199</BillingCode>
            <Name>Protege™GPS™ Self-expanding Billary Stent System</Name>
            <Description>Nitinol self expanding stent pre-mounted on 6F OTW delivery system</Description>
            <Size>Diameter (mm) 6 -14, Length (mm) 20 - 150</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>189741</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS200</BillingCode>
            <Name>VisiPro™ Balloon-Expandable Biliary Stent System</Name>
            <Description>Stainless Steel balloon expandable stent mounted onto a non-compliant balloon catheter</Description>
            <Size>Diameter (mm) 5 - 10, Length (mm) 12 -57</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>189741</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS051</BillingCode>
            <Name>Wallstent Biliary Stent</Name>
            <Description>Monofilament wire, self-expanding stent</Description>
            <Size>Diameters up to 10mm &amp; lengths up to 100mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>136261</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS215</BillingCode>
            <Name>WallFlex Biliary Stent</Name>
            <Description>Bare Metal Stent</Description>
            <Size>6 - 10 x 40 - 120mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>226864</ARTG>
                <ARTG>136261</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS354</BillingCode>
            <Name>Epic Biliary Endoscopic Stent System</Name>
            <Description>Uncovered self-expanding nitinol biliary stent</Description>
            <Size>Diameter 6-10mm, Length 40-100mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>299016</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET038</BillingCode>
            <Name>SX-Ella Biliary Stent</Name>
            <Description>Self-expanding nitinol stent</Description>
            <Size>Diameter 8 - 10mm, Length 40 - 100mm.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>144490</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET039</BillingCode>
            <Name>SX-Ella Tips Stent</Name>
            <Description>Uncovered, self-expanding nitinol stent</Description>
            <Size>Dia 10-14mm, length 52-77mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>144490</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY038</BillingCode>
            <Name>Niti-S Biliary Uncovered Stents</Name>
            <Description>Niti-S Biliary Uncovered Stents.</Description>
            <Size>Diameter:  6mm to 10mm   Length:  40mm to 120mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>130531</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK013</BillingCode>
            <Name>HANAROSTENT</Name>
            <Description>HANAROSTENT® Biliary Hilar (NNN)  HANAROSTENT® FAST™ Biliary (NNN)  HANAROSTENT® Biliary (NNN)  HANAROSTENT® Benefit™ Biliary (NNN)</Description>
            <Size>Diameter 6-10mm, Length 40-120mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>272684</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC270</BillingCode>
            <Name>Zilver Biliary Stent System</Name>
            <Description>Self expanding metal biliary stent system</Description>
            <Size>Diameters 6, 8, 10mm; Lengths 4, 6, 8, 10, 12cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>177491</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC308</BillingCode>
            <Name>Evolution Biliary Stent System (uncovered)</Name>
            <Description>Self expanding bare metal biliary stent system.</Description>
            <Size>Diameters :8 -10mm&#xD;
Lengths: 40 -100mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>177491</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC331</BillingCode>
            <Name>Zilver 635 Biliary Stent</Name>
            <Description>The Zilver 635 Biliary Stent is a self-expandable stent made of nitinol.</Description>
            <Size>Length: 4-8cm, Diameter: 6-14mm, Delivery system: 40cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4234</SubGroupID>
            <ARTGs>
                <ARTG>236948</ARTG>
            </ARTGs>
            <MinimumBenefit>2008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS052</BillingCode>
            <Name>Wallstent Biliary Stent</Name>
            <Description>Monofilament wire, self-expanding stent</Description>
            <Size>Diameters up to 10mm &amp; lengths up to 100mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>136261</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS070</BillingCode>
            <Name>Wallstent RX Biliary Stent</Name>
            <Description>Monofilament wire, self-expanding stent</Description>
            <Size>Diameters up to 10mm &amp; lengths up to 100mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>136261</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS214</BillingCode>
            <Name>WallFlex Biliary Stent</Name>
            <Description>Stent with permalume covering</Description>
            <Size>6 - 10 x 40 - 120mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>136261</ARTG>
                <ARTG>177661</ARTG>
                <ARTG>226864</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT116</BillingCode>
            <Name>Gore Biliary Endoprostheses</Name>
            <Description>ePTFE</Description>
            <Size>Short or Long Catheter 8-10mmx4-8cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>130493</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB023</BillingCode>
            <Name>Allium Biliary Stent</Name>
            <Description>Endoscopic or Transhepatic biliary stent made of nitinol with copolymer covering and unraveling technology for atraumatic removal</Description>
            <Size>Stent length - 60, 80, 100, 120mm. Diameter  - 8, 10mm. Anchor optional</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>205006</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY049</BillingCode>
            <Name>Niti-S Biliary Covered and Partially Covered Stents</Name>
            <Description>Niti-S Biliary Covered and Partially Covered Stents</Description>
            <Size>Diameter:  4mm to 16mm  Length:  10mm to 120mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>130531</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK012</BillingCode>
            <Name>HANAROSTENT</Name>
            <Description>HANAROSTENT Biliary, Plumber Biliary, Biliary Flap, Biliary Flap Lasso, Biliary Lasso, Multi-Hole Biliary, TwynLay Biliary, FAST Biliary Flap.  Self-expanding nitinol biliary stent</Description>
            <Size>Diameter 6-16mm, Length 20-150mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>272683</ARTG>
                <ARTG>336629</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC309</BillingCode>
            <Name>Evolution Biliary Stent System (covered)</Name>
            <Description>Self expanding partially or fully covered biliary stent system.</Description>
            <Size>Diameters: 8 - 10mm&#xD;
Lengths: 40 - 80mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1556</GroupID>
            <SubGroupID>4235</SubGroupID>
            <ARTGs>
                <ARTG>177491</ARTG>
            </ARTGs>
            <MinimumBenefit>2730</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS071</BillingCode>
            <Name>Ultraflex Precision Colonic Stent</Name>
            <Description>Nitinol, self expanding stent</Description>
            <Size>Diameters up to 30mm &amp; lengths up to 150mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1557</GroupID>
            <Suffix>Self Expanding</Suffix>
            <ARTGs>
                <ARTG>119517</ARTG>
            </ARTGs>
            <MinimumBenefit>2762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE692</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PY023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Niti-S Colorectal D-Type Stent</Name>
            <Description>Niti-S Colorectal D-Type self-expanding Stent</Description>
            <Size>Diameters: 18 to 30mm   Lengths: 60 to 150mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1557</GroupID>
            <Suffix>Self Expanding</Suffix>
            <ARTGs>
                <ARTG>130747</ARTG>
            </ARTGs>
            <MinimumBenefit>2762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE693</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PY024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Niti-S Colorectal Stent</Name>
            <Description>Niti-S Colorectal self-expanding metal stent made from Nitinol.  Stent PTFE covered and uncovered OTW or TTS with string for ease of removal.</Description>
            <Size>Diameter:  18mm to 30mm  Length: 30mm to 160mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1557</GroupID>
            <Suffix>Self Expanding</Suffix>
            <ARTGs>
                <ARTG>130747</ARTG>
            </ARTGs>
            <MinimumBenefit>2762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK008</BillingCode>
            <Name>HANAROSTENT</Name>
            <Description>HANAROSTENT Colon/Rectum, Colon/Rectum TTS, Colon/Rectum Asymmetric, Colon/Rectum Lasso, Intestine, Intestine Asymmetric, TwynLay Colon/Rectum.  Self-expanding nitinol colon/rectum stent.  </Description>
            <Size>Diameter: 16-24mm,  Length: 40-180 mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1557</GroupID>
            <Suffix>Self Expanding</Suffix>
            <ARTGs>
                <ARTG>272681</ARTG>
                <ARTG>336711</ARTG>
            </ARTGs>
            <MinimumBenefit>2762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS046</BillingCode>
            <Name>Ultraflex Oesophageal Stent; Ultraflex Oesophageal NG Stent</Name>
            <Description>Nitinol, self expanding stent</Description>
            <Size>Diameters up to 30mm &amp; lengths up to 150mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4237</SubGroupID>
            <ARTGs>
                <ARTG>120176</ARTG>
            </ARTGs>
            <MinimumBenefit>2256</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS089</BillingCode>
            <Name>WallFlex Oesophageal Stent, WallFlex RMV Oesophageal Stent</Name>
            <Description>Nitinol, self expanding stent</Description>
            <Size>Diameters up to 30mm &amp; lengths up to 155mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>120176</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS298</BillingCode>
            <Name>Ultraflex Oesophageal NG Covered Stent</Name>
            <Description>Translucent polyurethane covered nitinol, self expanding stent</Description>
            <Size>Diameters up to 30mm &amp; lengths up to 150mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>120176</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS381</BillingCode>
            <Name>Agile Esophageal Stent</Name>
            <Description>Nitinol, Self-expanding</Description>
            <Size>Diameters up to 23mm &amp; lengths up to 15cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>339843</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE690</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PY021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Niti-S Oesophageal Fully Covered Stent</Name>
            <Description>Niti-S Oesophageal fully covered self expanding nitinol stent with covering of PTFE, silicone, a polyurethane layer. Nylon drawstring for removal or repositiong</Description>
            <Size>Diameter: 10mm to 36mm  Length: 60mm to 230mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>130535</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE691</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PY022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Niti-S Oesophageal Double Stent &amp; Beta Double &amp; D-Double Stent</Name>
            <Description>Niti-S Oesophageal covered Double Stent &amp; Beta Double and D-Double self-expanding metal stent made from Nitinol, with an anti-migration outer uncovered wire construction to allow the mesh to embed in the oesophageal wall. Also with anti reflux valve inner polyurethane layer, PTFE &amp; silicone covering to prevent tumor ingrowth.  String for retrieval or re-positioning.</Description>
            <Size>Diameter: 10mm to 28mm  Length: 40mm to 200mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>130535</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET001</BillingCode>
            <Name>Ferx Ella Esophageal Stent</Name>
            <Description>Kit includes esophageal stent, introducer, balloon catheter</Description>
            <Size>Diam 20mm, Length 80 - 160mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>95573</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET045</BillingCode>
            <Name>Boubella Esophageal Stent</Name>
            <Description>Self expandable stainless steel wire stent with anti-reflux valve</Description>
            <Size>Length 90 - 210mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>95573</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET069</BillingCode>
            <Name>SX - ELLA Stent Esophageal HV (HV Stent Plus)</Name>
            <Description>The SX-ELLA Atent Esophageal HV (HV Stent Plus) is a self-expandable, fully covered nitinol stent, pre-loaded on a delivery system. The stent is designed to provide relief from malignant or benign strictures in the oesophagus, or treating anastomic leaks. HV Stent Plus includes an anti-migration collar &amp; is also available with an anti-reflux valve</Description>
            <Size>Stent Body Diameter = 18 - 20mm  Stent Flare Diameter = 24 - 25mm  Stent nominal length = 85/110/135/150mm  </Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>95573</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET070</BillingCode>
            <Name>SX- ELLA Stent Danis</Name>
            <Description>The Danis Procedure Pack Basic contains the SX-ELLA Stent Danis, a nitinol wire that is compressed &amp; preloaded within a delivery system, along with various instruments necessary for the stent implantation. The Stent Denis is a removable stent system for the treatment of bleeding esophageal varices. It is intended to be implanted and then removed within seven days of the date of implantation in order to avoid the risk of in-growth into the stent mesh</Description>
            <Size>One size: Stent flares diameter 30mm; Stent body diameter 25mm; Nominal length 135mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>95573</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK017</BillingCode>
            <Name>CHOOSTENT</Name>
            <Description>CHOOSTENT Esophagus, Esophagus Valve, Esophagus Asymmetric, Esophagus Upper. Covered esophageal stent, self-expanding nitinol</Description>
            <Size>Diameter 18-24mm, Length 50-220mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>272685</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK018</BillingCode>
            <Name>HANAROSTENT</Name>
            <Description>HANAROSTENT Esophagus, Esophagus Valve, Esophagus Benign BS, Bariatric Surgery, Esophagus TTS, Esophagus Skidproof, Esophagus Asymmetric,  Esophagus Bone Shape Partial Covered, Esophagus Valve Partial covered. Covered esophagus stent, self-expanding nitinol</Description>
            <Size>Diameter 18-30mm, Length 50-240mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>272685</ARTG>
                <ARTG>336712</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC246</BillingCode>
            <Name>Evolution Oesophageal Metal Stent</Name>
            <Description>Oesophogeal Self Expanding Metal Stent with controlled release delivery system</Description>
            <Size>8, 10, 12.5 and 15cm Lengths, 25mm flared ends with 20mm body or 23mm flared ends with 18mm body</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>153840</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC310</BillingCode>
            <Name>Evolution Oesophageal Stent System (Fully covered)</Name>
            <Description>Oesophageal self expanding metal stent with controlled release delivery system</Description>
            <Size>Diameters:18 - 20mm&#xD;
Lengths: 80 - 120mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>4238</SubGroupID>
            <ARTGs>
                <ARTG>200836</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET077</BillingCode>
            <Name>ELLA BD Stent</Name>
            <Description>The ELLA BD Stent is a self-expanding biodegradable stent made of polydiaxanone designed to slowly degrade when in contact with living tissue. Full degradation of stent occurs within 11-12 weeks of implantation. It is designed for dilation and treatment of benign oesophageal lesions.</Description>
            <Size>Stent body diameters = 18mm - 25mm;   Stent flares diameters = 23mm - 31mm;   Stent nominal length = 60/80/100/135mm.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1558</GroupID>
            <SubGroupID>6025</SubGroupID>
            <ARTGs>
                <ARTG>232514</ARTG>
            </ARTGs>
            <MinimumBenefit>4513</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS317</BillingCode>
            <Name>HOT AXIOS</Name>
            <Description>Stent with Electrocautery Enhanced Delivery System for use in pseudocyst drainage. Self-expanding nitinol stent</Description>
            <Size>Length 8-15mm, Lumen Diameter 6-20mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <SubGroupID>6011</SubGroupID>
            <Suffix>Electrocautery</Suffix>
            <ARTGs>
                <ARTG>282177</ARTG>
            </ARTGs>
            <MinimumBenefit>4345</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE709</BillingCode>
            <Name>Hot Spaxus</Name>
            <Description>Hot Spaxus is a self-expanding nitinol stent that maintains an anastomotic conduit between two adjacent organs. It has an Electrocautery Enhanced Delivery System.</Description>
            <Size>Length 20mm, Lumen Diameter 8 - 16mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <SubGroupID>6011</SubGroupID>
            <Suffix>Electrocautery</Suffix>
            <ARTGs>
                <ARTG>226438</ARTG>
            </ARTGs>
            <MinimumBenefit>4345</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS313</BillingCode>
            <Name>AXIOS</Name>
            <Description>Stent and Delivery System for use in pseudocyst drainage. Self-expanding nitinol stent</Description>
            <Size>Length 10mm, Lumen Diameter 10-15mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <SubGroupID>6011</SubGroupID>
            <ARTGs>
                <ARTG>271558</ARTG>
            </ARTGs>
            <MinimumBenefit>3334</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE694</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PY040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Niti-S Nagi and Spaxus Pancreatic, Pseudocyst and Gall Bladder Drainage Stent</Name>
            <Description>Fully Covered, self-expanding metal pancreatic pseudocyst intra-luminal drainage stent</Description>
            <Size>Diameter: 8, 10,12,14,16mm  Length: 1,2,3cm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <SubGroupID>6011</SubGroupID>
            <ARTGs>
                <ARTG>226438</ARTG>
            </ARTGs>
            <MinimumBenefit>3334</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK025</BillingCode>
            <Name>HANAROSTENT Pancreatic Stent</Name>
            <Description>Pancreatic Covered Stent</Description>
            <Size>Diameter 10-12mm, Length 20-40mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <SubGroupID>6011</SubGroupID>
            <ARTGs>
                <ARTG>336713</ARTG>
            </ARTGs>
            <MinimumBenefit>3334</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS290</BillingCode>
            <Name>Advanix Plastic Stent and Pusher Kit</Name>
            <Description>Plastic stent manufactured, indicated for the treatment of pancreatic strictures.&#xD;
Delivery System in form of a pusher (short wire or long wire system specific).&#xD;
</Description>
            <Size>2 - 18cm length / 3 - 10 FR diameter</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <Suffix>Pusher</Suffix>
            <ARTGs>
                <ARTG>226891</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS289</BillingCode>
            <Name>Advanix Plastic Stent</Name>
            <Description>Plastic stent manufactured individually, indicated for the treatment of pancreatic strictures.</Description>
            <Size>2 - 18cm length / 3 - 10 FR diameter</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <ARTGs>
                <ARTG>226891</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC079</BillingCode>
            <Name>Zimmon Pancreatic Stent</Name>
            <Description>Single pigtail with radio-opaque band</Description>
            <Size>Diameter 4 - 10FR, Length 2 - 18cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <ARTGs>
                <ARTG>142998</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC123</BillingCode>
            <Name>Geenen Pancreatic Stent</Name>
            <Description>Straight plastic pancreatic stent with or without ductal flaps</Description>
            <Size>Diameter 3 - 11.5 FR, length 2 - 20cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <ARTGs>
                <ARTG>142998</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC212</BillingCode>
            <Name>Zimmom Pancreatic Stent</Name>
            <Description>Single pigtail radio-opaque Polyethylene Stent with or without ductal flaps</Description>
            <Size>Diameter 3 - 7 FR, Length 3 - 18cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <ARTGs>
                <ARTG>142998</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC271</BillingCode>
            <Name>Geenen Sof-Flex Pancreatic Stent</Name>
            <Description>Straight plastic pancreatic stent with or without ductal flaps</Description>
            <Size>Diameter 3 - 10 Fr; length 2 - 15cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1561</GroupID>
            <ARTGs>
                <ARTG>142998</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS090</BillingCode>
            <Name>WallFlex Enteral Stent (Duodenal/Colonic)</Name>
            <Description>Nitinol, self expanding stent</Description>
            <Size>Diameters up to 30mm &amp; lengths up to 150mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1562</GroupID>
            <ARTGs>
                <ARTG>119517</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS337</BillingCode>
            <Name>WallFlex Soft Enteral Stent (Duodenal/Colonic)</Name>
            <Description>Nitinol, self expanding stent with Anchor Lock Delivery System</Description>
            <Size>Diameters up to 27mm &amp; lengths up to 120mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1562</GroupID>
            <ARTGs>
                <ARTG>119517</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE689</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PY017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Niti-S Pyloric/Duodenal Stent</Name>
            <Description>Niti-S Pyloric self-expanding stent, covered and uncovered, OTW or TTS</Description>
            <Size>Diameter:  16 to 28mm   Length: 40 to 160mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1562</GroupID>
            <ARTGs>
                <ARTG>130746</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK010</BillingCode>
            <Name>HANAROSTENT</Name>
            <Description>HANAROSTENT Duodenum/Pylorus Kim’s Flare, Duodenum/Pylorus Lasso, Duodenum/Pylorus Lasso, TwynLay Duodenum/Pylorus.  Self-expanding nitinol duodenum/pylorus stent  </Description>
            <Size>Diameter 18-24mm, Length 60-180mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1562</GroupID>
            <ARTGs>
                <ARTG>272682</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC268</BillingCode>
            <Name>Evolution Enteral Metal Stent</Name>
            <Description>Enteral Metal Stent</Description>
            <Size>Diameter 22 to 25mm body; 27 to 30mm flanges. Length: 6 to 12cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1562</GroupID>
            <ARTGs>
                <ARTG>157191</ARTG>
                <ARTG>157192</ARTG>
            </ARTGs>
            <MinimumBenefit>3159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AK009</BillingCode>
            <Name>Oesophageal Tracheal Stents</Name>
            <Description>Nitinol wire expandable stents, covered and non covered, Y shaped</Description>
            <Size>multiple sizes</Size>
            <SupplierCode>AK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1563</GroupID>
            <ARTGs>
                <ARTG>173875</ARTG>
            </ARTGs>
            <MinimumBenefit>1805</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AK010</BillingCode>
            <Name>Oesophageal Tracheal Stents</Name>
            <Description>self expanding nitinol stent, covered and uncovered, straight and J shape</Description>
            <Size>multiple sizes</Size>
            <SupplierCode>AK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1563</GroupID>
            <ARTGs>
                <ARTG>173875</ARTG>
            </ARTGs>
            <MinimumBenefit>1805</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS047</BillingCode>
            <Name>Ultraflex Tracheobronchial Stent</Name>
            <Description>Nitinol, self expanding stent</Description>
            <Size>Diameters up to 25mm &amp; lengths up to 80mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1563</GroupID>
            <ARTGs>
                <ARTG>149594</ARTG>
            </ARTGs>
            <MinimumBenefit>2708</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE695</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PY048</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Niti-S Tracheal and Bronchial Stents</Name>
            <Description>Niti-S Tracheal and Bronchial Stents</Description>
            <Size>Diameter:  10mm to 24mm  Length:  30mm to 100mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1563</GroupID>
            <ARTGs>
                <ARTG>130533</ARTG>
                <ARTG>130534</ARTG>
            </ARTGs>
            <MinimumBenefit>2708</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW004</BillingCode>
            <Name>AERO®, AERO DV® and AEROmini®</Name>
            <Description>Trachobronchial Stent</Description>
            <Size>6-20mm stent diameter, stent length 10-80mm</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1563</GroupID>
            <ARTGs>
                <ARTG>177098</ARTG>
            </ARTGs>
            <MinimumBenefit>2708</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BS311</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HANAROSTENT</Name>
            <Description>HANAROSTENT Trachea/Bronchial.  Covered trachea/bronchium stent, self-expanding nitinol</Description>
            <Size>Length 30-80mm, Diameter 12-20mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1563</GroupID>
            <ARTGs>
                <ARTG>272686</ARTG>
            </ARTGs>
            <MinimumBenefit>2708</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG002</BillingCode>
            <Name>NeuraGen</Name>
            <Description>NeuraGen is a semi-permeable Type 1 collagen tube for peripheral nerve repair. It provides a protective environment and conduit for axonal regrowth across a nerve gap.  It is biocompatible and completely resorbed. The open collagen structure facilitates suture placement. It has a resilient structure that maintains an open lumen throughout the process of axonal growth.</Description>
            <Size>2mm x 2cm, 3mm x 2cm, 4mm x 2cm, 5mm x 2cm, 6mm x 2cm, 7mm x 2cm, 1.5mm x 3cm, 2mm x 3cm, 3mm x 3cm, 4mm x 3cm, 5mm x 3cm, 6mm x 3cm, 7mm x 3cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1564</GroupID>
            <ARTGs>
                <ARTG>158870</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG003</BillingCode>
            <Name>NeuraWrap</Name>
            <Description>NeuraWrap nerve protector is designed to provide an interface between the nerve and the surrounding tissues. NeuraWrap remains in place during the active phase of tissue healing and is completely resorbed after tissue response has resolved. The porous outer layer of NeuraWrap comprises a tubular matrix that mechanically resists compression from surrounding tissue and excludes scar tissue ingrowth. The semi-permeable inner membrane allows passage of small molecules (ie water, ions, metabolites, nutrients) but prevents the escape of endogenous growth factors (Nerve Growth Factor). NeuraWrap provides a new alternative for the treatment of peripheral nerve injuries.</Description>
            <Size>3mm x 2cm, 3mm x 4cm, 5mm x 2cm, 5mm x 4cm, 7mm x 2cm, 7mm x 4cm, 10mm x 2cm, 10mm x 4cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1564</GroupID>
            <ARTGs>
                <ARTG>158924</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM080</BillingCode>
            <Name>Neurolac</Name>
            <Description>A bioresorbable tension-less Nerve repair guide</Description>
            <Size>1.5mm x 3cm to 10.0mm x 3cm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1564</GroupID>
            <ARTGs>
                <ARTG>139653</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM335</BillingCode>
            <Name>Nerve Capping Device</Name>
            <Description>A peripheral bioresorbable nerve capping device</Description>
            <Size>30mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1564</GroupID>
            <ARTGs>
                <ARTG>285368</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VQ002</BillingCode>
            <Name>Remplir</Name>
            <Description>A resorbable collagen barrier membrane intended for use in peripheral nerve repair.</Description>
            <Size>15mm x 20mm, 20mm x 30mm, 30mm x 40mm, 40mm x 50mm</Size>
            <SupplierCode>VQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>192</SubCategoryID>
            <GroupID>1564</GroupID>
            <ARTGs>
                <ARTG>385752</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE603</BillingCode>
            <Name>PleuraFlow® Active Clearance Technology® (ACT)</Name>
            <Description>Pleural drainage catheter</Description>
            <Size>20; 24; 28;32FR</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>218317</ARTG>
                <ARTG>324895</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FN002</BillingCode>
            <Name>Pleurx</Name>
            <Description>Pleurx Pleural Catheter Mini Kit</Description>
            <Size>Catheter 24cm x 15.5Fr</Size>
            <SupplierCode>FN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>321900</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME207</BillingCode>
            <Name>TRU-CLOSE THORACIC VENT</Name>
            <Description>Device for the treatment of spontanious, traumatic or iatrogenic simple pneumothorax.Allowing for amubulation during resolution and the aspiration of small amount of fluids</Description>
            <Size>Catheter outer diameter = 11 French, catheter length = 10cm&#xD;
Catheter outer diameter = 11 French, catheter length = 13cm&#xD;
Catheter outer diameter = 13 French, catheter length = 10cm&#xD;
Catheter outer diameter = 13 French, catheter length = 13cm</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>181784</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME208</BillingCode>
            <Name>Redax Unico Percutaneous Drainage Kit</Name>
            <Description>Percutaneous Drainage Kit</Description>
            <Size>9-12 CH</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>204898</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS065</BillingCode>
            <Name>ASEPT Pleural Drainage System</Name>
            <Description>Indwelling tunnelled pleural catheter insertion kit</Description>
            <Size>15F x 66cm silicone catheter with fenestrations and cuff</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>285155</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RK001</BillingCode>
            <Name>Rocket IPC Pleural/Peritoneal Tunnelled Catheter Insertion kit</Name>
            <Description>Rocket IPC Pleural/Peritoneal Tunnelled Catheter Insertion kit with catheter</Description>
            <Size>16fg x 69cm silicone catheter with cuff</Size>
            <SupplierCode>RK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>166369</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA001</BillingCode>
            <Name>Thal-Quick Chest Tube Set</Name>
            <Description>The set consists of introducer needle, wire guide, dilators, coaxial chest tube inserter and clear catheter with radiopaque strip.</Description>
            <Size>8-36 Fr, Length: 18-41cm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>142280</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA002</BillingCode>
            <Name>Fuhrman Pleural/Pneumopericardial Drainage Set</Name>
            <Description>Percutaneous drainage kit.  Components: Introducer needle, wire guide, dilator, radiopaque pigtail catheter, three-way stopcock, and multipurpose tubing adapter.</Description>
            <Size>Catheter length 15cm, 6-10.2 Fr</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>155952</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA005</BillingCode>
            <Name>Wayne Pneumothorax Set</Name>
            <Description>Wayne Pneumothorax Set for Seldinger Placement.  Set includes: introducer needle, wire guide, dilator, pigtail catheter, and Cook Chest Drain Valve</Description>
            <Size>Length: 29cm, 14Fr</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4242</SubGroupID>
            <ARTGs>
                <ARTG>142280</ARTG>
            </ARTGs>
            <MinimumBenefit>106</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS227</BillingCode>
            <Name>Flexima All-Purpose Drainage Catheter</Name>
            <Description>All-purpose drainage catheters for abscesses and fluid collections.</Description>
            <Size>Length up to 25cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4243</SubGroupID>
            <ARTGs>
                <ARTG>132027</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS229</BillingCode>
            <Name>Flexima vanSonnenburg Sump Catheter</Name>
            <Description>Dual lumen catheters that drain cavity contents by application of suction</Description>
            <Size>Length up to 35cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4243</SubGroupID>
            <ARTGs>
                <ARTG>132027</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB016</BillingCode>
            <Name>Skater All-Purpose Drainage Catheter</Name>
            <Description>All-purpose drainage catheters for abscesses and fluid collections</Description>
            <Size>Single Step Drainage Catheter w/Locking Pigtail&#xD;
6Fx20cm, 6Fx25cm, 7Fx20cm, 7Fx25cm, 8Fx20cm, 8Fx25cm, 8Fx30cm, 10Fx20cm, 10Fx25cm, 10Fx30cm, 12Fx20cm, 12Fx25cm, 14Fx20cm, 14Fx25cm, 16Fx25cm&#xD;
Single Step Drainage Catheter w/Non-Locking Pigtail&#xD;
6Fx20cm, 6Fx25cm, 7Fx20cm, 7Fx25cm, 8Fx20cm, 8Fx25cm, 8Fx30cm, 10Fx20cm, 10Fx25cm, 10Fx30cm, 12Fx20cm, 12Fx25cm, 14Fx20cm, 14Fx25cm, 16Fx25cm&#xD;
Drainage Catheter w/Locking Pigtail&#xD;
6Fx25cm, 6Fx35cm, 7Fx25cm, 7Fx35cm, 8Fx25cm, 8Fx35cm, 10Fx25cm, 10Fx35cm, 12Fx25cm, 12Fx35cm, 14Fx25cm, 14Fx35cm, 16Fx25cm&#xD;
Drainage Catheter w/Non-Locking Pigtail&#xD;
6Fx25cm, 6Fx35cm, 7Fx25cm, 7Fx35cm, 8Fx25cm, 8Fx35cm, 10Fx25cm, 10Fx35cm, 12Fx25cm, 12Fx35cm, 14Fx25cm, 16Fx25cm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4243</SubGroupID>
            <ARTGs>
                <ARTG>223261</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FN001</BillingCode>
            <Name>Pleurx</Name>
            <Description>Pleurx Peritoneal Catheter Mini Kit</Description>
            <Size>Catheter 71.0cm x 15.5 Fr</Size>
            <SupplierCode>FN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4243</SubGroupID>
            <ARTGs>
                <ARTG>321900</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME223</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NG075</PriorBillingCode>
            </PriorBillingCodes>
            <Name>General Purpose Drainage Catheter</Name>
            <Description>Abscess Drainage Catheters</Description>
            <Size>6FR x 12CM through to 28FR x 50CM</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4243</SubGroupID>
            <ARTGs>
                <ARTG>98030</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS068</BillingCode>
            <Name>ASEPT Peritoneal Drainage System</Name>
            <Description>Indwelling tunnelled peritoneal catheter insertion kit</Description>
            <Size>Catheter: 71 cm x 15.5F</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4243</SubGroupID>
            <ARTGs>
                <ARTG>285155</ARTG>
            </ARTGs>
            <MinimumBenefit>384</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC315</BillingCode>
            <Name>Multipurpose Drainage Catheter</Name>
            <Description>Catheter used in a variety of drainage applications</Description>
            <Size>8.5-14 Fr, Length: 15-60cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>4243</SubGroupID>
            <ARTGs>
                <ARTG>139357</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS250</BillingCode>
            <Name>Flexima Biliary Drainage Catheter</Name>
            <Description>Biliary drainage catheters for drainage of the biliary tree</Description>
            <Size>Length up to 35cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>5489</SubGroupID>
            <ARTGs>
                <ARTG>132027</ARTG>
            </ARTGs>
            <MinimumBenefit>101</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB017</BillingCode>
            <Name>Skater Biliary Drainage Catheter</Name>
            <Description>Used for biliary drainage applications</Description>
            <Size>Biliary Drainage Catheter w/Locking Pigtail&#xD;
8Fx40cm, 10Fx40cm, 12Fx40cm&#xD;
Biliary Drainage Catheter w/Non-Locking Pigtail&#xD;
8Fx40cm, 10Fx40cm, 12Fx40cm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>5489</SubGroupID>
            <ARTGs>
                <ARTG>223261</ARTG>
            </ARTGs>
            <MinimumBenefit>101</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC317</BillingCode>
            <Name>Ultrathane Biliary Drainage Catheter</Name>
            <Description>Used for biliary drainage applications.</Description>
            <Size>8.5-14 Fr, 40-60cm length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>5489</SubGroupID>
            <ARTGs>
                <ARTG>138381</ARTG>
            </ARTGs>
            <MinimumBenefit>101</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FN005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZQ010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Safe-T-Centesis Drainage system</Name>
            <Description>Safe-T-Centesis drainage for para/thoracentesis</Description>
            <Size>6FR and 8FR pigtail catheter with Veress technology</Size>
            <SupplierCode>FN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>6000</SubGroupID>
            <ARTGs>
                <ARTG>120894</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FN006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZQ011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Paracentesis/Thoracentesis Catheter Drainage</Name>
            <Description>Thora/Paracentesis kit</Description>
            <Size>8FR, 12cm polyurethane catheter</Size>
            <SupplierCode>FN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>6000</SubGroupID>
            <ARTGs>
                <ARTG>120894</ARTG>
            </ARTGs>
            <MinimumBenefit>91</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW008</BillingCode>
            <Name>One-Step Centesis Catheter</Name>
            <Description>Drainage catheter available in straight, pigtail, valved and non-valved with introducer needle</Description>
            <Size>4 French to 8 French&#xD;
7-17cm</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>6000</SubGroupID>
            <ARTGs>
                <ARTG>108467</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW010</BillingCode>
            <Name>ReSolve Locking and Non-Locking Drainage Catheters</Name>
            <Description>Hydrophilic locking and non-locking drainage catheters</Description>
            <Size>6.5 - 14 French</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>6001</SubGroupID>
            <ARTGs>
                <ARTG>328288</ARTG>
                <ARTG>108467</ARTG>
            </ARTGs>
            <MinimumBenefit>108</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET088</BillingCode>
            <Name>Comfort Drain</Name>
            <Description>The Comfort Drain is a silicone anorectal fistula drainage catheter, that is designed to provide a knotless closure of the drain.</Description>
            <Size>Inner Diameter: 0.3mm, Outer Diameter: 1.5mm, Length: 180mm.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1577</GroupID>
            <SubGroupID>7363</SubGroupID>
            <ARTGs>
                <ARTG>220607</ARTG>
            </ARTGs>
            <MinimumBenefit>114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL081</BillingCode>
            <Name>IBV Valve in Cartridge</Name>
            <Description>A one-way valve placed in the lung airway intended to treat diseased lung in emphysematous patients or damaged lung resulting in air leaks by limiting airflow to selected areas.</Description>
            <Size>5mm, 6mm, 7mm and 9mm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1578</GroupID>
            <ARTGs>
                <ARTG>188455</ARTG>
            </ARTGs>
            <MinimumBenefit>5686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PX001</BillingCode>
            <Name>Pulmonx</Name>
            <Description>Valve intended to improve lung function in patients with heterogeneous emphysema by controlling air flow with a one-way valve and to treat patients with pulmonary air leak.</Description>
            <Size>4.0 (4 to 7 mm) and 5.5 (5.5 to 8.5mm)</Size>
            <SupplierCode>PX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1578</GroupID>
            <ARTGs>
                <ARTG>165980</ARTG>
            </ARTGs>
            <MinimumBenefit>5686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FN003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZQ008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Denver Ascites Shunt, (PAK), Double-valved</Name>
            <Description>Ascite Shunt - Double Valved Percutaneous Access Kit (PAK). A fenestrated peritoneal catheter, a venous catheter, and a flexible pump chamber containing two miter valves, provided with a Percutaneous Access Kit.</Description>
            <Size>Double-valved, 42-2050</Size>
            <SupplierCode>FN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1793</GroupID>
            <ARTGs>
                <ARTG>163267</ARTG>
            </ARTGs>
            <MinimumBenefit>1986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FN004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZQ009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Denver Ascites Shunt, (PAK), Single-valved</Name>
            <Description>Ascites Shunt - Single Valved Percutaneous Access Kit (PAK). A fenestrated peritoneal catheter, a veneous catheter, and a flexible pump chamber containing one miter valve, provided with a Percutaneous Access Kit (PAK).</Description>
            <Size>Single valved, 42-2055</Size>
            <SupplierCode>FN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>193</SubCategoryID>
            <GroupID>1793</GroupID>
            <ARTGs>
                <ARTG>163266</ARTG>
            </ARTGs>
            <MinimumBenefit>1986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET064</BillingCode>
            <Name>AMI HAL-RAR Flexi Procedure Kit</Name>
            <Description>Doppler guided Haemorrhoidal Arterial Ligation and Recto-Anal Repair System.&#xD;
HAL Haemorrhoidal Ligating sutures, doppler/ultrasound proctoscope, flexiprobe, knot pusher</Description>
            <Size>One size, several components</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Doppler Guided, Endoscopic</Suffix>
            <ARTGs>
                <ARTG>144489</ARTG>
            </ARTGs>
            <MinimumBenefit>844</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS056</BillingCode>
            <Name>THD Slide</Name>
            <Description>Transanal Haemorrhoidal Dearterilisation and Pexis System</Description>
            <Size>One Size Only</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Doppler Guided, Endoscopic</Suffix>
            <ARTGs>
                <ARTG>377045</ARTG>
            </ARTGs>
            <MinimumBenefit>844</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MO441</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Angiodin Procto</Name>
            <Description>Single-use Ultrasound Proctoscope Kit (kit includes 1 x proctoscope, 6 x braided absorbable suture thread 75 cm with 26 mm needle, and 1 x knot pusher )</Description>
            <Size>Single item</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Doppler Guided, Endoscopic</Suffix>
            <ARTGs>
                <ARTG>279583</ARTG>
            </ARTGs>
            <MinimumBenefit>844</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AK007</BillingCode>
            <Name>Hemoclip Clip Applicator</Name>
            <SupplierCode>AK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>205634</ARTG>
            </ARTGs>
            <MinimumBenefit>71</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AK008</BillingCode>
            <Name>Ligation Loop</Name>
            <Description>A device used in combination with a dedicated endoscope. It is intended to ligate a polyp using loop wire for haemostasis or necrosis during endoscopy. It consist of an insertion sheath, a loop wire attached at the distal end of the sheath, and a control handle and operation wire connected to both the loop wire and control handle.</Description>
            <Size>Introducer up to 240cm long&#xD;
Loop sizes 15mm-40mm</Size>
            <SupplierCode>AK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>279077</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AK012</BillingCode>
            <Name>Lockado Clip and SureClip  </Name>
            <Description>An endotherapy device used in combination with a compatible flexible  endoscope for the application of haemostatic clips to the mucosal lining  of the gastrointestinal (GI) tract for endoscopic marking, haemostasis,  tissue approximation, closure of luminal perforations, and/or for treating  mucosal/submucosal defects during an endoscopic procedure.</Description>
            <Size>8mm, 11mm, 16mm</Size>
            <SupplierCode>AK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>261692</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS299</BillingCode>
            <Name>Resolution 360/Mantis Clip Device</Name>
            <Description>Radiopaque, single-use clip pre-loaded on a flexible, rotatable delivery system</Description>
            <Size>7Fr, 11mm jaw opening</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>271874</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS379</BillingCode>
            <Name>Resolution 360 Ultra Clip</Name>
            <Description>Radiopaque, single-use clip pre-loaded on a flexible, rotatable delivery system</Description>
            <Size>17mm jaw opening</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>271874</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE567</BillingCode>
            <Name>Hemoclip</Name>
            <Description>Pre-loaded Endoscopically  applied clip for the GI tract.</Description>
            <Size>Jaw openings: 9 - 16mm;&#xD;
Applicator length: 165 - 230cm.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>284272</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV144</BillingCode>
            <Name>DuraClip™ Repositionable Hemostasis Clip</Name>
            <Description>A single use repositionable hemostasis clip which is intended to be used for placement within the gastrointestinal tract.</Description>
            <Size>165cm Length and 235cm Length</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>274973</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL009</BillingCode>
            <Name>Rotatable Clip fixing device</Name>
            <Description>Disposable pre-loaded clip applier</Description>
            <Size>Standard or long clip length, 9 or 11mm jaw opening</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>146730</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL010</BillingCode>
            <Name>Ligation device</Name>
            <Description>Disposable pre-assembled applier and ligating loop</Description>
            <Size>Sheath Length 1650-2300mm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>145846</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VM002</BillingCode>
            <Name>Precision Clip</Name>
            <Description>Endoscopic Hemoclip</Description>
            <Size>Jaw Opening 13mm - 16mm</Size>
            <SupplierCode>VM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>289170</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA011</BillingCode>
            <Name>Instinct Plus Endoscopic Clipping Device</Name>
            <Description>The Instinct Plus Endoscopic Clipping Device consists of a single-use clip pre-loaded on a flexible delivery system. The device is designed to be compatible with forward viewing and side viewing endoscopes. The handle of the device allows the clip to be opened, closed, rotated, and deployed at the target site. </Description>
            <Size>Opening span up to 16mm. Catheter 7Fr, length 230cm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>96698</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC311</BillingCode>
            <Name>Instinct Endoscopic Hemoclip</Name>
            <Description>Endoscopic hemoclip used within the GI tract</Description>
            <Size>Opening span up to 16mm.</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>96698</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE645</BillingCode>
            <Name>Padlock clip</Name>
            <Description>Defect closure system</Description>
            <Size>Diameter - 9.5 - 14mm  Length - 162cm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic, OTS</Suffix>
            <ARTGs>
                <ARTG>295460</ARTG>
            </ARTGs>
            <MinimumBenefit>884</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER650</BillingCode>
            <Name>Apollo Endosurgery X-Tack™ Endoscopic HeliX Tacking System</Name>
            <Description>The X-Tack™ System is intended for approximation of soft tissue in minimally invasive gastroenterology procedures (e.g. closure and healing of ESD/EMR sites, and closing of fistula, perforation or leaks).using tensioned helical tacks.     The X-Tack system comprises respective delivery systems for tacking and cinching; tethered stainless steel HeliX tacks; and a PEEK cinch system.    1. The delivery system is composed of biocompatible plastic and drives the HeliX tacks into the tissue. This is replaced with the PEEK cinching system when the defect is ready for compression.  2. The stainless steel HeliX tacks are placed around the defect with the tether providing compression when tensioned and so enabling closure.  Compression is maintained using a PEEK cinch which terminates the closing construct.  3. The PEEK cinching system is a delivery system that deploys a PEEK plug/collar to the tethering system to ensure the tissue in the defect area remains compressed.</Description>
            <Size>160 and 235 cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic, OTS</Suffix>
            <ARTGs>
                <ARTG>376194</ARTG>
            </ARTGs>
            <MinimumBenefit>2283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET067</BillingCode>
            <Name>OTSC Clip</Name>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic, OTS</Suffix>
            <ARTGs>
                <ARTG>185054</ARTG>
                <ARTG>185057</ARTG>
            </ARTGs>
            <MinimumBenefit>840</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET068</BillingCode>
            <Name>OTSC System</Name>
            <Description>Has two components:&#xD;
1. The OTSC Clip is a superelastic Nitinol clip which compresses the tissue between its teeth; enables hemostasis as well as closing performations.&#xD;
&#xD;
2. Grasping and Anchoring Tool. Ovesco Twin Graspers – to approximate wound edges.. Ovesco Anchor- to grasp fibrous tissue or fistulas</Description>
            <Size>OTSC Clip is available in three sizes: 9mm, 10mm and 11 mm.&#xD;
Ovesco Twin Graspers : 165mm or 220mm&#xD;
Ovesco Anchor: 165mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic, OTS</Suffix>
            <ARTGs>
                <ARTG>18057</ARTG>
                <ARTG>185054</ARTG>
                <ARTG>185056</ARTG>
                <ARTG>185058</ARTG>
            </ARTGs>
            <MinimumBenefit>2283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET083</BillingCode>
            <Name>Full-Thickness Resection Device (FTRD)</Name>
            <Description>The FTRD System Set is used for diagnostic and therapeutic full-thickness resection via flexible endoscopy in the colon and rectum. The FTRD System Set is designed to ensure that the transection of tissue happens only after the defect has been completely closed.</Description>
            <Size>The FTRD clip is and 11mm nitinol clip.&#xD;
Also supplied with the FTRD marking probe (220cm) and FTRD Grasper (220cm).</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Endoscopic, OTS</Suffix>
            <ARTGs>
                <ARTG>235539</ARTG>
            </ARTGs>
            <MinimumBenefit>2283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AK011</BillingCode>
            <Name>Band Ligator</Name>
            <Description>A surgical instrument used to apply a ligature to haemorrhoids. A ligator typically consists of a long shaft or cannula with a clamp or grip at the distal end for holding the ligature. The proximal end consists of a handle with moving parts that mechanically operate the distal clamp or grip.</Description>
            <Size>Barrel with 5 bands</Size>
            <SupplierCode>AK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>5490</SubGroupID>
            <ARTGs>
                <ARTG>308836</ARTG>
            </ARTGs>
            <MinimumBenefit>236</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS225</BillingCode>
            <Name>Speedband Superview Super 7</Name>
            <Description>Multiple Band Ligator</Description>
            <Size>7 bands per unit, compatible with scopes with outer diameter of 8.6mm - 11.5mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>5490</SubGroupID>
            <ARTGs>
                <ARTG>133438</ARTG>
            </ARTGs>
            <MinimumBenefit>236</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DH011</BillingCode>
            <Name>KilRoid</Name>
            <Description>KilRoid® is a disposable haemorrhoid suction ligator with and without tubing.</Description>
            <Size>6 bands - available with and without tubing.</Size>
            <SupplierCode>DH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>5490</SubGroupID>
            <ARTGs>
                <ARTG>326510</ARTG>
            </ARTGs>
            <MinimumBenefit>36</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HB001</BillingCode>
            <Name>Haemoband</Name>
            <Description>A preloaded, single use, 4 band ligator for haemorrhoids.</Description>
            <Size>1 size, 4 bands</Size>
            <SupplierCode>HB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>5490</SubGroupID>
            <ARTGs>
                <ARTG>136643</ARTG>
            </ARTGs>
            <MinimumBenefit>49</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC314</BillingCode>
            <Name>Saeed Multi-band Ligator</Name>
            <Description>Multiple Band Ligator</Description>
            <Size>4, 6 or 10 bands per unit, compatible with scopes with outer diameter of 8.6mm - 14mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>5490</SubGroupID>
            <ARTGs>
                <ARTG>136845</ARTG>
            </ARTGs>
            <MinimumBenefit>236</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC318</BillingCode>
            <Name>ShortShot Saeed Hemorrhoidal Multi-Band Ligator</Name>
            <Description>The ShortShot Saeed Haemorrhoidal Multi-Band Ligator is used to ligate internal haemorrhoids and is available with or without the TriView Anoscope.  </Description>
            <Size>4 bands per ligator, 15mm in diameter</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>5490</SubGroupID>
            <ARTGs>
                <ARTG>136845</ARTG>
                <ARTG>139361</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA017</BillingCode>
            <Name>4D - SEMI ABSORBABLE HERNIA MESH</Name>
            <Description>4DMESH semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias</Description>
            <Size>6 x 13.5 cm &#xD;
10.5 x 14 cm &#xD;
12 x 15 cm</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>283655</ARTG>
            </ARTGs>
            <MinimumBenefit>316</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA016</BillingCode>
            <Name>4D - DOME SEMI ABSORBABLE HERNIA MESH</Name>
            <Description>4D DOME semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias</Description>
            <Size>2.4, 9 x 5 cm &#xD;
3.0, 9 x 5 cm &#xD;
3.8, 9 x 5 cm</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>222740</ARTG>
            </ARTGs>
            <MinimumBenefit>316</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS243</BillingCode>
            <Name>Parietex™ Hydrophilic Anatomical Mesh; Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name>
            <Description>Parietex™ hydrophilic anatomical mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) an assembly of a 2-dimensional textile and a 3-dimensional textile. Parietex™ hydrophilic anatomical mesh is available in right or left configurations and in different shapes and sizes. Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. This folding mesh is provided with a non-absorbable pre-placed yarn tied to the mesh. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile. This is a pre-cut and slit mesh - the mesh presents a slit for the passage of the cord.</Description>
            <Size>13 cm x 9 cm, 14 cm x 10 cm,  15 cm x 10 cm, 16 cm x 12 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA222</BillingCode>
            <Name>Bard 3D Max Mesh</Name>
            <Description>3D Mesh</Description>
            <Size>Medium left, Medium Right, large Left, Large Right</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <Suffix>Contoured, Without Fixation</Suffix>
            <ARTGs>
                <ARTG>122873</ARTG>
            </ARTGs>
            <MinimumBenefit>238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS164</BillingCode>
            <Name>Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name>
            <Description>Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. The mesh is available in two versions: a standard version and a rigid version. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile.</Description>
            <Size>13 cm x 9 cm, 15 cm x 10 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS174</BillingCode>
            <Name>Parietene™ Flat Sheet Mesh; Parietene™ Lightweight Mesh  </Name>
            <Description>Parietene™ flat sheet mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile. Parietene™ lightweight mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description>
            <Size>6 cm x 11 cm, 15 cm x 10 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS232</BillingCode>
            <Name>Versatex™ Monofilament Mesh</Name>
            <Description>The mesh is made of non-absorbable monofilament three-dimensional (3D) polyester (polyethylene terephthalate) textile.</Description>
            <Size>11 cm x 6 cm, 15 cm x 10 cm  </Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>237409</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA070</BillingCode>
            <Name>Bard Mesh  </Name>
            <Description>Flat mesh</Description>
            <Size>2.5x10cm, 4.5x10cm, 5x10cm, 6x13.7cm, 7.5x15cm, 10x15cm, 5x30.5cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>122873</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ175</BillingCode>
            <Name>Prolene Mesh</Name>
            <Description>Medium polypropylene monofilament non absorbable mesh</Description>
            <Size>7.6cm x 15cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>165074</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ177</BillingCode>
            <Name>Prolene Mesh</Name>
            <Description>Small keyhole polypropylene monofilament non absorbable mesh</Description>
            <Size>4.6cm x 10.2cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>165074</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ178</BillingCode>
            <Name>Prolene Mesh</Name>
            <Description>Large keyhole polypropylene monofilament non absorbable mesh</Description>
            <Size>6cm  x 13.7cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>165074</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ566</BillingCode>
            <Name>PROLENE Mesh</Name>
            <Description>Polypropylene Mesh</Description>
            <Size>10 x 15cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>389990</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN181</BillingCode>
            <Name>PROLENE™ Soft Polypropylene Mesh</Name>
            <Description>Nonabsorbable Synthetic Surigcal Mesh</Description>
            <Size>Size (cm) 2.5x10, 7.6x15, 6.4x11.4; quantity/pack 6  </Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5434</SubGroupID>
            <ARTGs>
                <ARTG>389989</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA018</BillingCode>
            <Name>4D - Semi Absorbable Hernia Mesh</Name>
            <Description>4DMESH semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias.</Description>
            <Size>12 x 17 cm&#xD;
17 x 17 cm</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>283655</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA223</BillingCode>
            <Name>Bard 3D Max Mesh</Name>
            <Description>3D Mesh</Description>
            <Size>Extra Large Left, Extra Large Right</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <Suffix>Contoured, Without Fixation</Suffix>
            <ARTGs>
                <ARTG>122873</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS122</BillingCode>
            <Name>Parietene™ Flat Sheet Mesh; Parietene™ Lightweight Mesh</Name>
            <Description>Parietene™ flat sheet mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile. Parietene™ lightweight mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description>
            <Size>20 cm x 20 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS165</BillingCode>
            <Name>Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name>
            <Description>Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. The mesh is available in two versions: a standard version and a rigid version. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile.</Description>
            <Size>15 cm x 15 cm,</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS170</BillingCode>
            <Name>Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name>
            <Description>Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile.</Description>
            <Size>20 cm x 20 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS176</BillingCode>
            <Name>Parietene™ Flat Sheet Mesh; Parietene™ Lightweight Mesh</Name>
            <Description>Parietene™ flat sheet mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile. Parietene™ lightweight mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description>
            <Size>15 cm x 15 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS234</BillingCode>
            <Name>Versatex™ Monofilament Mesh</Name>
            <Description>The mesh is made of non-absorbable monofilament three-dimensional (3D) polyester (polyethylene terephthalate) textile. A colored yarn (green) marker made of bi-dimensional monofilament polyester textile (D&amp;C Green No. 6) is available on the 15 cm x 15 cm size and present on the 20 cm x 20 cm size.</Description>
            <Size>15 cm x 15 cm, 20 cm x 20 cm  </Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>237409</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA157</BillingCode>
            <Name>Bard Mesh</Name>
            <Description>Flat Mesh</Description>
            <Size>15X15cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>122873</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ222</BillingCode>
            <Name>Prolene Mesh - medium</Name>
            <Description>Constructed of knitted filaments of extruded polypropylene identical to that used in Prolene suture.  Material is approx. 0.027mm thick.  Non-absorbable mesh for tension free-inguinal hernia techniques.</Description>
            <Size>Medium - 6" x 6"</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>165074</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN162</BillingCode>
            <Name>PROLENE Soft Polypropylene Mesh</Name>
            <Description>Nonabsorbable Synthetic Surgical Mesh</Description>
            <Size>Size (cm) 15x15; quantity/pack 6</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5435</SubGroupID>
            <ARTGs>
                <ARTG>389989</ARTG>
            </ARTGs>
            <MinimumBenefit>77</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS123</BillingCode>
            <Name>Parietene™ Flat Sheet Mesh; Parietene™ Lightweight Mesh</Name>
            <Description>Parietene™ flat sheet mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile. Parietene™ lightweight mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description>
            <Size>30 cm x 30 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5437</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS171</BillingCode>
            <Name>Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name>
            <Description>Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. The mesh is available in two versions: a standard version and a rigid version. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile.</Description>
            <Size>30 cm x 30 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5437</SubGroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS221</BillingCode>
            <Name>Versatex™ Monofilament Mesh</Name>
            <Description>The mesh is made of non-absorbable monofilament three-dimensional (3D) polyester (polyethylene terephthalate) textile. A colored yarn (green) marker made of bi-dimensional monofilament polyester textile (D&amp;C Green No. 6) is present.</Description>
            <Size>30 cm x 30 cm, 45 cm x 30 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5437</SubGroupID>
            <ARTGs>
                <ARTG>237409</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA158</BillingCode>
            <Name>Bard Mesh</Name>
            <Description>Flat Mesh</Description>
            <Size>25x35.5cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5437</SubGroupID>
            <ARTGs>
                <ARTG>122873</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ176</BillingCode>
            <Name>Prolene Mesh</Name>
            <Description>Large polypropylene monofilament non absorbable mesh</Description>
            <Size>30cm x 30cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5437</SubGroupID>
            <ARTGs>
                <ARTG>389990</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN180</BillingCode>
            <Name>PROLENE™ Soft Polypropylene Mesh</Name>
            <Description>Non-absorbable Synthetic Surgical Mesh</Description>
            <Size>Size (cm) 30.5x35.6, 25x25; quantity/pack 3  </Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5437</SubGroupID>
            <ARTGs>
                <ARTG>389989</ARTG>
            </ARTGs>
            <MinimumBenefit>248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS240</BillingCode>
            <Name>Versatex™ Monofilament Mesh</Name>
            <Description>The mesh is made of non-absorbable monofilament three-dimensional (3D) polyester (polyethylene terephthalate) textile. A colored yarn (green) marker made of bi-dimensional monofilament polyester textile (D&amp;C Green No. 6) is present.</Description>
            <Size>50 cm x 50 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5947</SubGroupID>
            <ARTGs>
                <ARTG>237409</ARTG>
            </ARTGs>
            <MinimumBenefit>582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN186</BillingCode>
            <Name>PROLENE Soft Polypropylene Mesh</Name>
            <Description>Nonabsorbable Synthetic Surgical Mesh</Description>
            <Size>≥2500cm²</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1782</GroupID>
            <SubGroupID>5947</SubGroupID>
            <ARTGs>
                <ARTG>389989</ARTG>
            </ARTGs>
            <MinimumBenefit>582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS162</BillingCode>
            <Name>Parietene ProGrip Mesh (FLAT)</Name>
            <Description>Mesh with self gripping FLAT</Description>
            <Size>15 x 9cm RECTANGLE</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>149430</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS214</BillingCode>
            <Name>PROGRIP™ Laparoscopic Self-Fixating Composite Mesh</Name>
            <Description>Laparoscopic self-fixating composite mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side)</Description>
            <Size>10x15, 16x12  rectangular</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>252653</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS236</BillingCode>
            <Name>Parietex Progrip Composite Mesh</Name>
            <Description>Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides</Description>
            <Size>15x9 rectangular</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>157201</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA226</BillingCode>
            <Name>Bard Mesh</Name>
            <Description>Ventralex Patch</Description>
            <Size>4.3cm circle, 6.4cm circle, 8cm circle</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>122873</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA236</BillingCode>
            <Name>Ventralex ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>4.3cm circle, 6.4cm circle, 8.0cm circle</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219323</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA237</BillingCode>
            <Name>Ventralight ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>11.4cm circle, 10.2 x 15.2cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219332</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA246</BillingCode>
            <Name>Ventrio ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>7.6cm circle, 11.4cm circle, 8 x 12cm oval, 11 x 14cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219324</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ446</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh B1</Description>
            <Size>2x4 (inches)</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ447</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh R1</Description>
            <Size>3x6 inches</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ448</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh N1</Description>
            <Size>4x6 inches oval</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ449</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh D1</Description>
            <Size>4x8 inches</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ816</BillingCode>
            <Name>Proceed™ Ventral Patch</Name>
            <Description>3D, sterile, self expanding, partially absorbable, flexible laminate mesh for hernia or other abdominal, fascial defect repair that require addition of a reinforcing or bridging material to obtain the desired surgical result.</Description>
            <Size>medium (6.4cm x 6.4cm)</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>161186</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ817</BillingCode>
            <Name>Proceed™ Ventral Patch</Name>
            <Description>3D, sterile, self expanding, partially absorbable, flexible laminate mesh for hernia or other abdominal, fascial defect repair that require addition of a reinforcing or bridging material to obtain the desired surgical result.</Description>
            <Size>small (4.3cm x 4.3cm)</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>161186</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN192</BillingCode>
            <Name>PHYSIOMESH Open</Name>
            <Description>Flexible Composite Mesh</Description>
            <Size>≤200cm²</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>274361</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS030</BillingCode>
            <Name>Titanized Mesh Implants [TiMESH, TiLENE, TiLENE Blue]</Name>
            <Description>Prosthetic warp-knitted fabric made of monofil polypropylene threads with an encapsulating titanic coating</Description>
            <Size>Weight: 16 g/m² - 65 g/m²; Surface Area: ≤ 200cm²</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>97288</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS161</BillingCode>
            <Name>Parietene ProGrip Mesh (PRE-SHAPED)</Name>
            <Description>Pre-Cut, slit mesh with self gripping overlapping flap - right or left</Description>
            <Size>12 x 8cm elliptic</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>149430</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS211</BillingCode>
            <Name>Parietex Composite Ventral Patch</Name>
            <Description>Parietex Composite ventral patch is used for the reinforcement of soft tissues during surgical repair. It is indicated for the treatment of ventral defects (primary and incisional hernias).</Description>
            <Size>4.6cm, 6.6cm, 8.6cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>258212</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS217</BillingCode>
            <Name>Symbotex Composite Mesh with pre placed suture</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description>
            <Size>Rectangular 15x10 cm&#xD;
Round 15 cm, 12 cm&#xD;
Elliptical 17x10&#xD;
Round 9cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270737</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS219</BillingCode>
            <Name>PROGRIP™ Laparoscopic Self-Fixating Composite Mesh</Name>
            <Description>Laparoscopic self-fixating composite right or left or bilateral anatomical mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side)</Description>
            <Size>10x15 cm  Rectangular Bilateral Anatomical,  10x15 cm  Rectangular Right Anatomical, 10x15 cm  Left Anatomical,  13x09 cm  Right Anatomical, &#xD;
13x09 cm  Left Anatomical</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>252653</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS220</BillingCode>
            <Name>Parietex Progrip Composite Mesh</Name>
            <Description>Pre-Cut, slit mesh with self gripping overlapping flap - right or left knitted (monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides)</Description>
            <Size>Elliptic slit 12x8cm left side, elliptic slit 12x8cm right side, elliptic slit 14x9 left side, elliptic slit right side 14x9cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>157201</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS224</BillingCode>
            <Name>PROGRIP™ Laparoscopic Self-Fixating Composite Mesh</Name>
            <Description>Laparoscopic self-fixating composite right or left anatomical mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side)</Description>
            <Size>16 x 12 cm right anatomical, &#xD;
16 x 12 cm left anatomical</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>252653</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS235</BillingCode>
            <Name>Symbotex Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.</Description>
            <Size>Round 15 cm, 12 cm, 9 cm&#xD;
Elliptical 17x10 cm&#xD;
Rectangular 15x10 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270735</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS241</BillingCode>
            <Name>Symbotex Skirted Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester skirted composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh.</Description>
            <Size>8 cm Round, 15x10 cm Rectangle</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270736</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA272</BillingCode>
            <Name>Bard Onflex and Modified Onflex</Name>
            <Description>Multi-layer, contoured polypropylene hernia repair system incorporating positioning pockets and an absorbable ring.</Description>
            <Size>≤200cm²</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>122873</ARTG>
            </ARTGs>
            <MinimumBenefit>271</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ585</BillingCode>
            <Name>Ultrapro Hernia System</Name>
            <Description>Ultrapro Hernia System. Mesh Made From Composite of Monocryl &amp; Prolene</Description>
            <Size>Small to Large Oval</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>132509</ARTG>
            </ARTGs>
            <MinimumBenefit>271</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ240</BillingCode>
            <Name>VYPRO II Mesh</Name>
            <Description>Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn.  Partly absorbable lightweight mesh for tension free-inguinal hernia techniques</Description>
            <Size>Small 6 x 11cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>128896</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ241</BillingCode>
            <Name>VYPRO II Mesh</Name>
            <Description>Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn.  Partly absorbable lightweight mesh for tension free-inguinal hernia techniques</Description>
            <Size>Medium 12 x 10cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>128896</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ242</BillingCode>
            <Name>VYPRO II Mesh</Name>
            <Description>Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn.  Partly absorbable lightweight mesh for tension free-inguinal hernia techniques</Description>
            <Size>Large 15 x 10cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>128896</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ465</BillingCode>
            <Name>ULTRAPRO Mesh</Name>
            <Description>ULTRAPRO Mesh S3</Description>
            <Size>6 x 11cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>390525</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ466</BillingCode>
            <Name>ULTRAPRO Mesh</Name>
            <Description>ULTRAPRO Mesh P3</Description>
            <Size>10 x 12cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>390525</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ467</BillingCode>
            <Name>ULTRAPRO Mesh</Name>
            <Description>ULTRAPRO Mesh N3</Description>
            <Size>10 x 15cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>390525</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ565</BillingCode>
            <Name>ULTRAPRO Mesh</Name>
            <Description>Composite Mesh</Description>
            <Size>7.6cm x 15cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>390525</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN182</BillingCode>
            <Name>Ultrapro Advanced</Name>
            <Description>Macroporous, Partially Absorbable Mesh</Description>
            <Size>Size (cm) 6x12, 7.6x15, 10x15;,quantity/pack 1 or 3</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5438</SubGroupID>
            <ARTGs>
                <ARTG>390526</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA019</BillingCode>
            <Name>4D VENTRAL COMPOSITE MESH</Name>
            <Description>4D VENTRAL COMPOSITE MESH</Description>
            <Size>15 X 15 CM</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>354550</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS218</BillingCode>
            <Name>PROGRIP™ Laparoscopic Self-Fixating Composite Mesh</Name>
            <Description>Laparoscopic self-fixating composite mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side)</Description>
            <Size>16 x 14 cm rectangular</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>252653</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS225</BillingCode>
            <Name>Parietex Progrip Composite Mesh</Name>
            <Description>Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides</Description>
            <Size>Rectangular 15x15cm, 20x15cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>157201</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA238</BillingCode>
            <Name>Ventralight ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>15.2 x 20.3cm oval, 15.2 x 25.4cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219332</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA247</BillingCode>
            <Name>Ventrio ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>13.8 x 17.8cm oval, 15.5 x 25.7cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219324</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ450</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh M1</Description>
            <Size>6x6 inches</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ451</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh G1</Description>
            <Size>6x8 inches oval</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN193</BillingCode>
            <Name>PHYSIOMESH Open</Name>
            <Description>Flexible Composite Mesh</Description>
            <Size>201-400cm²</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>274361</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS033</BillingCode>
            <Name>Titanized Mesh Implants (TiMESH, TiLENE, TiLENE Blue, TiLOOP Bra, TiLOOP Bra MPX)</Name>
            <Description>Prosthetic warp-knitted fabric made of monofil polypropylene threads with an encapsulating titanic coating</Description>
            <Size>Weight: 16 g/m² - 65 g/m² ; Surface Area: 201cm² - 400cm²</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>97288</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA242</BillingCode>
            <Name>Ventralight ST with ECHO PS Positioning System</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>201-400cm2</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated, Complex delivery System</Suffix>
            <ARTGs>
                <ARTG>219333</ARTG>
            </ARTGs>
            <MinimumBenefit>911</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA304</BillingCode>
            <Name>Ventralight™ ST Mesh with Echo 2™ Positioning System </Name>
            <Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair.</Description>
            <Size>11cm  10cm x 15cm  15cm  15cm x 20cm  15cm x 25cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated, Complex delivery System</Suffix>
            <ARTGs>
                <ARTG>365351</ARTG>
            </ARTGs>
            <MinimumBenefit>911</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS215</BillingCode>
            <Name>Symbotex Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh. (On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera)</Description>
            <Size>Elliptical 25x15 cm, &#xD;
Elliptical 20x12 cm&#xD;
Rectangular 20x15cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270735</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS238</BillingCode>
            <Name>Symbotex Skirted Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester skirted, coated, contoured composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh.</Description>
            <Size>20 x15 cm Rectangle</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270736</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS239</BillingCode>
            <Name>Symbotex Composite Mesh with pre placed suture</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description>
            <Size>Rectangular 20x15 cm&#xD;
Elliptical 25x15 cm, &#xD;
Elliptical 20x12 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270737</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ173</BillingCode>
            <Name>VICRYL Mesh</Name>
            <Description>Polyglactin 910 - synthetic absorbable mesh.</Description>
            <Size>15cm x 15cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <ARTGs>
                <ARTG>143774</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ243</BillingCode>
            <Name>VYPRO II Mesh</Name>
            <Description>Composition - equal part Vicryl polyglactin yarn - non-absorbable Prolene polypropylene yarn.  Partly absorbable lightweight mesh for tension free-inguinal hernia techniques</Description>
            <Size>Extra large 15 x 15cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <ARTGs>
                <ARTG>128896</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ468</BillingCode>
            <Name>ULTRAPRO Mesh</Name>
            <Description>ULTRAPRO Mesh M3</Description>
            <Size>15 x 15cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <ARTGs>
                <ARTG>390525</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN183</BillingCode>
            <Name>Ultrapro Advanced</Name>
            <Description>Macroporous, Partially Absorbable Mesh</Description>
            <Size>Size (cm) 15x15;,quantity/pack 1 or 3</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5439</SubGroupID>
            <ARTGs>
                <ARTG>390526</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA020</BillingCode>
            <Name>4D VENTRAL COMPOSITE MESH</Name>
            <Description>4D VENTRAL COMPOSITE MESH</Description>
            <Size>15 X 30 CM, 20 X 25 CM.</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>354550</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS222</BillingCode>
            <Name>Parietex Progrip Composite Mesh</Name>
            <Description>Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides</Description>
            <Size>Rectangular 30x15cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>157201</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA239</BillingCode>
            <Name>Ventralight ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>17.8 x 22.9cm oval, 20.3 x 25.4cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219332</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA248</BillingCode>
            <Name>Ventrio ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>19.6 x 24.6cm oval, 22.1 x 27.1cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219324</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ452</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh H1</Description>
            <Size>8x10 inches oval</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ453</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh J1</Description>
            <Size>8x12 inches</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN194</BillingCode>
            <Name>PHYSIOMESH Open</Name>
            <Description>Flexible Composite Mesh</Description>
            <Size>401-600cm²</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>274361</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS035</BillingCode>
            <Name>Titanized Mesh Implants [TiMESH, TiLOOP Bra MPX]</Name>
            <Description>Prosthetic warp-knitted fabric made of monofil polypropylene threads with an encapsulating titanic coating</Description>
            <Size>Weight: 16 g/m² - 65 g/m² ; Surface Area: 401cm² - 600cm²</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>97288</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS216</BillingCode>
            <Name>Symbotex Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester mesh provides long term reinforcement of soft tissues. (On the opposite side, the absorbable&#xD;
hydrophilic film minimizes tissue attachment to the mesh in case&#xD;
of direct contact with the viscera.)</Description>
            <Size>Rectangular 30x20 cm,  &#xD;
Rectangular 25x20 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270735</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS223</BillingCode>
            <Name>Symbotex Skirted Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester skirted composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh.</Description>
            <Size>30x20 cm Rectangle&#xD;
25x20 cm Rectangle</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270736</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS233</BillingCode>
            <Name>Symbotex Composite Mesh with pre placed suture</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description>
            <Size>Rectangular 30x20 cm, Rectangular  25x20 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated, Contoured</Suffix>
            <ARTGs>
                <ARTG>270737</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA243</BillingCode>
            <Name>Ventralight ST with ECHO PS Positioning System</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>401-600cm2</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated, Integrated Delivery System</Suffix>
            <ARTGs>
                <ARTG>219333</ARTG>
            </ARTGs>
            <MinimumBenefit>1074</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA306</BillingCode>
            <Name>Ventralight™ ST Mesh with Echo 2™ Positioning System</Name>
            <Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair.</Description>
            <Size>18cm x 23cm  20cm  20cm x 25cm  </Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <Suffix>Coated, Integrated Delivery System</Suffix>
            <ARTGs>
                <ARTG>365351</ARTG>
            </ARTGs>
            <MinimumBenefit>1074</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ469</BillingCode>
            <Name>ULTRAPRO Mesh</Name>
            <Description>ULTRAPRO Mesh T1</Description>
            <Size>15x30cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <ARTGs>
                <ARTG>390525</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN184</BillingCode>
            <Name>Ultrapro Advanced</Name>
            <Description>Macroporous, Partially Absorbable Mesh</Description>
            <Size>Size (cm) 15x30;,quantity/pack 1</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5440</SubGroupID>
            <ARTGs>
                <ARTG>390526</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA021</BillingCode>
            <Name>4D VENTRAL COMPOSITE MESH </Name>
            <Description>4D VENTRAL COMPOSITE MESH</Description>
            <Size>30 X 30 </Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>354550</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS230</BillingCode>
            <Name>Symbotex Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh. (On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.)</Description>
            <Size>Elliptical 40x24cm, 34x20cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>270735</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS237</BillingCode>
            <Name>Symbotex Composite Mesh with pre placed suture</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description>
            <Size>Elliptical 40x24cm, Elliptical 34x20 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>270737</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA240</BillingCode>
            <Name>Ventralight ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>22.4 x 33.0cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219332</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA249</BillingCode>
            <Name>Ventrio ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>27.4 x 34.9cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219324</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ454</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh T1</Description>
            <Size>10x13 inches oval</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ455</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh W1</Description>
            <Size>10x14 inches</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ456</BillingCode>
            <Name>PROCEED Surgical Mesh</Name>
            <Description>PROCEED Surgical Mesh L1</Description>
            <Size>12x12 inches</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>357230</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN195</BillingCode>
            <Name>PHYSIOMESH Open</Name>
            <Description>Flexible Composite Mesh&#xD;
</Description>
            <Size>601cm²-1000cm²</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>274361</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS038</BillingCode>
            <Name>Titanized Mesh Implants [TiLENE, TiMESH, TiLOOP Bra Pocket)</Name>
            <Description>Prosthetic warp-knitted fabric made of monofil polypropylene threads with an encapsulating titanic coating</Description>
            <Size>Weight: 16 g/m² - 65 g/m²; Surface Area: 601cm² - 1000cm²</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>97288</ARTG>
            </ARTGs>
            <MinimumBenefit>1013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA244</BillingCode>
            <Name>Ventralight ST with ECHO PS Positioning System</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>25.4 x 33.0cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated, Integrated Delivery System</Suffix>
            <ARTGs>
                <ARTG>219333</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA307</BillingCode>
            <Name>Ventralight™ ST Mesh with Echo 2™ Positioning System </Name>
            <Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair.</Description>
            <Size>25cm x 33cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <Suffix>Coated, Integrated Delivery System</Suffix>
            <ARTGs>
                <ARTG>365351</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ020</BillingCode>
            <Name>Vicryl Mesh</Name>
            <Description>1 sheet/box</Description>
            <Size>Large - 30cm x 30cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <ARTGs>
                <ARTG>143774</ARTG>
            </ARTGs>
            <MinimumBenefit>271</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ470</BillingCode>
            <Name>ULTRAPRO Mesh</Name>
            <Description>ULTRAPRO Mesh L1</Description>
            <Size>30x30cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <ARTGs>
                <ARTG>390525</ARTG>
            </ARTGs>
            <MinimumBenefit>271</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN185</BillingCode>
            <Name>Ultrapro Advanced</Name>
            <Description>Macroporous, Partially Absorbable Mesh</Description>
            <Size>Size (cm) 30x30;,quantity/pack 1</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5503</SubGroupID>
            <ARTGs>
                <ARTG>390526</ARTG>
            </ARTGs>
            <MinimumBenefit>271</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AA022</BillingCode>
            <Name>4D VENTRAL COMPOSITE MESH</Name>
            <Description>4D VENTRAL COMPOSITE MESH</Description>
            <Size>30 X 50 CM</Size>
            <SupplierCode>AA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5505</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>354550</ARTG>
            </ARTGs>
            <MinimumBenefit>2876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS226</BillingCode>
            <Name>Symbotex Composite Mesh with pre placed suture</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description>
            <Size>Rectangular 42x32 cm, Rectangular 37x28 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5505</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>270737</ARTG>
            </ARTGs>
            <MinimumBenefit>2876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS231</BillingCode>
            <Name>Symbotex Composite Mesh</Name>
            <Description>Non-absorbable three-dimensional polyester composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.</Description>
            <Size>Rectangular 42x32cm,&#xD;
Rectangular 37x28cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5505</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>270735</ARTG>
            </ARTGs>
            <MinimumBenefit>2876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA241</BillingCode>
            <Name>Ventralight ST</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>30.5 x 35.6cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5505</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219332</ARTG>
            </ARTGs>
            <MinimumBenefit>2876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA245</BillingCode>
            <Name>Ventralight ST with ECHO PS positioning System</Name>
            <Description>Bioresorbable Barrier/Permanent Mesh</Description>
            <Size>30.5 x 35.6cm oval</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5505</SubGroupID>
            <Suffix>Coated, Integrated Delivery System</Suffix>
            <ARTGs>
                <ARTG>219333</ARTG>
            </ARTGs>
            <MinimumBenefit>2996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA305</BillingCode>
            <Name>Ventralight™ ST Mesh with Echo 2™ Positioning System </Name>
            <Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair</Description>
            <Size>30cm x 35cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1783</GroupID>
            <SubGroupID>5505</SubGroupID>
            <Suffix>Coated, Integrated Delivery System</Suffix>
            <ARTGs>
                <ARTG>365351</ARTG>
            </ARTGs>
            <MinimumBenefit>2996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS182</BillingCode>
            <Name>Permacol  Biological Implant</Name>
            <Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description>
            <Size>3 x 3cm, 5 x 5cm, 2 x 20cm, 5 x 10cm, 4 x 18cm, 10 x 10cm, 10 x 15cm, 6 x 3cm, 10 x 15cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>269662</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA281</BillingCode>
            <Name>Phasix ST</Name>
            <Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description>
            <Size>PHASIX ST 7.6CM ROUND   PHASIX ST 7CMX10CM   PHASIX ST 11CM ROUND   PHASIX ST 10CMX10CM   PHASIX ST 10X15CM   PHASIX ST 15CM ROUND   PHASIX ST 10CMX20CM</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>318512</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX332</BillingCode>
            <Name>Veritas Collagen Matrix - Small</Name>
            <Description>Bovine pericardium biologic mesh for the repair of soft tissue for size &amp;lt; 200cm²</Description>
            <Size>RM0816ANZ 8cm x 16cm; RM0818ANZ 8cm x 18cm; RM1016ANZ 10cm x 16cm; </Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219240</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET090</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC177</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biodesign Tissue Graft</Name>
            <Description>Surgical Mesh composed of Sub-Intestinal Submucosa (SIS)</Description>
            <Size>Length - 10cm, Width - 7cm; Length - 7cm, Width - 4cm; Length - 3cm, Width - 2cm.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153047</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET091</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC242</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biodesign Surgisis Hernia Graft</Name>
            <Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description>
            <Size>13cm x 15cm, 10cm x 10cm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153052</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET098</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC255</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surgisis Biodesign 4-layer Tissue Graft</Name>
            <Description>Surgisis Soft Tissue Graft</Description>
            <Size>Length 20cm, Width 7cm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153047</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET099</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC284</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surgisis Biodesign Hiatal Hernia Graft</Name>
            <Description>Surgisis Biodesign Hiatal Hernia Graft is an extracellular collagen matrix, non cross-linked sterile graft material, that provides support for damaged tissues and assists in host tissue regeneration and remodelling of the diaphragmatic wall following surgical repair for paraoesophageal and hiatal hernia.</Description>
            <Size>7 x 10cm rectangular and U-shaped</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153051</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET100</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WA010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biodesign Rectopexy Graft</Name>
            <Description>The Biodesign Rectopexy Graft is a dried multi-layered small intestinal submucosa (SIS) sheet. The graft is used to reinforce soft tissue for the repair of rectal prolapse and rectal intussusception.</Description>
            <Size>7cm x 20cm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>317940</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA275</BillingCode>
            <Name>Phasix</Name>
            <Description>Fully resorbable synthetic mesh</Description>
            <Size>Phasix™ Mesh – 3 in. Diameter Circle (7.6 cm.)  Phasix™ Mesh – 4.5 in. Diameter Circle (11 cm.)  Phasix™ Mesh – 2.4 x 6.3 in. Rectangle (6 x 16 cm)  Phasix™ Mesh – 3 x 3 in. Square (8 x 8 cm.)  Phasix™ Mesh – 3 x 6.3 in. Rectangle (8 x 16 cm.)  Phasix™ Mesh – 4 x 4 in. Square (10 x 10 cm.)  Phasix™ Mesh – 4 x 6 in. Rectangle (10.2 x 15.2 cm.)  Phasix™ Mesh – 3 x 8 in. Rectangle (8 x 20 cm.)  Phasix™ Mesh – 4 x 8 in. Rectangle (10 x 20 cm.)</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>318473</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER410</BillingCode>
            <Name>TIGR Matrix Surgical Mesh-Small</Name>
            <Description>TIGR Matrix Surgical Mesh-Small, biosynthetic</Description>
            <Size>10x15 cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>202446</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT256</BillingCode>
            <Name>BIO-A Tissue Reinforcement</Name>
            <Description>BIO-A Tissue Reinforcement</Description>
            <Size>8cm x 8cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>175834</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT257</BillingCode>
            <Name>BIO-A Tissue Reinforcement</Name>
            <Description>BIO-A Tissue Reinforcement</Description>
            <Size>9cm x 15cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>175834</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT258</BillingCode>
            <Name>BIO-A Tissue Reinforcement</Name>
            <Description>BIO-A Tissue Reinforcement - Configured for Hiatal Hernia</Description>
            <Size>7cm x 10cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5491</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>175834</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS183</BillingCode>
            <Name>Permacol  Biological Implant</Name>
            <Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description>
            <Size>15 x 20cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>269662</ARTG>
            </ARTGs>
            <MinimumBenefit>1341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX333</BillingCode>
            <Name>Veritas Collagen Matrix- Large</Name>
            <Description>Bovine pericardium biologic mesh repair of soft tissue    &gt; 200cm²  </Description>
            <Size>12cm x 25cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>219240</ARTG>
            </ARTGs>
            <MinimumBenefit>1341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET094</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC247</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biodesign Surgisis 8-Layer Tissue Graft</Name>
            <Description>Biodesign Surgisis 8-layer Tissue Graft is 8 layers of compressed and perforated porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description>
            <Size>13cm x 22cm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153048</ARTG>
            </ARTGs>
            <MinimumBenefit>1341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET095</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC249</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biodesign Surgisis Hernia Graft</Name>
            <Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description>
            <Size>13cm x 22cm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153052</ARTG>
            </ARTGs>
            <MinimumBenefit>1341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET096</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC250</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biodesign Surgisis Hernia Graft</Name>
            <Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description>
            <Size>20cm x 20cm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153052</ARTG>
            </ARTGs>
            <MinimumBenefit>1341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA286</BillingCode>
            <Name>Phasix ST</Name>
            <Description>Fully resorbable, synthetically derived biologic hernia mesh with added barrier to assist adhesion prevention</Description>
            <Size>13 cm x 25 cm  15 cm x 20 cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>318512</ARTG>
            </ARTGs>
            <MinimumBenefit>1399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA288</BillingCode>
            <Name>Phasix Mesh</Name>
            <Description>Synthetic Bioresorbable Mesh</Description>
            <Size>15.2 cm x 20.3 cm rectangle  10 cm x 25 cm rectangle  15 cm x 25 cm rectangle</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>318473</ARTG>
            </ARTGs>
            <MinimumBenefit>1399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER411</BillingCode>
            <Name>TIGR Matrix Surgical Mesh-Medium</Name>
            <Description>TIGR Matrix Surgical Mesh-Medium, biosynthetic</Description>
            <Size>15x20 cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>202446</ARTG>
            </ARTGs>
            <MinimumBenefit>1399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT267</BillingCode>
            <Name>Bio A Tissue Reinforcement</Name>
            <Description>Bio A Tissue Reinforcement</Description>
            <Size>10cm x 30cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5492</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>175834</ARTG>
            </ARTGs>
            <MinimumBenefit>1399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS184</BillingCode>
            <Name>Permacol  Biological Implant</Name>
            <Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description>
            <Size>18 x 28cm and 20 x 30cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5493</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>269662</ARTG>
            </ARTGs>
            <MinimumBenefit>3114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA278</BillingCode>
            <Name>Phasix ST</Name>
            <Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description>
            <Size>PHASIX ST 20X25CM</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5493</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>318512</ARTG>
            </ARTGs>
            <MinimumBenefit>3114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET097</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC251</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biodesign Surgisis  Hernia Graft</Name>
            <Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description>
            <Size>20cm x 30cm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5493</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>153052</ARTG>
            </ARTGs>
            <MinimumBenefit>3114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA276</BillingCode>
            <Name>Phasix</Name>
            <Description>Fully resorbable synthetic mesh</Description>
            <Size>Phasix™ Mesh – 6 x 12 in. Rectangle (15 x 30 cm.)  Phasix™ Mesh – 8 x 10 in. Rectangle (20.3 x 25.4 cm.)  Phasix™ Mesh – 8 x 12 in. Rectangle (20 x 30 cm.)</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5493</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>318473</ARTG>
            </ARTGs>
            <MinimumBenefit>3204</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER412</BillingCode>
            <Name>TIGR Matrix Surgical Mesh-Large</Name>
            <Description>TIGR Matrix Surgical Mesh-Large, biosynthetic</Description>
            <Size>20x30 cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5493</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>202446</ARTG>
            </ARTGs>
            <MinimumBenefit>3204</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT268</BillingCode>
            <Name>Bio A Tissue Reinforcement</Name>
            <Description>Bio A Tissue Reinforcement</Description>
            <Size>20cm x 30cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5493</SubGroupID>
            <Suffix>Contoured</Suffix>
            <ARTGs>
                <ARTG>175834</ARTG>
            </ARTGs>
            <MinimumBenefit>3204</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS187</BillingCode>
            <Name>Permacol  Biological Implant</Name>
            <Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description>
            <Size>20 x 40cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5494</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>269662</ARTG>
            </ARTGs>
            <MinimumBenefit>4061</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA279</BillingCode>
            <Name>Phasix ST</Name>
            <Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description>
            <Size>PHASIX ST 25X30CM</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5494</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>318512</ARTG>
            </ARTGs>
            <MinimumBenefit>4061</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA287</BillingCode>
            <Name>Phasix Mesh</Name>
            <Description>Synthesised biologic, resorbable Hernia mesh</Description>
            <Size>25.4 cm x 30.5 cm rectangle</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5494</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>318473</ARTG>
            </ARTGs>
            <MinimumBenefit>4061</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS188</BillingCode>
            <Name>Permacol  Biological Implant</Name>
            <Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description>
            <Size>20 x 50cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5495</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>269662</ARTG>
            </ARTGs>
            <MinimumBenefit>4964</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA277</BillingCode>
            <Name>Phasix</Name>
            <Description>Fully resorbable synthetic mesh</Description>
            <Size>Phasix™ Mesh – 12 x 12 in. Square (30 x 30 cm.)  Phasix™ Mesh – 10 x 16 in. Rectangle (10 x 16 cm.)  Phasix™ Mesh – 14 x 14 in. Square (35 x 35 cm.)  Phasix™ Mesh – 12 x 18 in. Rectangle (30 x 45 cm.)  Phasix™ Mesh – 16 x 16 in. Square (40 x 40 cm.)  Phasix™ Mesh – 18 x 18 in. Square (45 x 45 cm.)  Phasix™ Mesh – 19.5 x 19.5 in. Square (50 x 50 cm.)</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5495</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>318473</ARTG>
            </ARTGs>
            <MinimumBenefit>4964</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA280</BillingCode>
            <Name>Phasix ST</Name>
            <Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description>
            <Size>PHASIX ST 30X35CM</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1798</GroupID>
            <SubGroupID>5495</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>318512</ARTG>
            </ARTGs>
            <MinimumBenefit>4964</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT201</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE</Description>
            <Size>8cm x 12cm x 1mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5446</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT202</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE, oval</Description>
            <Size>10cm x 15cm x 1mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5446</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT206</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE, oval</Description>
            <Size>10cm x 15cm x 2mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5446</SubGroupID>
            <Suffix>Coated, 2mm thickness</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT104</BillingCode>
            <Name>Gore-Tex DualMesh PLUS  </Name>
            <Description>ePTFE</Description>
            <Size>1mm Thickness 7.5 x 10cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5446</SubGroupID>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>316</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT207</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE, oval</Description>
            <Size>15cm x 19cm x 2mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5447</SubGroupID>
            <Suffix>Coated, 2mm thickness</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>1832</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT107</BillingCode>
            <Name>Gore-Tex DualMesh PLUS  </Name>
            <Description>ePTFE</Description>
            <Size>15.0 x 19.0cm x 1mm Oval</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5447</SubGroupID>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>939</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT203</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE</Description>
            <Size>18cm x 24cm x 1mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5448</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>1645</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT208</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE,</Description>
            <Size>18cm x 24cm x 2mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5448</SubGroupID>
            <Suffix>Coated, 2mm thickness</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>2664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT205</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE, oval</Description>
            <Size>26cm x 34cm x 1mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5449</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>3044</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT210</BillingCode>
            <Name>Dualmesh Plus Biomaterial</Name>
            <Description>ePTFE, oval</Description>
            <Size>26cm x 34cm x 2mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1785</GroupID>
            <SubGroupID>5449</SubGroupID>
            <Suffix>Coated, 2mm thickness</Suffix>
            <ARTGs>
                <ARTG>233234</ARTG>
            </ARTGs>
            <MinimumBenefit>4685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET092</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC243</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surgisis Biodesign Anal Fistula Plug</Name>
            <Description>Surgisis Biodesign Anal Fistula Plug is a small intestine submucosal porcine derived, rolled and shaped collagen matrix, non cross-linked, that signals the body and provides support for native tissue remodeling, healing and closure of anal fistulas</Description>
            <Size>0.6cm Width Tapering to 0.2cm Width x 9.5cm Length. Conical Shape</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1691</GroupID>
            <SubGroupID>4519</SubGroupID>
            <ARTGs>
                <ARTG>153045</ARTG>
            </ARTGs>
            <MinimumBenefit>903</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET093</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WC245</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surgisis Biodesign Recto-Vaginal Fistula Plug</Name>
            <Description>Small intestine submucous porcine collagen matrix, non-crosslinked, supports native tissue remodelling, healing and closure of recto-vaginal fistulas. Conical shape with attached button.</Description>
            <Size>2mm width x 5.5cm length; 4mm wide tapering to 2mm wide x 5.5cm length; 7mm wide tapering to 2mm wide x 5.5 length.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1691</GroupID>
            <SubGroupID>4519</SubGroupID>
            <ARTGs>
                <ARTG>153046</ARTG>
                <ARTG>230911</ARTG>
            </ARTGs>
            <MinimumBenefit>903</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS130</BillingCode>
            <Name>Parietex-Multifilament Polyester Mesh</Name>
            <Description>Parietex-Multifilament Polyester Mesh Plug</Description>
            <Size>6 cm, 8 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1691</GroupID>
            <ARTGs>
                <ARTG>125428</ARTG>
            </ARTGs>
            <MinimumBenefit>238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA061</BillingCode>
            <Name>Bard Mesh </Name>
            <Description>PerFix Plug</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1691</GroupID>
            <ARTGs>
                <ARTG>24168</ARTG>
            </ARTGs>
            <MinimumBenefit>238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ602</BillingCode>
            <Name>ULTRAPRO Plug</Name>
            <Description>Partially Absorbable Synthetic Surgical Mesh Device</Description>
            <Size>Small- Onlay patch plug: 12cm x 7.5cm, 5cm rim diameter, 3cm anchor diameter; Medium- Onlay patch plug: 12cm x 7.5cm, 5cm rim diameter, 4cm anchor diameter; Large- Onlay patch plug: 12cm x 7.5cm, 5cm rim diameter, 5cm anchor diameter</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1691</GroupID>
            <ARTGs>
                <ARTG>142608</ARTG>
            </ARTGs>
            <MinimumBenefit>238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS043</BillingCode>
            <Name>Titanized Mesh Implants (TiLENE Plug &amp; TiLENE Plug Set)</Name>
            <Description>Titanized polypropylene composite. Prosthetic warp-knitted fabric made of monofilament polypropylene threads with an encapsulating titanic coating.</Description>
            <Size>Size: Small, Medium &amp; Large; Diameter: 5 cm - 9 cm; Weight: 16 g/m2 - 65 g/m2</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1691</GroupID>
            <ARTGs>
                <ARTG>97288</ARTG>
            </ARTGs>
            <MinimumBenefit>238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER197</BillingCode>
            <Name>Anastoclips</Name>
            <Description>Vessel Closure System (VCS) (8 and 15 cm shaft)</Description>
            <Size>Small, Medium, Large, Extra Large</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1771</GroupID>
            <ARTGs>
                <ARTG>120976</ARTG>
            </ARTGs>
            <MinimumBenefit>403</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER283</BillingCode>
            <Name>AnastoClip GC</Name>
            <Description>AnastoClip GC</Description>
            <Size>Medium&#xD;
Large&#xD;
Extra Large&#xD;
Medium, with long applier&#xD;
Large, with long applier&#xD;
Extra Large, with long applier</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1771</GroupID>
            <ARTGs>
                <ARTG>278601</ARTG>
            </ARTGs>
            <MinimumBenefit>403</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM492</BillingCode>
            <Name>DermaClose</Name>
            <Description>DERMACLOSE continuous external tissue expander</Description>
            <Size>Multiple lengths to suit size of wound</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1799</GroupID>
            <SubGroupID>5499</SubGroupID>
            <ARTGs>
                <ARTG>341527</ARTG>
            </ARTGs>
            <MinimumBenefit>6254</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MZ010</BillingCode>
            <Name>ABRA Abdominal Wall Closure Set</Name>
            <Description>Abdominal Wall Closure System, for primary closure of large full thickness retrated adbominal wounds.</Description>
            <Size>For wounds up to 30cm long up 30cm across.</Size>
            <SupplierCode>MZ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1799</GroupID>
            <SubGroupID>5499</SubGroupID>
            <ARTGs>
                <ARTG>181416</ARTG>
            </ARTGs>
            <MinimumBenefit>6254</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MZ011</BillingCode>
            <Name>ABRA Abdominal Wall Closure Set (Extension Kit Only)</Name>
            <Description>Extention Kit for use with ABRA Abdominal Wall Closure Set CWK08. Used when width or length of open abdomen exceeds 30cm. ABRA is for the primary closure of large full thickness retracted abdominal wounds</Description>
            <Size>Extention Kit, used when wounds to be closed are larger than 30cm long and/or 30cm across.</Size>
            <SupplierCode>MZ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1799</GroupID>
            <SubGroupID>5500</SubGroupID>
            <ARTGs>
                <ARTG>181416</ARTG>
            </ARTGs>
            <MinimumBenefit>1787</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB290</BillingCode>
            <Name>T-Bar Yasargil Aneurysm Clip</Name>
            <Description>T-Bar Yarsargil Aneurysm Clip, Titanium, Permanent Standard Fenestrated</Description>
            <Size>5mm-9mm, 45 Deg</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>123979</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB291</BillingCode>
            <Name>T-Bar Yasargil Aneurysm Clip</Name>
            <Description>T-Bar Yarsargil Aneurysm Clip, Titanium, Permanent Standard Fenestrated</Description>
            <Size>5mm-13mm, 90 Deg</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>123979</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB292</BillingCode>
            <Name>T-Bar Yasargil Aneurysm Clip</Name>
            <Description>T-Bar Yarsargil Aneurysm Clip, Pyhnox Cobalt Alloy, Permanent Standard Fenestrated</Description>
            <Size>5mm-9mm, 45 Deg</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>123979</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB293</BillingCode>
            <Name>T-Bar Yasargil Aneurysm Clip</Name>
            <Description>T-Bar Yarsargil Aneurysm Clip, Pyhnox Cobalt Alloy, Permanent Standard Fenestrated</Description>
            <Size>5mm-13mm, 90 Deg</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>123979</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH294</BillingCode>
            <Name>Aneurism Clip - T2</Name>
            <Description>Sugita Clips, Titanium 2, Fenestrated and Crankshaft.</Description>
            <Size>One size each</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>100120</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB108</BillingCode>
            <Name>Aneurysm Clip</Name>
            <Description>Aneurysm clip</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <ARTGs>
                <ARTG>138333</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH119</BillingCode>
            <Name>Aneurism Clip - T2</Name>
            <Description>Sugita Clips, Titanium2. Slim, mini, curved and L-shape.</Description>
            <Size>One Size Each</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <ARTGs>
                <ARTG>100108</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH147</BillingCode>
            <Name>Aneurism Clip - T2</Name>
            <Description>Sugita Clips, Titanium 2. L-shape, bayoneted, slightly curved, curved.</Description>
            <Size>One Size Each</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <ARTGs>
                <ARTG>100108</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH148</BillingCode>
            <Name>Aneurism Clip - T2</Name>
            <Description>Sugita Clips, Titanium 2. Mini, temp, straight.</Description>
            <Size>One Size Each</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <ARTGs>
                <ARTG>100108</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH170</BillingCode>
            <Name>Aneurism Clip - T1</Name>
            <Description>Sugita Clips, Titanium 1. Titanium alloy (Ti-6AI-4V)</Description>
            <Size>One Size Each</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <ARTGs>
                <ARTG>100108</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH494</BillingCode>
            <Name>Aneurism Clip - Elgiloy</Name>
            <Description>Sugita Clips, Elgiloy. Cobalt Chrome alloy.</Description>
            <Size>One size each</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1655</GroupID>
            <ARTGs>
                <ARTG>100108</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB218</BillingCode>
            <Name>Kopitnik Microneurosurgical AVM Clips</Name>
            <Description>Composition: Phynox (Cobalt-base-alloy)</Description>
            <Size>2mm, 3mm, 4mm, 5mm - straight. 2mm, 3mm, 4mm, 5mm - curved.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1656</GroupID>
            <ARTGs>
                <ARTG>101731</ARTG>
            </ARTGs>
            <MinimumBenefit>244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH155</BillingCode>
            <Name>Sugita Microneurosurgical AVM Clips</Name>
            <Description>Composition: Cobalt-Chromium-molybdenum based alloy</Description>
            <Size>One Size Each</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>218</SubCategoryID>
            <GroupID>1656</GroupID>
            <ARTGs>
                <ARTG>100108</ARTG>
            </ARTGs>
            <MinimumBenefit>244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB356</BillingCode>
            <Name>Lyoplant Onlay</Name>
            <Description>Biological Onlay &amp; Suturable Dura Substitute</Description>
            <Size>2.5 x 2.5cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1657</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>264832</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG038</BillingCode>
            <Name>DuraGen</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>2.5cm x 2.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1657</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158829</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG039</BillingCode>
            <Name>DuraGen Plus</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>2.5cm x 2.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1657</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158825</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC750</BillingCode>
            <Name>Durepair</Name>
            <Description>Dura Substitute, Collagen</Description>
            <Size>1" x 1"</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1657</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>134482</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK492</BillingCode>
            <Name>DuraMatrix</Name>
            <Description>Resorbable Collagen Dura Substitute Membrane</Description>
            <Size>1" x 1" (2.5cm x 2.5cm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1657</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>154606</ARTG>
                <ARTG>367947</ARTG>
                <ARTG>367948</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB118</BillingCode>
            <Name>Neuropatch Dura Substitute</Name>
            <Description>Polyurethane</Description>
            <Size>1.5 x 3cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1657</GroupID>
            <ARTGs>
                <ARTG>138310</ARTG>
            </ARTGs>
            <MinimumBenefit>65</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ022</BillingCode>
            <Name>Regenerative Dural Repair Patch (ReDuraTM)</Name>
            <Description>Absorbable synthetic patch with biomimetic design.</Description>
            <Size>Small</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1657</GroupID>
            <ARTGs>
                <ARTG>363114</ARTG>
            </ARTGs>
            <Note>The the PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>65</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB357</BillingCode>
            <Name>Lyoplant Onlay</Name>
            <Description>Biological Onlay &amp; Suturable Dura Substitute</Description>
            <Size>5 x 5cm and 2.5 x 7.5cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>264832</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG040</BillingCode>
            <Name>DuraGen</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>2.5cm x 7.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158829</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG041</BillingCode>
            <Name>DuraGen Plus</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>2.5cm x 7.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158825</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG042</BillingCode>
            <Name>DuraGen Suturable</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>2.5cm x 7.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158826</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG043</BillingCode>
            <Name>DuraGen</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>5cm x 5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158829</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG044</BillingCode>
            <Name>DuraGen Plus</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>5cm x 5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158825</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG045</BillingCode>
            <Name>DuraGen Suturable</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>5cm x 5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158826</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI081</BillingCode>
            <Name>Durepair</Name>
            <Description>Dura Substitute, Collagen</Description>
            <Size>1"-2" x 2"-3"</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>134482</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK493</BillingCode>
            <Name>DuraMatrix</Name>
            <Description>Resorbable Collagen Dura Substitute Membrane</Description>
            <Size>1" x 3" (2.5cm x 7.5cm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>154606</ARTG>
                <ARTG>367947</ARTG>
                <ARTG>367948</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK496</BillingCode>
            <Name>DuraMatrix</Name>
            <Description>Resorbable Collagen Dura Substitute Membrane</Description>
            <Size>2" x 2" (5cm x 5cm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>154606</ARTG>
                <ARTG>367947</ARTG>
                <ARTG>367948</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB363</BillingCode>
            <Name>Neuropatch Dura Substitute</Name>
            <Description>Polyurethane</Description>
            <Size>Medium</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <ARTGs>
                <ARTG>138310</ARTG>
            </ARTGs>
            <MinimumBenefit>426</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ023</BillingCode>
            <Name>Regenerative Dural Repair Patch (ReDuraTM)</Name>
            <Description>Absorbable synthetic patch with biomimetic design.</Description>
            <Size>Medium</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1658</GroupID>
            <ARTGs>
                <ARTG>363114</ARTG>
            </ARTGs>
            <Note>The the PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>426</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB358</BillingCode>
            <Name>Lyoplant Onlay</Name>
            <Description>Biological Onlay &amp; Suturable Dura Substitute</Description>
            <Size>7.5 x 7.5cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>264832</ARTG>
            </ARTGs>
            <MinimumBenefit>959</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG046</BillingCode>
            <Name>DuraGen</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>7.5cm x 7.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158829</ARTG>
            </ARTGs>
            <MinimumBenefit>959</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG047</BillingCode>
            <Name>DuraGen Plus</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>7.5cm x 7.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158825</ARTG>
            </ARTGs>
            <MinimumBenefit>959</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG048</BillingCode>
            <Name>DuraGen Suturable</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>7.5cm x 7.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158826</ARTG>
            </ARTGs>
            <MinimumBenefit>959</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC753</BillingCode>
            <Name>Durepair</Name>
            <Description>Dura Substitute, Collagen</Description>
            <Size>3" x 3"</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>134482</ARTG>
            </ARTGs>
            <MinimumBenefit>959</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK495</BillingCode>
            <Name>Dura Matrix</Name>
            <Description>Resorbable Collagen Dura Substitute Membrane</Description>
            <Size>3" x 3" (7.5cm x 7.5cm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>154606</ARTG>
                <ARTG>367947</ARTG>
                <ARTG>367948</ARTG>
            </ARTGs>
            <MinimumBenefit>959</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB113</BillingCode>
            <Name>Neuropatch Dura Substitute</Name>
            <Description>Polyurethane</Description>
            <Size>Large</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <ARTGs>
                <ARTG>138310</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ024</BillingCode>
            <Name>Regenerative Dural Repair Patch (ReDuraTM)</Name>
            <Description>Absorbable synthetic patch with biomimetic design</Description>
            <Size>Large</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1659</GroupID>
            <ARTGs>
                <ARTG>363114</ARTG>
            </ARTGs>
            <Note>The the PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB359</BillingCode>
            <Name>Lyoplant Onlay</Name>
            <Description>Biological Onlay &amp; Suturable Dura Substitute</Description>
            <Size>10 x 12.5cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>264832</ARTG>
            </ARTGs>
            <MinimumBenefit>1619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG049</BillingCode>
            <Name>DuraGen</Name>
            <Description>Collagen Dural graft matrix</Description>
            <Size>10cm x 12.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158829</ARTG>
            </ARTGs>
            <MinimumBenefit>1619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG051</BillingCode>
            <Name>DuraGen Suturable</Name>
            <Description>Collagen dural graft matrix</Description>
            <Size>10cm x 12.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158826</ARTG>
            </ARTGs>
            <MinimumBenefit>1619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG059</BillingCode>
            <Name>DURAGEN PLUS</Name>
            <Description>Collagen Dural Graft Matrix</Description>
            <Size>10cm x 12.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158825</ARTG>
            </ARTGs>
            <MinimumBenefit>1619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG060</BillingCode>
            <Name>DURAGEN PLUS</Name>
            <Description>Collagen Dural Graft Matrix</Description>
            <Size>12.5cm x 17.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>158825</ARTG>
            </ARTGs>
            <MinimumBenefit>1619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC754</BillingCode>
            <Name>Durepair</Name>
            <Description>Dura Substitute, Collagen</Description>
            <Size>4" x 5"</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>134482</ARTG>
            </ARTGs>
            <MinimumBenefit>1619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK494</BillingCode>
            <Name>DuraMatrix</Name>
            <Description>Resorbable Collagen Dura Substitute Membrane</Description>
            <Size>4" x 5" (10cm x 12.5cm), 5” x 7” (12.5cm x 17.5cm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>154606</ARTG>
                <ARTG>159826</ARTG>
                <ARTG>367947</ARTG>
                <ARTG>367948</ARTG>
            </ARTGs>
            <Note>The PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>1619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB015</BillingCode>
            <Name>Neuro-Patch</Name>
            <Description>Polyesterurethane</Description>
            <Size>12 x 14cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <ARTGs>
                <ARTG>138310</ARTG>
            </ARTGs>
            <MinimumBenefit>591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ025</BillingCode>
            <Name>Regenerative Dural Repair Patch (ReDuraTM)</Name>
            <Description>Absorbable synthetic patch with biomimetic design.</Description>
            <Size>Extra Large</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1660</GroupID>
            <ARTGs>
                <ARTG>363114</ARTG>
            </ARTGs>
            <Note>The the PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH722</BillingCode>
            <Name>TissuePatchDural 100*100</Name>
            <Description>Self adhesive dural sealant</Description>
            <Size>100*100mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1695</GroupID>
            <ARTGs>
                <ARTG>377573</ARTG>
            </ARTGs>
            <Note>The PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC642</BillingCode>
            <Name>Strata Valve Assembly with Bioglide PSM range</Name>
            <Description>CSF Flow Valves. Polypropylene and acetal plastic base. Silicone elastomer dome.</Description>
            <Size>One size</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Coating, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>169061</ARTG>
            </ARTGs>
            <MinimumBenefit>2857</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI019</BillingCode>
            <Name>Strata Valve with Bioglide</Name>
            <Description>Adjustable CSF Valve with five symmetric performance level steps, surface of valve bonded with hydrogel</Description>
            <Size>13-16mm x 35-47mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Coating, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>2689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB337</BillingCode>
            <Name>Miethke proGAV Shunt System</Name>
            <Description>Shunt system containing an adjustable valve with a gravitational unit, a distal catheter, a ventricular catheter and a reservoir.</Description>
            <Size>Adjustable valve: diameter 18mm, opening pressure 0-20 cmH2O, height 4.5mm.  Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cmH2O.  Distal catheter: length 1200mm, inside diameter 1200mm, inside diameter 1.2mm, outside diameter 2.5mm.  Reservoir: diameter 14/20mm.  Ventricular catheter: 180/250mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
                <ARTG>375143</ARTG>
            </ARTGs>
            <MinimumBenefit>2888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG158</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ219</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hakim Programmable Valve System</Name>
            <Description>Fixed pressure hydrocephalus shunt, packaged sterile, stainless steel and ruby valve mechanism, silicone rubber ventricular and peritoneal catheters.  In line or right angled with reservoir.  Valve can be reprogrammed non-invasively 18 pressure settings a</Description>
            <Size>One size only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>140904</ARTG>
                <ARTG>149291</ARTG>
            </ARTGs>
            <MinimumBenefit>2888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC640</BillingCode>
            <Name>Strata Shunt, Unitised</Name>
            <Description>Adjustable CSF valve with five symmetric performance level steps.  Includes strata valve, pre-attached ventricular catheter, and a pre-attached peritoneal catheter. Right Angle Clip. Disposable Quick Release Ventricular Catheter Introducer. Disposable Sub</Description>
            <Size>8-13.5cm x 9-120cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
                <ARTG>145335</ARTG>
            </ARTGs>
            <MinimumBenefit>2888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB335</BillingCode>
            <Name>Miethke proGAV with distal catheter</Name>
            <Description>Adjustable valve with a gravitational unit and a distal catheter</Description>
            <Size>Adjustable valve: diameter 18mm, opening pressure 0-20 cmH2O, height 4.5mm  Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cm H2O  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>2757</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB338</BillingCode>
            <Name>Miethke proGAV with pre-attached reservoir</Name>
            <Description>Shunt system containing an adjustable valve with a gravitational unit and a reservoir.</Description>
            <Size>Adjustable valve: diameter 18mm, opening pressure 0-20 cmH20, height 4.5mm.  Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cmH2O  Reservoir: diameter 14/20mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>2757</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB339</BillingCode>
            <Name>Miethke adjustable gratitational unit with differential pressure unit (miniNAV) and distal catheter</Name>
            <Description>proSA and M.blue adjustable gravitational units for the treatment of hydracephalus. The valve can be combined with any differential pressure valve. miniNAV is a very small differential pressure unit, which is often used. The valves are made from titanium and are MR safe up to 3 tesla. The distal catheter is made of silicone.</Description>
            <Size>Adjustable gravitational unit: height 4.5mm, diameter 18mm, opening pressure 0-40 cmH2O.  Differential pressure unit (miniNAV): length 14.7mm, diameter 2.8mm.  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>2757</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG187</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MN110</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Certas Programmable Valve - with Reservoir, Siphonguard and catheter</Name>
            <Description>Programmable valve with reservoir, siphonguard and catheters</Description>
            <Size>30-210mmH2O</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>186233</ARTG>
                <ARTG>186235</ARTG>
            </ARTGs>
            <MinimumBenefit>2757</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI086</BillingCode>
            <Name>Strata Shunt Assembly</Name>
            <Description>Assembly: Strata Shunt, Strata Burr Hole Shunt, Strata Snap Shunt. Adjustable CSF Valve with five symmetric performance level steps, includes integral (distal) peritoneal catheter.</Description>
            <Size>90-120cm, 35-50mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
                <ARTG>134740</ARTG>
                <ARTG>169061</ARTG>
            </ARTGs>
            <MinimumBenefit>2757</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB332</BillingCode>
            <Name>Miethke proGAV</Name>
            <Description>Adjustable valve with intergrated gravitational unit.  Titanium, MR safe up to 3 tesla.</Description>
            <Size>Adjustable valve: Diameter 18mm, Opening pressure 0-20 cmH2O, Height 4.5mm.  Gravitational unit: Length 14.9mm, Height 4.6mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>2591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB340</BillingCode>
            <Name>Miethke adjustable gratitational unit with differential pressure unit (miniNAV)</Name>
            <Description>proSA and M.blue are adjustable gravitational units for the treatment of hydrocephalus. They can be combined with any differential pressure valve. miniNAV is a very small differential pressure unit, which is often used. The valves are made from titanium and are MR safe up to 3 tesla.</Description>
            <Size>Adjustable gravitational unit: height 4.5mm, diameter 18mm, opening pressure 0-40 cmH2O.  Differential pressure unit (miniNAV): length 14.7mm, diameter 2.8mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>2591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG167</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ437</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Hakim Programmable Valves with Siphonguard</Name>
            <Description>18 different pressure settings and SIPHONGUARD technology</Description>
            <Size>One Size Only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>140904</ARTG>
            </ARTGs>
            <MinimumBenefit>2591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG186</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MN109</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Certas Programmable Valve - with Reservoir and Siphonguard</Name>
            <Description>Programmable valve with Reservoir and Siphonguard</Description>
            <Size>30-210mmH2O</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>190248</ARTG>
            </ARTGs>
            <MinimumBenefit>2591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI087</BillingCode>
            <Name>Strata Valve</Name>
            <Description>Strata Valve, Strata Burr Hole Valve,. Adjustable CSF Valve with five symmetric performance level steps.</Description>
            <Size>13-20mm x 35-50mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
                <ARTG>169054</ARTG>
            </ARTGs>
            <MinimumBenefit>2591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI190</BillingCode>
            <Name>StrataMR Valve</Name>
            <Description>Adjustable CSF Valve with five symmetric performance level steps</Description>
            <Size>Small, Regular</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>2591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI499</BillingCode>
            <Name>StrataMR II Valve</Name>
            <Description>Adjustable CSF Valve with five symmetric performance level steps</Description>
            <Size>Small, Regular</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>389073</ARTG>
            </ARTGs>
            <MinimumBenefit>2591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI080</BillingCode>
            <Name>Strata NSC LP Shunt Kit</Name>
            <Description>Strata NSC LP Shunt Kit with Lumbar Catheter and Peritoneal Catheter, Small Lumen</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Distal catheter, Lumboperitoneal, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>165018</ARTG>
            </ARTGs>
            <MinimumBenefit>2734</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG154</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ159</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hakim Programmable Valve System</Name>
            <Description>Standard system. Silicone casing with catheter; stainless steel ruby ball in cone mechanism with variable pressure</Description>
            <Size>Peritoneal Catheter length 80 cm, Ventricular catheter length 14 cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>149291</ARTG>
            </ARTGs>
            <MinimumBenefit>2437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM463</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Sterile Hydrocephalic Shunts</Name>
            <Description>Plastic/magnetic. Programmable valve. Programmer kit and shunts kit.</Description>
            <Size>3, 8 settings</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>143218</ARTG>
            </ARTGs>
            <MinimumBenefit>2437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG185</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MN108</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Certas Programmable Valve - with reservoir and catheter</Name>
            <Description>Programmable valve with reservoir and catheters</Description>
            <Size>30-210mmH2O</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>186232</ARTG>
                <ARTG>186234</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC646</BillingCode>
            <Name>Strata Valve Assembly NSC (non siphon control) PSM range</Name>
            <Description>Adjustable CSF valve with five symmetrical performance level steps. Includes a strata valve, an integral distal peritoneal catheter and catheter passer, and a female leur adaptor and prefill tubing.</Description>
            <Size>One size</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>134740</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC963</BillingCode>
            <Name>Strata NSC Burr Hole Shunt Assembly</Name>
            <Description>Adjustable cerebrospinal fluid (CSF) flow valve. Polypropylene and acetal plastic base. Silicone elastomer dome. With integral catheter.</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>169061</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC928</BillingCode>
            <Name>Strata NSC L-P Shunt</Name>
            <Description>Lumboperitoneal Shunt</Description>
            <Size>44mm x 23mm x 12mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Lumboperitoneal, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>2437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG166</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ436</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Hakim Programmable Valves</Name>
            <Description>Programmable valve with reservoir</Description>
            <Size>One Size Only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>140904</ARTG>
                <ARTG>149291</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG188</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MN111</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Certas Programmable Valve - with reservoir</Name>
            <Description>Programmable valve with reservoir</Description>
            <Size>30-210mmH2O</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>190248</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI082</BillingCode>
            <Name>Strata Valve NSC PSM Range</Name>
            <Description>Strata NSC, Strata NSC Burr Hole Valve. Adjustable cerebrospinal fluid (CSF) flow valve. Polypropylene and acetal plastic base. Silicone elastomer dome.</Description>
            <Size>13-20mm x 23-35mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <Suffix>Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
                <ARTG>169054</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG153</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ158</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hakim Programmable Valve System</Name>
            <Description>Valve only</Description>
            <Size>One size only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4468</SubGroupID>
            <ARTGs>
                <ARTG>149291</ARTG>
            </ARTGs>
            <MinimumBenefit>1823</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB324</BillingCode>
            <Name>Aesculap-Miethke gravitational shunt</Name>
            <Description>Single valve, anti-siphon gravitational shunt, titanium construction (MRI safe to 3 tesla)</Description>
            <Size>24mm and 27mm long, 4.0mm and 4.6mm diameter, 4cmH2O and 5cmH2O-40cmH2O</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>1083</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC648</BillingCode>
            <Name>Delta Valve Unitised with Bioglide PSM range</Name>
            <Description>CSF Flow Valves. Polypropylene and acetal plastic base. Silicone elastomer dome. Unitised system includes the valve, integral ventricular and peritoneal catheter (all components connected). Surface of valve bonded with hydrogel (Bioglide surface modificat</Description>
            <Size>8-13.5cm x 90-120cm (0.5-2.0)</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Coating, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>1646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC651</BillingCode>
            <Name>Delta Valve Assembly with Bioglide PSM range</Name>
            <Description>CSF Flow Valves. Polypropylene and acetal plastic base. Silicone elastomer dome. Assembly system includes the valve, integral peritoneal catheter, female luer adapter and prefill tubing. Surface of the valve bonded with hydrogel (Bioglide surface modifica</Description>
            <Size>90-120cm (0.5, 1.0, 1.5, 2.0)</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Coating, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>134740</ARTG>
            </ARTGs>
            <MinimumBenefit>1526</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC647</BillingCode>
            <Name>Delta Valve with Bioglide PSM range</Name>
            <Description>CSF Flow Valve. Polypropylene and acetal plastic base. Silicone elastomer dome. Surface of valve bonded with hydrogel (Bioglide surface modification).</Description>
            <Size>36-40mm x 9-20mm (0.5-2.0)</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Coating, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>1373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB403</BillingCode>
            <Name>Aesculap-Miethke GAV Shunt System  </Name>
            <Description>Single valve, (anti-siphon) gravitational shunt, titanium construction (MRI safe to 3 tesla), with incorporated reservoir, distal catheter and ventricular catheter.      </Description>
            <Size>Valve: do=4.2 mm, Connector: do=1.4 mm/1.9 mm  Catheter: di=1.2 mm, do=2.5 mm,  5cmH2O-30cmH2O</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>1697</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG159</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ220</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hakim Precision Valve System</Name>
            <Description>Fixed pressure valve with reservoir, siphonguard, ventricular and peritoneal catheters</Description>
            <Size>Very low to very high including micro</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>149290</ARTG>
            </ARTGs>
            <MinimumBenefit>1697</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC649</BillingCode>
            <Name>Delta Shunt Unitised</Name>
            <Description>Delta valve is a fixed pressure CSF valve, available in four performance levels. Delta Unitised shunt includes a delta valve, pre-attached ventricular catheter, and a pre-attached peritoneal catheter. Right Angle Clip. Disposable Quick Release Ventricular</Description>
            <Size>Delta Unitised Shunt small (Distal 65cm-90cm, ventricular 11cm) - 0.5, 1.0, 1.5 and 2.0. Delta Unitised Shunt regular (Distal 90cm, ventricular catheter 13cm) - 0.5, 1.0, 1.5 and 2.0</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>139696</ARTG>
            </ARTGs>
            <MinimumBenefit>1697</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC650</BillingCode>
            <Name>Delta Shunt Assembly</Name>
            <Description>Delta valve is a fixed CSF pressure valve, available in four performance levels. Includes an Integral (distal) Peritoneal Catheter, Disposable Peritoneal Catheter Passer, Female Luer Adapter and Prefill Tubing.</Description>
            <Size>90-120cm (0.5 - 2.0)</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>134740</ARTG>
            </ARTGs>
            <MinimumBenefit>1564</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG175</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ858</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Hakim Precision Valves</Name>
            <Description>Valves with Siphonguard and Reservoir</Description>
            <Size>10-130mm H2O including micro</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>140904</ARTG>
            </ARTGs>
            <MinimumBenefit>1399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC532</BillingCode>
            <Name>Hydrocephalus Shunt</Name>
            <Description>With Hydrostatic Valve, Delta Valves/Shunts/BioGlide, Vent Catheters</Description>
            <Size>12mm-90cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Antisyphon function, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>1399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG017</BillingCode>
            <Name>Precision Flow-OSV II Valve System</Name>
            <Description>Lumbar peritoneal OSV11-Lumboperitoneal System Hydrocephalus Shunt</Description>
            <Size>Lumber Catheter 80cm, F5  Peritoneal Catheter 110cm, F7</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Distal catheter, Lumboperitoneal</Suffix>
            <ARTGs>
                <ARTG>151647</ARTG>
            </ARTGs>
            <MinimumBenefit>1345</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG018</BillingCode>
            <Name>Precision Flow-OSV II Valve System </Name>
            <Description>Ventricular/Atrial OSV11-Ventricular /Atrial Hydrocephalus Shunt</Description>
            <Size>Drainage Cath 110 cm, F7. Ventricular Catheters 7,9,13 &amp; 15 cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Distal catheter, Proximal catheter</Suffix>
            <ARTGs>
                <ARTG>151647</ARTG>
            </ARTGs>
            <MinimumBenefit>1300</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG152</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ157</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hakim Precision Valve System</Name>
            <Description>Precision valve standard with reservoir, peritoneal and ventricular catheters</Description>
            <Size>Very low to very high including micro</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>149290</ARTG>
            </ARTGs>
            <MinimumBenefit>1616</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG160</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ221</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hakim Precision Valve System</Name>
            <Description>Fixed pressure hydrocephalus shunt, packaged sterile, stainless steel and ruby valve mechanism, silicone rubber ventricular and peritoneal catheters.  In line or right angled with reservoir.  Opening pressure  H20; Very high 130mm, high 100mm, medium 70mm</Description>
            <Size>One size only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>149290</ARTG>
            </ARTGs>
            <MinimumBenefit>1616</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC531</BillingCode>
            <Name>Hydrocephalus Shunt</Name>
            <Description>Ventricular/Peritoneal. CSF Flow Control Valves, BioGlide Contoured, Ventriculostomy Kit-E, Neonatal Delta Snap Shunt</Description>
            <Size>12mm-90cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Distal catheter, Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>1372</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG168</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ440</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Hakim Precision Valve, Right Angle Reservoir</Name>
            <Description>features 5 operating pressures</Description>
            <Size>10, 40, 70, 100, and 130mmH2O</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>140904</ARTG>
            </ARTGs>
            <MinimumBenefit>1104</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM527</BillingCode>
            <Name>Sophy Valves - hydrocephalic</Name>
            <Description>Monopressure Valve with Antechamber or Burr-Hole Reservoir  </Description>
            <Size>50 - 170mmH2O</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>143218</ARTG>
            </ARTGs>
            <MinimumBenefit>1104</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC530</BillingCode>
            <Name>Hydrocephalus Shunt</Name>
            <Description>Ventricular/Atrial, CSF Flow Control Shunts, Cont Small Valve</Description>
            <Size>38cm-90cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <Suffix>Reservoir/Priming function</Suffix>
            <ARTGs>
                <ARTG>129681</ARTG>
            </ARTGs>
            <MinimumBenefit>1104</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB325</BillingCode>
            <Name>Aesculap-Miethke DualSwitch shunt</Name>
            <Description>Non-adjustable valve with preset values for treatment of patients susceptible to complication due to tumour cells or high protein levels. Treats patients in both supine and upright position. Titanium construction MRI compatible to 3 tesla</Description>
            <Size>28mm diameter, 5.7mm profile, 510-50cmH2O pressure setting</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>1001</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG019</BillingCode>
            <Name>Precision Flow-OSV II Valve System</Name>
            <Description>Ventricular/Peritoneal OSV11-  Ventricular/Peritoneal Hydrocephalus Shunt</Description>
            <Size>Drainage Cath 110 cm, F7. Ventricular Catheters 7,9,13 &amp; 15 cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <ARTGs>
                <ARTG>151647</ARTG>
            </ARTGs>
            <MinimumBenefit>1001</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG032</BillingCode>
            <Name>Burr Hole Valve Shunt Assemblies</Name>
            <Description>Shunt Assembly: silicone encased valve, silicone ventricular and peritoneal catheters</Description>
            <Size>16mm or 12mm base; low, medium or high pressure, various kit configurations</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>4469</SubGroupID>
            <ARTGs>
                <ARTG>152728</ARTG>
            </ARTGs>
            <MinimumBenefit>1001</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB341</BillingCode>
            <Name>Miethke adjustable gravitational unit with proGAV and distal catheter</Name>
            <Description>proSA and M.blue are adjustable gravitational units. proGAV is an adjustable differential pressure unit. They are combined to treat pediatric and adult hydrocephalus. The valves are made from titanium and are MR safe up to 3 tesla. The distal catheters are made of silicone.</Description>
            <Size>Adjustable gravitational unit: diameter 18mm  Adjustable differential pressure unit (proGAV): diameter 18mm  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm  Distal catheter (connection between both valves): inside diameter 1.2mm, outside diameter 2.5mm  FV783T:   proSA adjustable between 0-40 cmH2O, proGAV adjustable between 0-20 cmH2O</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>5978</SubGroupID>
            <Suffix>Distal Catheter</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>3813</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB343</BillingCode>
            <Name>Miethke shunt system with reservoir and distal catheter</Name>
            <Description>Shunt system containing an adjustable gravitational unit and an adjustable differential pressure unit with distal catheters and a ventircular catheter, combined with a deflector, a pediatric prechamber or a reservoir.  There are two types of reservoirs: Control reservoir and pediatric Burrhole reservoir. The shunt system is used for the treatment of pediatric and adult hydrocephalus. The valves, the prechamber, the deflector and the reservoirs are made from titanium. The catheters are made from silicone. The shunt system is MR safe up to 3 tesla.</Description>
            <Size>Adjustable gravitational unit: height 4.5mm, diameter 18mm  Adjustable differential pressure unit: diameter 18mm  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm  Distal catheter for connections: inside diameter 1.2mm, outside diameter 2.5mm, adjustable between 0-40 cmH2O, 0-20 cmH2O.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>5978</SubGroupID>
            <Suffix>Distal Catheter, Reservoir/Priming Function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>4129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB342</BillingCode>
            <Name>Miethke adjustable gravitational unit with proGAV</Name>
            <Description>proSA and M.blue are adjustable gravitational units. proGAV is an adjustable differential pressure unit. They are combined to treat pediatric and adult hydrocephalus. The valves are made from titanium and are MR safe up to 3 tesla. They are connected by a distal catheter, which is made of silicone.</Description>
            <Size>Adjustable gravitational unit: diameter 18mm Adjustable differential pressure unit (proGAV): diameter 18mm Distal catheter: inside diameter 1.2mm, outside diameter 2.5mm  FV782T: gravitational unit adjustable between 0-40 cmH2O  proGAV adjustable between 0-20 cmH2O</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1666</GroupID>
            <SubGroupID>5978</SubGroupID>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>3646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB322</BillingCode>
            <Name>Aesculap-Miethke gravitational shunt (with catheter)</Name>
            <Description>Single valve, (anti-siphon) gravitational shunt, titanium construction (MRI safe to 3 tesla), with incorporated distal catheter, supplied sterile</Description>
            <Size>23mm long , 4.6mm diameter, 5cmH2O - 40cmH2O, Catheter - di=1.2mm, do=2.5cm, 1200mm long</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1667</GroupID>
            <Suffix>Antisyphon function</Suffix>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>1350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG023</BillingCode>
            <Name>Cordis Omnishunt System</Name>
            <Description>Silicone and Synthetic ruby</Description>
            <Size>Very low to very high pressures</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1667</GroupID>
            <ARTGs>
                <ARTG>151644</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG172</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ855</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman-Medos Non-programmable Valve System</Name>
            <Description>Lumbar/peritoneal catheter, James and Holter designs</Description>
            <Size>25-80cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1667</GroupID>
            <ARTGs>
                <ARTG>149300</ARTG>
                <ARTG>150123</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC529</BillingCode>
            <Name>Hydrocephalus Shunt</Name>
            <Description>Lumbar peritoneal</Description>
            <Size>84cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1667</GroupID>
            <ARTGs>
                <ARTG>130410</ARTG>
                <ARTG>140357</ARTG>
                <ARTG>140358</ARTG>
                <ARTG>140359</ARTG>
                <ARTG>140360</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG179</BillingCode>
            <Name>Codman Ventricular Catheter with Bactiseal Silicone </Name>
            <Description>Silicone ventricular catheter, antibiotic impregnated</Description>
            <Size>14cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Antibiotics</Suffix>
            <ARTGs>
                <ARTG>343683</ARTG>
            </ARTGs>
            <MinimumBenefit>424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG180</BillingCode>
            <Name>Codman Peritoneal Catheter with Bactiseal Silicone</Name>
            <Description>Silicone peritoneal catheter, antibiotic impregnated</Description>
            <Size>120cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Antibiotics</Suffix>
            <ARTGs>
                <ARTG>343684</ARTG>
            </ARTGs>
            <MinimumBenefit>424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI165</BillingCode>
            <Name>ARES Antibiotic-Impregnated Catheter</Name>
            <Description>ARES antibiotic-impregnated ventricular catheter</Description>
            <Size>23cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Antibiotics</Suffix>
            <ARTGs>
                <ARTG>245273</ARTG>
            </ARTGs>
            <MinimumBenefit>424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI166</BillingCode>
            <Name>ARES antibiotic -impregnated catheter</Name>
            <Description>ARES antibiotic-impregnated peritoneal catheter</Description>
            <Size>120cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Antibiotics</Suffix>
            <ARTGs>
                <ARTG>245274</ARTG>
            </ARTGs>
            <MinimumBenefit>424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG155</BillingCode>
            <Name>Codman Ventricular Catheter and Codman Peritoneal Catheter with Bactiseal Silicone</Name>
            <Description>Silicone antibiotic impregnated catheter kit</Description>
            <Size>Kit</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Antibiotics, Distal, Proximal</Suffix>
            <ARTGs>
                <ARTG>343682</ARTG>
            </ARTGs>
            <MinimumBenefit>609</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI167</BillingCode>
            <Name>ARES antibiotic-impregnated catheter kit</Name>
            <Description>ARES antibiotic catheter kit includes ventricular and peritoneal catheter</Description>
            <Size>23 - 120cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Antibiotics, Distal, Proximal</Suffix>
            <ARTGs>
                <ARTG>245275</ARTG>
            </ARTGs>
            <MinimumBenefit>609</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB329</BillingCode>
            <Name>Miethke Peritoneal Catheter</Name>
            <Description>Peritoneal catheter, barium impregnated, radio-opaque silicon&#xD;
2) Peritoneal catheter with integrated barium strip</Description>
            <Size>d 1.2mm od =2.5mm; 600,900 1200mm long</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>181747</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG010</BillingCode>
            <Name>Shunt</Name>
            <Description>Components - catheter: Atrial</Description>
            <Size>55cm - 60cm, Low - High pressure range</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>151659</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG011</BillingCode>
            <Name>Shunt</Name>
            <Description>Peritoneal</Description>
            <Size>90 - 120cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>151659</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG020</BillingCode>
            <Name>Atrial Catheter </Name>
            <Description>Components - catheter: Atrial Atrial Catheters  Hydrocephalux Valve Accessories</Description>
            <Size>Length: 46cm, F7.  OD: 2.1mm; ID:1.1mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>151659</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG021</BillingCode>
            <Name>Peritoneal Catheter</Name>
            <Description>Peritoneal Catheters</Description>
            <Size>Length: 91cm, F7.  OD: 2.1mm; ID:1.1mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>151659</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG030</BillingCode>
            <Name>Cardiac/Peritoneal Catheters</Name>
            <Description>SiliconDistal Catheter, ID 1.3mm, OD 2.5mm</Description>
            <Size>90cm, barium impregnated silicone catheter, closed or open ended, with or without slits</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>150579</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG162</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ229</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Medos Peritoneal Catheter</Name>
            <Description>85cm, packaged sterile, silicone rubber</Description>
            <Size>85cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>149295</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG163</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ261</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACCU-FLO Intracranial Pressure shunt</Name>
            <Description>ACCU-FLO catheter, packaged sterile, silicone rubber</Description>
            <Size>91cm in length</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>150089</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG174</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ857</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HOLTER Intracranial Pressure Shunt</Name>
            <Description>HOLTER distal peritoneal catheter/Salmon, packaged sterile, silicone</Description>
            <Size>90cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>149299</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC584</BillingCode>
            <Name>CSF - Distal Catheters</Name>
            <Description>Non metallic and latex free, Models 43418,43103,43111,43209,43522,43551,27211</Description>
            <Size>Distal cardiac/peritoneal catheters ID 1.3mm OD 2.5mm Length 90cm, 96cm, 110cm, 120cm, ID 1.2mm, OD 2.1mm, Length 90cm, 75cm, 58cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>140357</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC857</BillingCode>
            <Name>Small Lumen Peritoneal Catheter</Name>
            <Description>CSF Distal Catheter</Description>
            <Size>ID - 0.7mm OD - 2.5mm Length - 120cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal</Suffix>
            <ARTGs>
                <ARTG>130410</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC638</BillingCode>
            <Name>Peritoneal Catheter PSM range with Bioglide</Name>
            <Description>Translucent silicone elastomer with Barium impregnated stripe.  Catheter surface bonded with Hydrogel.</Description>
            <Size>60-90cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Distal, Coating</Suffix>
            <ARTGs>
                <ARTG>130410</ARTG>
            </ARTGs>
            <MinimumBenefit>214</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB331</BillingCode>
            <Name>Miethke Ventricular catheter with deflector</Name>
            <Description>Ventricular catheters (with deflector) are used to drain CSF out of the ventricle. All catheters are made of radiopaque silicone. The deflectors allow 90 degree deflection of the ventricular catheter in the burrhole without kinking the catheter. All deflectors are made of titanium. The deflectors are adjustable on the catheter, have suture fixation holes and are radiopaque.</Description>
            <Size>Ventricular catheter with deflector:&#xD;
Inside diameter 1.2mm, Outside diameter 2.5mm.&#xD;
FV075P: Ventricular catheter 180mm, graduated.&#xD;
Deflector: Large.&#xD;
FV078P: Ventricular catheter 250mm, graduated.&#xD;
Deflector: Large.&#xD;
Ventricular catheter with deflector (for pediatric application):&#xD;
Inside diameter 1.2mm, Outside diameter 2.5mm.&#xD;
FV076P: Ventricular catheter 180mm, graduated.&#xD;
Deflector: Small.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>196110</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB336</BillingCode>
            <Name>Miethke Ventricular Catheter with stylet</Name>
            <Description>Ventricluar catheters (with stylet) are used to drain CSF out of the ventricle. All catheters are made of radiopaque silicone.</Description>
            <Size>Inside diameter 1.2mm, Outside diameter 2.5mm.&#xD;
FV074P: 180mm, graduated.&#xD;
FV077P: 250mm, graduated.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>196110</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG012</BillingCode>
            <Name>Shunt</Name>
            <Description>Ventricular</Description>
            <Size>14.5cm - 23cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>163262</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG014</BillingCode>
            <Name>Heyer Schulte Portnoy Flanged Ventricular Catheter</Name>
            <Description>Composition - silicone with tantalum markings</Description>
            <Size>Length 18cm, outer diameter 8mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>163262</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG025</BillingCode>
            <Name>Right Angle Ventricular Catheter</Name>
            <Description>Silicone, integral right angle</Description>
            <Size>3-11cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>151660</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG031</BillingCode>
            <Name>Ventricular Catheters</Name>
            <Description>Silicon Ventricular Catheter</Description>
            <Size>15cm - 25cm, optional flanges or right angle or endoscopic tip. ID 1.3mm, OD 2.5mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>150579</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG157</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ218</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HOLTER Intracranial Pressure Shunt</Name>
            <Description>HOLTER Ventricular Catheter, packaged sterile, silicone rubber</Description>
            <Size>3 - 7cm and 15cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>150090</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG161</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ227</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Medos Straight Ventricular Catheter</Name>
            <Description>14cm, packaged sterile, silicone rubber</Description>
            <Size>14cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>150085</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG164</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ263</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACCU-FLO Intracranial Pressure shunt</Name>
            <Description>ACCU-FLO barium ventricular catheter, packaged sterile, silicone rubber</Description>
            <Size>One size only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>150088</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI122</BillingCode>
            <Name>CSF Ventricular Catheter PSM range</Name>
            <Description>Ventricular catheter, non metallic latex free. Barium impregnated, include stainless steel stylet.</Description>
            <Size>1.3 - 35cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal</Suffix>
            <ARTGs>
                <ARTG>141100</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC639</BillingCode>
            <Name>Ventricular Catheter PSM range with Bioglide</Name>
            <Description>Translucent silicone elastomer with Barium impregnated stripe. Catheter surface bonded with Hydrogel.</Description>
            <Size>15-23cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1668</GroupID>
            <Suffix>Proximal, Coating</Suffix>
            <ARTGs>
                <ARTG>141102</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB323</BillingCode>
            <Name>Aesculap-Miethke SHUNTASSISTANT</Name>
            <Description>Anti-siphon gravitational unit to treat standing pressure over drainage in conjunction with existing shunts in children and adults, titanium construction (MRI safe to 3 tesla).</Description>
            <Size>19.5mm long and 23.7mm long , 4.0mm diameter and 4.6mm diameter, 10cmH2O and 15-35cmH2O. Straight and u-shaped.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1669</GroupID>
            <ARTGs>
                <ARTG>181718</ARTG>
            </ARTGs>
            <MinimumBenefit>794</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG156</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ164</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Siphonguard CSF Control Device</Name>
            <Description>PET shell anti-siphon device for shunt</Description>
            <Size>One size only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1669</GroupID>
            <ARTGs>
                <ARTG>165962</ARTG>
            </ARTGs>
            <MinimumBenefit>794</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB330</BillingCode>
            <Name>Miethke Reservoir with integrated catheter</Name>
            <Description>The reservoirs are all made of titanium and are radiopaque. They have a low overall height for easy and safe positioning and fixation of the ventricular catheter. They allow CSF extraction and drug injection by inserting a syringe through the silicone dome. The solid titanium base prevents penetration with a syringe needle.&#xD;
The reservoirs come with integrated catheters. There are 4 different types of reservoirs with integrated catheters: Burrhole reservoir, sprung reservoir, flushing reservoir and control reservoir.</Description>
            <Size>Burrhole reservoir: &#xD;
FV027T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm. &#xD;
FV054T - Diameter 14mm, Height 4.8mm, with integrated catheter 200mm (pediatric).&#xD;
Sprung reservoir: &#xD;
FV044T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm.&#xD;
Flushing reservoir: &#xD;
FV034T - Diameter 20mm, Height 5.65mm, with integrated 600mm.&#xD;
FV081T - Diameter 14mm, Height 4.8mm, with integrated catheter 600mm (pediatric).&#xD;
Control reservoir: &#xD;
FV048T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <Suffix>Integrated Catheter</Suffix>
            <ARTGs>
                <ARTG>181719</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB326</BillingCode>
            <Name>Aesculap-Miethke Shunt inline Flushing reservoir</Name>
            <Description>Titanium, (MRI safe 3 tesla), radio- opaque with low overall height for easy and safe positioning of ventricular catheter. Allows CSF extraction and drug injection by syringe through silicone dome. Solid Titanium base ensures syringes will not penetrate.</Description>
            <Size>Radio-opaque titanium. 14mm diameter,4.8mmheight; 20mm diameter, 5.65mm height. For catheters - id = 1.2mm,od = 2.5mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>181719</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB327</BillingCode>
            <Name>Aesculap-Miethke Shunt Burr hole port</Name>
            <Description>Titanium, (MRI safe 3 tesla), radio-opaque with low overall height for easy and safe positioning of ventricular catheter. Allows CSF extraction and drug injection by syringe through silicone dome. Solid Titanium base ensures syringes will not penetrate, supplied sterile.</Description>
            <Size>Radio- opaque titanium. 14mm diameter, 4.8mm height; 20/9.5mm diameter, 5.65mm height. For catheters - id =1.2mm, od =2.5mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>181719</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB333</BillingCode>
            <Name>Miethke Port / Reservoir</Name>
            <Description>The ports / reservoirs are all made of titanium and are radiopaque. They have a low overall height for easy and safe positioning and fixation of the ventricular catheter. They allow CSF extraction and drug injection by inserting a syringe through the silicone dome. The solid titanium base prevents penetration with a syringe needle. There are 6 different types: Burrhole port, CSF port, Burrhole reservoir, Sprung reservoir, Flushing reservoir, Control reservoir.</Description>
            <Size>Burrhole port:&#xD;
FV030T: Diameter 20mm, Height 5.65mm.&#xD;
FV040T: Diameter 14mm, Height 4.8mm (for pediatric application).&#xD;
CSF port:&#xD;
FV060T: Diameter 20mm, Height 5.65mm.&#xD;
Burrhole reservoir:&#xD;
FV028T: Diameter 20mm, Height 5.65mm.&#xD;
FV029T: Diameter 20mm, Height 5.65mm with adjustable connector.&#xD;
FV039T: Diameter 14mm, Height 4.8mm (for pediatric application).&#xD;
Sprung reservoir:&#xD;
FV043T: Diameter 20mm, Height 5.65mm.&#xD;
Flushing reservoir:&#xD;
FV033T: Diameter 20mm, Height 5.65mm.&#xD;
FV035T: Diameter 14mm, Height 4.8mm (for pediatric application).&#xD;
Control reservoir:&#xD;
FV047T: Diameter 20mm, Height 5.65mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>181719</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG008</BillingCode>
            <Name>Heyer-Schulte Ommaya CSF Reservoir</Name>
            <Description>Standard, side-inlet, convertible, mini</Description>
            <Size>1.5 - 2.5cm and mini</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>161176</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG013</BillingCode>
            <Name>Shunt</Name>
            <Description>Reservoir</Description>
            <Size>Standard, Large</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>151646</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG033</BillingCode>
            <Name>Reservoirs</Name>
            <Description>Shunt component</Description>
            <Size>9mm to 25mm, with or without convertible outlet port, burr hole or flat bottom style</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>163539</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG173</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ856</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Burr Hole Button Reservoirs</Name>
            <Description>Various ventriculostomy reservoirs</Description>
            <Size>Standard, dome, flat profile and large</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>140900</ARTG>
                <ARTG>149297</ARTG>
                <ARTG>149298</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC534</BillingCode>
            <Name>Pressure valve (anti-siphon device or  flushing valve or flush pump)</Name>
            <Description>Neonatal Reservior, CSF Lumbo Peritoneal</Description>
            <Size>2 - 90cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>129650</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI018</BillingCode>
            <Name>Reservoir</Name>
            <Description>CSF Reservoir, Port, Neonatal, Snap assembly</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1670</GroupID>
            <ARTGs>
                <ARTG>129650</ARTG>
                <ARTG>145332</ARTG>
                <ARTG>145336</ARTG>
            </ARTGs>
            <MinimumBenefit>338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB328</BillingCode>
            <Name>Miethke Titanium connectors &amp; deflectors</Name>
            <Description>Titanium, (MRI safe 3 tesla), deflector allows 90 degree deflection of the ventricular catheter in the burr hole without kinking, adjustable on length of catheter, suture fixture hole</Description>
            <Size>Radio-opaque titanium, connector diameter: 1,9mm for use with catheters of id = 1.2mm; of id 1.2mm; od = 2.5mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1671</GroupID>
            <SubGroupID>4470</SubGroupID>
            <ARTGs>
                <ARTG>181719</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG022</BillingCode>
            <Name>Connectors</Name>
            <Description>Silicone and Stainless Steel</Description>
            <Size>Straight, right angle, Y, T</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1671</GroupID>
            <SubGroupID>4470</SubGroupID>
            <ARTGs>
                <ARTG>151592</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG184</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ934</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman Hydrocephalus Connectors</Name>
            <Description>Metal and plastic connectors</Description>
            <Size>8mm to 20mm length</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1671</GroupID>
            <SubGroupID>4470</SubGroupID>
            <ARTGs>
                <ARTG>140901</ARTG>
                <ARTG>150104</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI022</BillingCode>
            <Name>Shunt Component Connector</Name>
            <Description>Connectors, fixation tabs</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1671</GroupID>
            <SubGroupID>4470</SubGroupID>
            <ARTGs>
                <ARTG>128403</ARTG>
                <ARTG>128523</ARTG>
                <ARTG>134760</ARTG>
                <ARTG>95539</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB334</BillingCode>
            <Name>Miethke Titanium connectors - right angled / shaped</Name>
            <Description>In general, titanium connectors are preferably used with catheters of internal diameter 1.2m and external diameter 2.5mm.&#xD;
Step-down connectors are designed for connecting standard catheters to lumbar catheters.&#xD;
L-P connectors are designed for connecting two lumbar catheters to each other.</Description>
            <Size>Titanium connector: Connector diameter, 1.9mm.&#xD;
L-shape:&#xD;
FV051T: 1pc&#xD;
Y-shape:&#xD;
FV015T: 1 pc, FV016T: 5 pcs, FV017T: 10 pcs.&#xD;
T-shape:&#xD;
FV018T: 1 pc, FV019T: 5 pcs, FV020T: 10 pcs.&#xD;
X-shape:&#xD;
FV021T: 1 pc, FV022T: 5 pcs, FV023T: 10 pcs.&#xD;
Y-shape:&#xD;
FV056T: 1 pc.&#xD;
U-shape:&#xD;
FV057T: 1 pc.&#xD;
F-shape:&#xD;
FV058T: 1 pc.&#xD;
L-shape:&#xD;
FV059T: 1 pc.&#xD;
Titanium connector, step-down: Connector diameters: 1.9mm to 1.4mm:&#xD;
L-shape: &#xD;
FV052T: 1 pc.&#xD;
Titanium connector, L-P drainage: Connector diameters 1.4mm to 1.4mm:&#xD;
L-shape: &#xD;
FV053T: 1 pc.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1671</GroupID>
            <SubGroupID>4471</SubGroupID>
            <ARTGs>
                <ARTG>194850</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG052</BillingCode>
            <Name>Electa right angle guide</Name>
            <Description>Silicone</Description>
            <Size>One Size Only</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>220</SubCategoryID>
            <GroupID>1671</GroupID>
            <SubGroupID>4471</SubGroupID>
            <ARTGs>
                <ARTG>151661</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS318</BillingCode>
            <Name>Vercise PC</Name>
            <Description>Dual channel primary cell deep brain stimulation system</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>279185</ARTG>
            </ARTGs>
            <MinimumBenefit>13592</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS382</BillingCode>
            <Name>Vercise Genus </Name>
            <Description>8, 16 &amp; 32 Contact Dual channel primary cell pulse generator with anodic stimulation</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>363570</ARTG>
                <ARTG>363571</ARTG>
                <ARTG>363572</ARTG>
            </ARTGs>
            <MinimumBenefit>13592</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM433</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK111</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dual Channel Implantable Pulse generator</Name>
            <Description>Dual Channel Implantable Pulse generator</Description>
            <Size>Sizes as suitable for patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>307525</ARTG>
            </ARTGs>
            <MinimumBenefit>13592</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC838</BillingCode>
            <Name>Medtronic ACTIVA PC Neurostimulator for Deep Brain Stimulation</Name>
            <Description>ACTIVA PC Dual channel primary cell neuro stimulator for Deep Brain Stimulation (37601)</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>160118</ARTG>
            </ARTGs>
            <MinimumBenefit>13592</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI401</BillingCode>
            <Name>Medtronic Percept PC Neurostimulator for Deep Brain Stimulation</Name>
            <Description>Percept PC Dual channel primary cell neuro stimulator for Deep Brain Stimulation with Brain Sensing Technology</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>351590</ARTG>
                <ARTG>351630</ARTG>
            </ARTGs>
            <MinimumBenefit>13592</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ206</BillingCode>
            <Name>Libra XP DBS IPG 6644</Name>
            <Description>Implantable pulse generation for deep brain stimulation - Dual 4 Channel</Description>
            <Size>76mm x 58mm x 14mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>161009</ARTG>
            </ARTGs>
            <MinimumBenefit>13592</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ376</BillingCode>
            <Name>Infinity IPG</Name>
            <Description>Implantable Pulse Generator</Description>
            <Size>55mm, 68mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>278846</ARTG>
                <ARTG>278847</ARTG>
                <ARTG>278849</ARTG>
                <ARTG>278850</ARTG>
            </ARTGs>
            <MinimumBenefit>13592</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM429</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK107</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Single Channel Implantable Pulse Generator</Name>
            <Description>Single Channel Implantable Pulse Generator</Description>
            <Size>Suitable for patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <ARTGs>
                <ARTG>307524</ARTG>
            </ARTGs>
            <MinimumBenefit>8168</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI031</BillingCode>
            <Name>Medtronic Activa SC Neurostimulator for Deep Brain Stimulation</Name>
            <Description>Single channel neurostimulator for Deep Brain stimulation</Description>
            <Size>New or Old Header choice</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <ARTGs>
                <ARTG>188034</ARTG>
                <ARTG>188274</ARTG>
            </ARTGs>
            <MinimumBenefit>8168</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ197</BillingCode>
            <Name>Libra Deep Brain Stimulation System - Libra IPG - 6608</Name>
            <Description>Implantable pulse generator for deep brain stimulation - 8 channel</Description>
            <Size>50mm x 54mm x 14mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4472</SubGroupID>
            <ARTGs>
                <ARTG>161008</ARTG>
            </ARTGs>
            <MinimumBenefit>8168</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM434</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK112</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dual Channel Rechargeable Implantable Pulse Generator</Name>
            <Description>Dual Channel Rechargeable Implantable Pulse Generator</Description>
            <Size>Sized as suitable for patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4473</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>307526</ARTG>
            </ARTGs>
            <MinimumBenefit>17283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC946</BillingCode>
            <Name>Medtronic ACTIVA RC Neurostimulator for Deep  Brain Stimulation</Name>
            <Description>ACTIVA RC Dual channel rechargeable neurostimulator for Deep Brain Stimulation (37612)</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4473</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>160117</ARTG>
            </ARTGs>
            <MinimumBenefit>17283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ202</BillingCode>
            <Name>Brio DBS Implantable Pulse Generator 6788</Name>
            <Description>Dual Channel 16 Contact rechargeable IPG</Description>
            <Size>29g, 17cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4473</SubGroupID>
            <Suffix>Dual Channel</Suffix>
            <ARTGs>
                <ARTG>164510</ARTG>
            </ARTGs>
            <MinimumBenefit>17283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS237</BillingCode>
            <Name>Vercise IPG Kit</Name>
            <Description>Dual Channel, 16 Contact, Zero Volt Rechargeable Deep Brain Stimulation IPG</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4473</SubGroupID>
            <Suffix>Unlimited Deep Discharge Battery</Suffix>
            <ARTGs>
                <ARTG>201944</ARTG>
            </ARTGs>
            <MinimumBenefit>19855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS358</BillingCode>
            <Name>Vercise Gevia IPG Kit</Name>
            <Description>Dual Channel, 16 Contact, Zero Volt Rechargeable Deep Brain Stimulation IPG</Description>
            <Size>51.3 mm x 46 mm x 10.8 mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4473</SubGroupID>
            <Suffix>Unlimited Deep Discharge Battery</Suffix>
            <ARTGs>
                <ARTG>308573</ARTG>
            </ARTGs>
            <MinimumBenefit>19855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS387</BillingCode>
            <Name>Vercise Genus</Name>
            <Description>Dual Channel,16 &amp; 32 Contact, Zero Volt Rechargeable Deep Brain Stimulation IPG with anodic stimulation</Description>
            <Size>52 mm x 46 mm x 11 mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1672</GroupID>
            <SubGroupID>4473</SubGroupID>
            <Suffix>Unlimited Deep Discharge Battery</Suffix>
            <ARTGs>
                <ARTG>363573</ARTG>
                <ARTG>363574</ARTG>
            </ARTGs>
            <MinimumBenefit>19855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS243</BillingCode>
            <Name>Vercise Remote Control, Vercise Remote Control 2, Vercise Remote Control 3, Vercise Remote Control 4</Name>
            <Description>Remote patient control for DBS, remote patient control kit for DBS</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4474</SubGroupID>
            <ARTGs>
                <ARTG>202019</ARTG>
                <ARTG>279188</ARTG>
                <ARTG>308575</ARTG>
                <ARTG>308577</ARTG>
                <ARTG>363576</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM431</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK109</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Patient or Clinician Programmer</Name>
            <Description>Patient or Clinician Programmer</Description>
            <Size>N/A</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4474</SubGroupID>
            <ARTGs>
                <ARTG>308945</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC837</BillingCode>
            <Name>Medtronic Activa Patient Programmer</Name>
            <Description>Medtronic Activa Patient Programmer (Model 37642)</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4474</SubGroupID>
            <ARTGs>
                <ARTG>160115</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI367</BillingCode>
            <Name>Medtronic Activa Patient Programming System</Name>
            <Description>Medtronic Activa Patient Programming System</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4474</SubGroupID>
            <ARTGs>
                <ARTG>339925</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI400</BillingCode>
            <Name>Medtronic Percept PC Patient Programmer</Name>
            <Description>Medtronic Percept PC Patient Programmer</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4474</SubGroupID>
            <ARTGs>
                <ARTG>351590</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ204</BillingCode>
            <Name>Brio DBS Patient Controller 6856</Name>
            <Description>Patient Controller for DBS</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4474</SubGroupID>
            <ARTGs>
                <ARTG>164509</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS245</BillingCode>
            <Name>Vercise Charging System</Name>
            <Description>Recharging system for DBS</Description>
            <Size>N/A</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4475</SubGroupID>
            <ARTGs>
                <ARTG>202018</ARTG>
                <ARTG>203085</ARTG>
                <ARTG>308576</ARTG>
                <ARTG>363579</ARTG>
            </ARTGs>
            <MinimumBenefit>1782</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM432</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK110</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Patient programmer Recharger</Name>
            <Description>Patient programmer Recharger</Description>
            <Size>N/A</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4475</SubGroupID>
            <ARTGs>
                <ARTG>309804</ARTG>
            </ARTGs>
            <MinimumBenefit>1782</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC945</BillingCode>
            <Name>Medtronic ACTIVA Recharging System for Deep Brain Stimulation</Name>
            <Description>Recharging System for Deep Brain Stimulation</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4475</SubGroupID>
            <ARTGs>
                <ARTG>121279</ARTG>
            </ARTGs>
            <MinimumBenefit>1782</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI398</BillingCode>
            <Name>Medtronic Recharging System for Deep Brain Stimulation</Name>
            <Description>Wireless recharging System for Deep Brain Stimulation</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4475</SubGroupID>
            <ARTGs>
                <ARTG>121279</ARTG>
                <ARTG>341408</ARTG>
                <ARTG>341712</ARTG>
            </ARTGs>
            <MinimumBenefit>1782</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ351</BillingCode>
            <Name>Brio LE Charging System 6722</Name>
            <Description>Charging system for Brio Deep Brain Stimualtion Device</Description>
            <Size>One size only </Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1673</GroupID>
            <SubGroupID>4475</SubGroupID>
            <ARTGs>
                <ARTG>231655</ARTG>
            </ARTGs>
            <MinimumBenefit>1782</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS319</BillingCode>
            <Name>Cartesia Directional Lead</Name>
            <Description>Deep brain stimulation lead with 8 in-line contact electrodes. Independent 19-filar platinum-core. Contacts are separated circumferentially allowing for both axial and&#xD;
rotational stimulation selectivity.</Description>
            <Size>30cm - 45cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4476</SubGroupID>
            <Suffix>Current steering</Suffix>
            <ARTGs>
                <ARTG>279186</ARTG>
            </ARTGs>
            <MinimumBenefit>4120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI488</BillingCode>
            <Name>SenSight™ Directional Lead Kit</Name>
            <Description>Deep brain stimulation lead with 8 proximal and distal contact electrodes. Distal orientation marker determines positioning of the electrodes under certain imaging modalities.</Description>
            <Size>33cm and 42cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4476</SubGroupID>
            <Suffix>Current steering</Suffix>
            <ARTGs>
                <ARTG>387432</ARTG>
            </ARTGs>
            <MinimumBenefit>4120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ378</BillingCode>
            <Name>Infinity directional lead</Name>
            <Description>Lead with 8 electrode segmented contacts. Steerable and directional current.</Description>
            <Size>30-40cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4476</SubGroupID>
            <Suffix>Current steering</Suffix>
            <ARTGs>
                <ARTG>279017</ARTG>
            </ARTGs>
            <MinimumBenefit>4120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS238</BillingCode>
            <Name>Boston Scientific DBS Lead Kit</Name>
            <Description>Deep brain stimulation lead with 8 in-line contact electrodes. Independent 19-filar platinum-core.</Description>
            <Size>30cm - 45cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4476</SubGroupID>
            <ARTGs>
                <ARTG>202017</ARTG>
            </ARTGs>
            <MinimumBenefit>3746</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM430</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK108</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Implantable Lead Kits</Name>
            <Description>Implantable Lead Kits</Description>
            <Size>Multiple sizes suitable for patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4476</SubGroupID>
            <ARTGs>
                <ARTG>313134</ARTG>
            </ARTGs>
            <MinimumBenefit>3746</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC244</BillingCode>
            <Name>Medtronic Australasia DBS Lead Model 3389,  Medtronic quadripolar Itrel II- 7424DBS, Active Implantable Stimulator &amp; Ancillary Equipment</Name>
            <Description>Deep brain stimulation lead with four platinum iridium electrodes Models 3387 and 3389.  Electrode spacing is 1.5mm apart for Model 3387 and 0.5mm apart for Model 3389.  PTFE, polyurethane, platinum/iridium, nickel alloy, tungsten</Description>
            <Size>28 - 40cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4476</SubGroupID>
            <ARTGs>
                <ARTG>137138</ARTG>
                <ARTG>137374</ARTG>
            </ARTGs>
            <MinimumBenefit>3746</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ148</BillingCode>
            <Name>Libra Deep Brain Stimulation System  - Leads 6142 - 6149</Name>
            <Description>DBS Leads 6142-6145 1.5mm electrode and space 1.5mm; 6146-6149 1.5mm electrode and 0.5mm space</Description>
            <Size>25-40cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4476</SubGroupID>
            <ARTGs>
                <ARTG>160826</ARTG>
            </ARTGs>
            <MinimumBenefit>3746</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS239</BillingCode>
            <Name>Boston Scientific DBS Extension Kit</Name>
            <Description>Deep brain stimulation extension kit</Description>
            <Size>55 &amp; 95 cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>363575</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS293</BillingCode>
            <Name>B26 Pocket Adaptor</Name>
            <Description>Pocket Adaptor for Deep Brain Stimulation IPG</Description>
            <Size>15cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>231754</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS324</BillingCode>
            <Name>Vercise M8 Adapter</Name>
            <Description>1 x 8 in-line connector designed to connect another manufacturer's previously implanted lead extensions to the Vercise Stimulator</Description>
            <Size>15 - 55cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>281579</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM435</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK113</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Implantable Extension Kit</Name>
            <Description>Implantable Extension Kit</Description>
            <Size>Suitable for patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>313133</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC852</BillingCode>
            <Name>Medtronic Extension for Deep Brain Stimulation</Name>
            <Description>Medtronic ACTIVA Stretch Coil Extension for use with ACTIVA RC and PC</Description>
            <Size>40cm, 60cm, 95cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>239412</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC940</BillingCode>
            <Name>Pocket Adaptors for Deep Brain Stimulation</Name>
            <Description>Pocket Adaptors for Deep Brain Stimulation (Single and Dual Channel)</Description>
            <Size>25.5cm and 27.4cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>165114</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI491</BillingCode>
            <Name>SenSight™ Extension Kit</Name>
            <Description>8 contacts on the distal and proximal ends. Directional lead is connected into the distal end of the extension.</Description>
            <Size>40 cm, 60 cm and 95 cm   </Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>387436</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ234</BillingCode>
            <Name>Pocket Adaptor</Name>
            <Description>IS-1 Pocket Adaptor</Description>
            <Size>25cm and 50cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>170021</ARTG>
                <ARTG>233169</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ350</BillingCode>
            <Name>8-Channel Adapter</Name>
            <Description>8-Channel Adapter</Description>
            <Size>10cm and 60cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>233169</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ373</BillingCode>
            <Name>St Jude Deep Brain Stimulation System</Name>
            <Description>Extension Lead for DBS</Description>
            <Size>50-90cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1674</GroupID>
            <SubGroupID>4477</SubGroupID>
            <ARTGs>
                <ARTG>160827</ARTG>
                <ARTG>183454</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER612</BillingCode>
            <Name>Alpha Omega NeuroProbe Microelectrodes</Name>
            <Description>Alpha Omega Neuroprobe family of microtargeting electrodes; shielded, Sonus  shielded or unshielded, various configurations, sterile</Description>
            <Size>Length: 240-300 mm  Microtip length: 2.5-27 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1675</GroupID>
            <ARTGs>
                <ARTG>346530</ARTG>
            </ARTGs>
            <MinimumBenefit>1240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER647</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SJ198</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MicroTargeting Electrodes</Name>
            <Description>Microtargeting mono- and bipolar- electrodes</Description>
            <Size>100-300mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1675</GroupID>
            <ARTGs>
                <ARTG>161735</ARTG>
            </ARTGs>
            <MinimumBenefit>1240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI073</BillingCode>
            <Name>Medtronic MicroTargeting Electrodes</Name>
            <Description>Microelectrodes used for intra-operative recording of neuronal activity for DBS</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1675</GroupID>
            <ARTGs>
                <ARTG>133619</ARTG>
            </ARTGs>
            <MinimumBenefit>1240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS244</BillingCode>
            <Name>SureTek Burr Hole Cover</Name>
            <Description>Burr hole cover</Description>
            <Size>14mm compatability</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4478</SubGroupID>
            <ARTGs>
                <ARTG>203999</ARTG>
            </ARTGs>
            <MinimumBenefit>497</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC767</BillingCode>
            <Name>Stimloc</Name>
            <Description>Burr Hole Cover</Description>
            <Size>14mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4478</SubGroupID>
            <ARTGs>
                <ARTG>151095</ARTG>
            </ARTGs>
            <MinimumBenefit>497</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI492</BillingCode>
            <Name>SenSight™ Burr Hole Device Kit</Name>
            <Description>Intended to cover a burr hole on the skull and anchor a directional lead.</Description>
            <Size>various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4478</SubGroupID>
            <ARTGs>
                <ARTG>387430</ARTG>
                <ARTG>387431</ARTG>
            </ARTGs>
            <MinimumBenefit>497</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ199</BillingCode>
            <Name>Guardian Burr Hole Cover System</Name>
            <Description>Cranial Burr Hole Cover</Description>
            <Size>14 - 17mm outer diameter</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4478</SubGroupID>
            <ARTGs>
                <ARTG>163234</ARTG>
            </ARTGs>
            <MinimumBenefit>497</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS242</BillingCode>
            <Name>Boston Scientific DBS OR Cable &amp; Extension</Name>
            <Description>OR cable and extension for DBS</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4479</SubGroupID>
            <ARTGs>
                <ARTG>157994</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER614</BillingCode>
            <Name>Alpha Omega Electrode cable</Name>
            <Description>Alpha Omega Elecrode cable, sterile </Description>
            <Size>Various</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4479</SubGroupID>
            <ARTGs>
                <ARTG>321642</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC764</BillingCode>
            <Name>Microelectrode Cable</Name>
            <Description>Cable used for intracranial recording of neural activity prior to DBS</Description>
            <Size>One size</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4479</SubGroupID>
            <ARTGs>
                <ARTG>138186</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC770</BillingCode>
            <Name>Snap Lid Connector</Name>
            <Description>Connector for implanted lead to external Implantable Pulse Generator</Description>
            <Size>2.5" x 5.0"</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4479</SubGroupID>
            <ARTGs>
                <ARTG>119991</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC842</BillingCode>
            <Name>Medtronic Screening Cable (Twist Lock)</Name>
            <Description>Screening Cable with Twist Lock for Intraoperative testing</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4479</SubGroupID>
            <ARTGs>
                <ARTG>119991</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC843</BillingCode>
            <Name>Medtronic Screening Cable (Alligator Clip)</Name>
            <Description>Screening Cable with Alligator Clip for Intraoperative testing</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4479</SubGroupID>
            <ARTGs>
                <ARTG>119991</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI490</BillingCode>
            <Name>SenSight™ Lead Test Cable Kit</Name>
            <Description>Connects the External Neurostimulator (ENS) with the directional lead.</Description>
            <Size>one size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4479</SubGroupID>
            <ARTGs>
                <ARTG>359713</ARTG>
                <ARTG>360032</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS240</BillingCode>
            <Name>Vercise Physician's Spare Kit</Name>
            <Description>Boots accessory kit for DBS</Description>
            <Size>N/A</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>203998</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS241</BillingCode>
            <Name>Boston Scientific DBS Tunneling Tool</Name>
            <Description>Tunneling tool for DBS - straw, long</Description>
            <Size>N/A</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>156757</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER613</BillingCode>
            <Name>Alpha Omega Cannula</Name>
            <Description>Alpha Omega Cannula, standard or tapered used for microelectrodes recording (MER) and for lead insertion; stylet, sterile</Description>
            <Size>Length: 130-216.5 mm  Inner diameter: 0.6-1.6 mm  Outer diameter: 1.07-1.81 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>346590</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC826</BillingCode>
            <Name>Medtronic Accessory Kit for Deep Brain Stimulation</Name>
            <Description>Boots accessory kit for DBS (3550-25)</Description>
            <Size>N/A</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>240576</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI003</BillingCode>
            <Name>Medtronic DBS Tunneling Tool Accessory Kit</Name>
            <Description>DBS Tunneling Tool Accessory Kit</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>121281</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI119</BillingCode>
            <Name>Electrode Insertion Tube set</Name>
            <Description>Electrode Insertion Tube Set for DBS</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>212222</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI489</BillingCode>
            <Name>SenSight™ Lead Cap Kit</Name>
            <Description>Protects and isolates the directional lead contacts after the implant but prior to extension connection.</Description>
            <Size>one size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>387435</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI493</BillingCode>
            <Name>SenSight™ Tunneler Kit   </Name>
            <Description>Creates a subcutaneous path for tunnelling the lead to the intended location and retains the lead position.</Description>
            <Size>one size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>372651</ARTG>
                <ARTG>387433</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI494</BillingCode>
            <Name>SenSight™ Connector Plug</Name>
            <Description>Fits into an unused socket of a dual channel neurostimulator, or the distal end of an unused DBS extension.</Description>
            <Size>one size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>221</SubCategoryID>
            <GroupID>1676</GroupID>
            <SubGroupID>4498</SubGroupID>
            <ARTGs>
                <ARTG>387434</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI495</BillingCode>
            <Name>Vanta™ Recharge-Free Neurostimulator </Name>
            <Description>16 electrode recharge-free INS for pain management with AdaptiveStim and Surescan MRI technology</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <Suffix>Adaptive Stimulation</Suffix>
            <ARTGs>
                <ARTG>386887</ARTG>
            </ARTGs>
            <MinimumBenefit>19088</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS322</BillingCode>
            <Name>Precision Novi IPG</Name>
            <Description>16-output, multi-channel, neurostimulation system IPG with 3D algorythmic programming</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <Suffix>Multi waveforms</Suffix>
            <ARTGs>
                <ARTG>283692</ARTG>
                <ARTG>283693</ARTG>
            </ARTGs>
            <MinimumBenefit>21660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS383</BillingCode>
            <Name>WaveWriter Alpha</Name>
            <Description>16 &amp; 32 output, multi-channel, neurostimulation system IPG with 3D Algorythmic Programming, Combination Therapy and Multi Waveform capability </Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <Suffix>Multi waveforms</Suffix>
            <ARTGs>
                <ARTG>362970</ARTG>
                <ARTG>362971</ARTG>
            </ARTGs>
            <MinimumBenefit>21660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ379</BillingCode>
            <Name>Proclaim IPG</Name>
            <Description>Implantable pulse generator</Description>
            <Size>55mm, 68mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <Suffix>Multi waveforms</Suffix>
            <ARTGs>
                <ARTG>279015</ARTG>
                <ARTG>279016</ARTG>
            </ARTGs>
            <MinimumBenefit>21660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ389</BillingCode>
            <Name>Proclaim DRG</Name>
            <Description>Implantable Pulse Generator</Description>
            <Size>one size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <Suffix>Multi waveforms</Suffix>
            <ARTGs>
                <ARTG>289235</ARTG>
                <ARTG>333461</ARTG>
            </ARTGs>
            <MinimumBenefit>21660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ432</BillingCode>
            <Name>Proclaim XR IPG</Name>
            <Description>Implantable pulse generator</Description>
            <Size>55mm and 68mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <Suffix>Multi waveforms</Suffix>
            <ARTGs>
                <ARTG>351631</ARTG>
                <ARTG>351632</ARTG>
            </ARTGs>
            <MinimumBenefit>21660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI135</BillingCode>
            <Name>PrimeAdvanced Surescan MRI Neurostimulator</Name>
            <Description>16 electrode non-rechargeable implantable neurostimulator for pain management with Surescan MRI technology Model 97702</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <ARTGs>
                <ARTG>215751</ARTG>
            </ARTGs>
            <MinimumBenefit>17283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PQ004</BillingCode>
            <Name>Reactiv8 Implantable Pulse Generator</Name>
            <Description>Two channel implantable stimulator</Description>
            <Size>One size only</Size>
            <SupplierCode>PQ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4480</SubGroupID>
            <ARTGs>
                <ARTG>327089</ARTG>
            </ARTGs>
            <MinimumBenefit>17283</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI274</BillingCode>
            <Name>Intellis AdaptiveStim Neurostimulator</Name>
            <Description>16 Electrode Rechargeable, multi-channel, implantable Neurostimulator for pain management with AdaptiveStim, SureScan MRI, and Overdrive technology</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Adaptive Stimulation, Multi waveform, Recharge protection, Unlimited Deep Discharge Battery,</Suffix>
            <ARTGs>
                <ARTG>298746</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY003</BillingCode>
            <Name>Evoke Closed Loop Stimulator (CLS)  </Name>
            <Description>A 24 contact implantable, rechargeable spinal cord stimulator capable of providing ECAP-controlled closed-loop stimulation. </Description>
            <Size>N/A</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Adaptive Stimulation, Multi waveform, Recharge protection, Unlimited Deep Discharge Battery,</Suffix>
            <ARTGs>
                <ARTG>336330</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS254</BillingCode>
            <Name>Precision Spectra IPG</Name>
            <Description>32-output, multi-channel, zero-volt rechargeable neurostimulation system IPG with 3D alogrythmic programming</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Adaptive Stimulation, Unlimited Deep Discharge Battery, 32 Electrode IPG</Suffix>
            <ARTGs>
                <ARTG>205793</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS362</BillingCode>
            <Name>Precision Spectra WaveWriter IPG</Name>
            <Description>32-output, multi-channel, zero-volt rechargeable neurostimulation system IPG with Combination Therapy, Sub-Perception Algorithms and Waveform Automation</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Adaptive Stimulation, Unlimited Deep Discharge Battery, 32 Electrode IPG</Suffix>
            <ARTGs>
                <ARTG>318260</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS389</BillingCode>
            <Name>WaveWriter Alpha</Name>
            <Description>16 or 32-output, multi-channel, zero-volt rechargeable neurostimulation system IPG with Combination Therapy, Sub-Perception Algorithms and Waveform Automation</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Adaptive Stimulation, Unlimited Deep Discharge Battery, 32 Electrode IPG</Suffix>
            <ARTGs>
                <ARTG>362972</ARTG>
                <ARTG>362973</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FP001</BillingCode>
            <Name>StimRouter Neuromodulation System Kit</Name>
            <Description>Implantable multi-electrode lead with integrated receiver, delivery tools, external pulse transmitter, patient programmer, and charger set.</Description>
            <Size>One size only</Size>
            <SupplierCode>FP</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Integrated Leads</Suffix>
            <ARTGs>
                <ARTG>313344</ARTG>
            </ARTGs>
            <MinimumBenefit>18032</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS330</BillingCode>
            <Name>Precision Montage MRI IPG</Name>
            <Description>MRI Conditional, 16-output, multi-channel, zero-volt rechargeable neurostimulation system IPG with 3D algorythmic programming</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Multi waveform, Recharge protection</Suffix>
            <ARTGs>
                <ARTG>286709</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ374</BillingCode>
            <Name>Prodigy IPG</Name>
            <Description>Implantable Pulse Generator</Description>
            <Size>26g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Multi waveform, Recharge protection</Suffix>
            <ARTGs>
                <ARTG>230721</ARTG>
                <ARTG>279911</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER496</BillingCode>
            <Name>Senza II IPG Kit</Name>
            <Description>Implantable Pulse Generator Kit</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Unlimited Deep Discharge Battery, 10kHz Stimulation</Suffix>
            <ARTGs>
                <ARTG>186043</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER535</BillingCode>
            <Name>Senza Omnia IPG Kit</Name>
            <Description>Implantable Pulse Generator Kit</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1677</GroupID>
            <SubGroupID>4481</SubGroupID>
            <Suffix>Unlimited Deep Discharge Battery, 10kHz Stimulation</Suffix>
            <ARTGs>
                <ARTG>330704</ARTG>
            </ARTGs>
            <MinimumBenefit>23465</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ388</BillingCode>
            <Name>Patient Programmer</Name>
            <Description>Patient Programmer - bluetooth</Description>
            <Size>iPod Touch</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <Suffix>Bluetooth</Suffix>
            <ARTGs>
                <ARTG>277756</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS106</BillingCode>
            <Name>Precision Plus Remote Patient Programmer; Precision Plus with MultiwaveTechnology Remote Patient Programmer</Name>
            <Description>Hand held remote control External Patient Programmer</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>128681</ARTG>
                <ARTG>166929</ARTG>
                <ARTG>231196</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS253</BillingCode>
            <Name>Precision Spectra Patient Remote Programmer</Name>
            <Description>Hand held remote control External Patient Programmer</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>206305</ARTG>
                <ARTG>206306</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS325</BillingCode>
            <Name>FreeLink Remote Control Kit</Name>
            <Description>Hand held remote control/external patient programmer</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>283694</ARTG>
                <ARTG>287237</ARTG>
                <ARTG>287738</ARTG>
                <ARTG>318330</ARTG>
                <ARTG>318331</ARTG>
                <ARTG>362974</ARTG>
                <ARTG>362991</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER608</BillingCode>
            <Name>Nevro PTRC2300 Patient Remote Control </Name>
            <Description>External patient programmer for Senza spinal cord stimulation system</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>330707</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI138</BillingCode>
            <Name>Surescan MRI Patient programmer</Name>
            <Description>Patient controller for Surescan MRI Neurostimulators</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>214421</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI276</BillingCode>
            <Name>Intellis Rechargeable Neurostimulation System - PTM Patient Programmer</Name>
            <Description>External Patient Programmer Model 97745</Description>
            <Size>One Size Only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>298760</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI496</BillingCode>
            <Name>Vanta Neurostimulator System Patient Programmer (Handset +App)</Name>
            <Description>The patient programmer consists of a handset that hosts the MyStim PC Therapy Application (App) </Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>386871</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PQ005</BillingCode>
            <Name>Reactiv8 Activator</Name>
            <Description>Patient Activator for use with Reactiv8 Implantable Pulse Generator </Description>
            <Size>One size only</Size>
            <SupplierCode>PQ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>327090</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ177</BillingCode>
            <Name>ANS Spinal Cord Stimulation System (SCS) GENESIS</Name>
            <Description>QuikLink Patient Programmer Model 3860</Description>
            <Size>One Size Only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>106669</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ183</BillingCode>
            <Name>Eon Neurostimulation System</Name>
            <Description>Eon Programmer #3851</Description>
            <Size>.</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>127127</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ348</BillingCode>
            <Name>Prodigy Patient Programmer</Name>
            <Description>Prodigy Patient Programmer for use with Prodigy Neurostimulator.</Description>
            <Size>One size. </Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>230778</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ355</BillingCode>
            <Name>Axium Neurostimulator System - Programmer - Patient</Name>
            <Description>Programmer - patient</Description>
            <Size>1 size (1 presentation)</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>202322</ARTG>
                <ARTG>300051</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY007</BillingCode>
            <Name>Evoke Pocket Console </Name>
            <Description>A handheld remote control for an implantable closed-loop stimulator.  </Description>
            <Size>N/A</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4483</SubGroupID>
            <ARTGs>
                <ARTG>336570</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC694</BillingCode>
            <Name>Restore Rechargeable Neurostimulation System</Name>
            <Description>External Patient Programmer Antenna Model 37092</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4484</SubGroupID>
            <ARTGs>
                <ARTG>146936</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI497</BillingCode>
            <Name>Patient Communicator</Name>
            <Description>The communicator allows the MyStim PC Therapy Application on the Patient Handset (Programmer) connect to the implantable neurostimulator</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4484</SubGroupID>
            <ARTGs>
                <ARTG>386870</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER009</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Patient Remote Kit</Name>
            <Description>The patient remote control is a handheld, battery operated unit able to communicate via radiofrequency (RF) with the Implantable Pulse Generator and trial stimulator</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4485</SubGroupID>
            <ARTGs>
                <ARTG>185994</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER536</BillingCode>
            <Name>Senza Omnia Patient Remote</Name>
            <Description>Handheld, battery operated unit able to communicate via radiofrequency with the Senza Omnia IPG,  </Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4485</SubGroupID>
            <ARTGs>
                <ARTG>330708</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PQ001</BillingCode>
            <Name>Reactiv8 Magnet</Name>
            <Description>Communication Magnet</Description>
            <Size>One size</Size>
            <SupplierCode>PQ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4485</SubGroupID>
            <ARTGs>
                <ARTG>327094</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ433</BillingCode>
            <Name>ANS Spinal Cord Stimulation System (SCS) GENESIS</Name>
            <Description>Communication Magnet 1210</Description>
            <Size> One type only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4485</SubGroupID>
            <ARTGs>
                <ARTG>267026</ARTG>
                <ARTG>342820</ARTG>
            </ARTGs>
            <MinimumBenefit>1264</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS143</BillingCode>
            <Name>Precision SCS External Patient Recharger System</Name>
            <Description>External Patient Recharging System: Base Station, Charger, Cradle power supply, charger base station.</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>149462</ARTG>
                <ARTG>155857</ARTG>
                <ARTG>155859</ARTG>
                <ARTG>155924</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER008</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Charger Kit</Name>
            <Description>The Charger is a battery powered rechargeable device intended to recharge the Implantable Pulse Generator (IPG) battery transcutaneously</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>181182</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER540</BillingCode>
            <Name>Senza Omnia Charger</Name>
            <Description>Battery powered rechargeable device intended to recharge the Senza Omnia IPG battery transcutaneously</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>328684</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI139</BillingCode>
            <Name>Medtronic Patient Recharger System</Name>
            <Description>Recharging system for Surescan MRI Neurostimulators Model 97754</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>121279</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI277</BillingCode>
            <Name>Intellis Rechargeable Neurostimulation System - RTM Recharger</Name>
            <Description>External Patient Recharger Model 97755</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>121279</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ342</BillingCode>
            <Name>Eon Mini Charger </Name>
            <Description>Charger to recharge Implantable Pulse Generator</Description>
            <Size>One size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>221544</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ349</BillingCode>
            <Name>Prodigy Charging System</Name>
            <Description>Prodigy Charging System for use with Prodigy Neurostimulator.</Description>
            <Size>One size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>230779</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ352</BillingCode>
            <Name>Eon Charging System 3726</Name>
            <Description>Eon Charging System </Description>
            <Size>One size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>233616</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY005</BillingCode>
            <Name>Evoke Charger (AU)</Name>
            <Description>External recharging system for an implantable closed-loop stimulator.  </Description>
            <Size>N/A</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>4497</SubGroupID>
            <ARTGs>
                <ARTG>338061</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER649</BillingCode>
            <Name>Nevro® Senza® Bluetooth® Trial Stimulator</Name>
            <Description>Sterile, single-use trial stimulator device </Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>5854</SubGroupID>
            <ARTGs>
                <ARTG>388432</ARTG>
            </ARTGs>
            <MinimumBenefit>1083</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI280</BillingCode>
            <Name>Intellis Wireless External Neurostimulator</Name>
            <Description>Wireless External Neurostimulator</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1678</GroupID>
            <SubGroupID>5854</SubGroupID>
            <ARTGs>
                <ARTG>293256</ARTG>
            </ARTGs>
            <MinimumBenefit>1083</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC827</BillingCode>
            <Name>Medtronic Pisces Quad Leads</Name>
            <Description>Pisces Quad Lead (3487A), Pisces Quad Compact Lead (3887), Pisces Quad Plus Lead (3888)</Description>
            <Size>Various</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>4 electrodes</Suffix>
            <ARTGs>
                <ARTG>137348</ARTG>
                <ARTG>143034</ARTG>
                <ARTG>143035</ARTG>
            </ARTGs>
            <MinimumBenefit>3041</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PQ003</BillingCode>
            <Name>Reactiv8 Percutaneous Lead</Name>
            <Description>Four electrode lead kit</Description>
            <Size>45cm; 65cm</Size>
            <SupplierCode>PQ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>4 electrodes</Suffix>
            <ARTGs>
                <ARTG>327091</ARTG>
            </ARTGs>
            <MinimumBenefit>3041</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ162</BillingCode>
            <Name>ANS Spinal Cord Stimulation System (SCS)</Name>
            <Description>Quattrode Lead. 4 Electrode.</Description>
            <Size>30cm, 60cm, 90cm 110cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>4 electrodes</Suffix>
            <ARTGs>
                <ARTG>131944</ARTG>
            </ARTGs>
            <MinimumBenefit>3041</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ186</BillingCode>
            <Name>Lamitrode S Series Leads</Name>
            <Description>Lamitrode S Series, 4 Channel, Model # 3243</Description>
            <Size>Length = 30cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>4 electrodes</Suffix>
            <ARTGs>
                <ARTG>126076</ARTG>
            </ARTGs>
            <MinimumBenefit>3041</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ187</BillingCode>
            <Name>Lamitrode S Series Leads</Name>
            <Description>Lamitrode S Series, 4 Channel, Model # 3246</Description>
            <Size>Length = 60cm, 90cm, 110cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>4 electrodes</Suffix>
            <ARTGs>
                <ARTG>126076</ARTG>
            </ARTGs>
            <MinimumBenefit>3041</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ359</BillingCode>
            <Name>Axium Neurostimulator System - Implant Lead Kit</Name>
            <Description>Implant lead kit and Implant lead kit, slim tip</Description>
            <Size>Package containing either 50cm or 90cm lead</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>4 electrodes</Suffix>
            <ARTGs>
                <ARTG>301386</ARTG>
                <ARTG>301387</ARTG>
                <ARTG>333462</ARTG>
                <ARTG>333463</ARTG>
                <ARTG>202325</ARTG>
            </ARTGs>
            <MinimumBenefit>3041</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ474</BillingCode>
            <Name>Slim Tip DRG lead kit</Name>
            <Description>Implant Lead kit</Description>
            <Size>50-90cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>4 electrodes</Suffix>
            <ARTGs>
                <ARTG>333463</ARTG>
                <ARTG>333462</ARTG>
            </ARTGs>
            <MinimumBenefit>3041</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS109</BillingCode>
            <Name>Precision SCS Eight Contact Leads</Name>
            <Description>Eight contact percutaneous leads.</Description>
            <Size>30cm to 70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>128775</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS331</BillingCode>
            <Name>Avista MRI 8 Contact Lead</Name>
            <Description>Eight contact percutaneous leads, MRI Conditional</Description>
            <Size>56cm - 74cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>287236</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER006</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Lead Kit</Name>
            <Description>The percutaneous lead is intended to be single use and interfaces with the Implantable Pulse Generator, lead extender OR cable, and lead accessories.</Description>
            <Size>Spacing: 1-9mm spacing, 1-9mm in 1mm increments; Length: 30-90cm in 5cm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>185992</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC710</BillingCode>
            <Name>Neurostimulation System - Octad Leads</Name>
            <Description>Octad Standard Lead Kit with Percutaneous extension model 3877</Description>
            <Size>45, 60 &amp; 75cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>123241</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC712</BillingCode>
            <Name>Neurostimulation System - Octad Leads</Name>
            <Description>Octad Compact Lead Kit with Percutaneous Extension Model 3878</Description>
            <Size>45, 60 &amp; 75cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>123243</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI136</BillingCode>
            <Name>Vectris Surescan MRI Neurostimulation Leads</Name>
            <Description>Octad Compact Lead Kit Model 977A2, Subcompact lead Kit Model 977A1</Description>
            <Size>60cm, 75cm, 90cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>214838</ARTG>
                <ARTG>214839</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ161</BillingCode>
            <Name>ANS Spinal Cord Stimulation System (SCS)</Name>
            <Description>Octrode Lead. 8 Electrode (thoracic or cervical placement).</Description>
            <Size>30cm, 60cm, 90cm 110cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>132097</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ168</BillingCode>
            <Name>ANS Spinal Cord Stimulation System (SCS)</Name>
            <Description>Lamitrode Plate Electrode</Description>
            <Size>60cm, 90cm, 110cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>126005</ARTG>
                <ARTG>126079</ARTG>
                <ARTG>126076</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ185</BillingCode>
            <Name>Lamitrode S Series</Name>
            <Description>Lamitrode S Series, 8 Channel</Description>
            <Size>Length = 30-110cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>8 electrodes</Suffix>
            <ARTGs>
                <ARTG>126002</ARTG>
            </ARTGs>
            <MinimumBenefit>3817</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS255</BillingCode>
            <Name> CoverEdge 32 Contact Surgical Leads</Name>
            <Description>CoverEdge, CoverEdge MRI, CoverEdge X, CoverEdge X MRI - 4x8 spaced electrodes.    </Description>
            <Size>Up to 70cm in length</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>≥32 electrodes</Suffix>
            <ARTGs>
                <ARTG>218230</ARTG>
            </ARTGs>
            <MinimumBenefit>11011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS356</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BS110</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INFINION Lead</Name>
            <Description>16 contact point leads with multiple independent current control</Description>
            <Size>50cm - 70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>197909</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS357</BillingCode>
            <Name>ARTISAN, ARTISAN MRI Lead</Name>
            <Description>16 contact point leads with multiple independent current control</Description>
            <Size>50cm - 70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>163471</ARTG>
                <ARTG>308180</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC776</BillingCode>
            <Name>Specify 5-6-5 Surgical Lead</Name>
            <Description>Triple Array 16 Electrode Surgical Lead with Duraloc Technology</Description>
            <Size>30, 65cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>148397</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI199</BillingCode>
            <Name>Specify SureScan MRI 5-6-5 Lead Kit</Name>
            <Description>Triple Array 16 Electrode Surgical Lead MRICS</Description>
            <Size>65 - 90 cms</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>280179</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI209</BillingCode>
            <Name>Specify SureScan MRI 2x8 Surgical Lead Kit</Name>
            <Description>MRI conditional surgical lead</Description>
            <Size>65-90cms</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>280180</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ138</BillingCode>
            <Name>Lamitrode Lead - Tripole 16C</Name>
            <Description>Tripole 16C - 3214, 3128, 3219, 3220, 3221</Description>
            <Size>30-110cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>155013</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ169</BillingCode>
            <Name>ANS Spinal Cord Stimulation System (SCS)</Name>
            <Description>Lamitrode Dual 8 Plate Electrode Lead</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>126004</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY009</BillingCode>
            <Name>Evoke 12C Percutaneous Lead Kit </Name>
            <Description>A 12 contact lead that delivers electrical stimulation to neural tissue and captures ECAPs from the same tissue. </Description>
            <Size>60 and 90cm lengths</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes</Suffix>
            <ARTGs>
                <ARTG>336573</ARTG>
            </ARTGs>
            <MinimumBenefit>6895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS312</BillingCode>
            <Name>Infinion CX Lead</Name>
            <Description>1 x 16 lead with two 8 contact tails</Description>
            <Size>50 - 70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes, Bifurcated proximal tail</Suffix>
            <ARTGs>
                <ARTG>275241</ARTG>
            </ARTGs>
            <MinimumBenefit>8123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER388</BillingCode>
            <Name>Surpass Surgical Lead</Name>
            <Description>16 Contact Lead with two bifurcating 8 contact tails with embedded differentiating colour pigment in tail</Description>
            <Size>Length: 30 - 90 cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes, Bifurcated proximal tail</Suffix>
            <ARTGs>
                <ARTG>284256</ARTG>
            </ARTGs>
            <MinimumBenefit>8123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER607</BillingCode>
            <Name>Surpass-C Surgical Lead</Name>
            <Description>Surgical lead, 10, 12 and 14 electrode</Description>
            <Size>50cm, 70cm, 90cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes, Bifurcated proximal tail</Suffix>
            <ARTGs>
                <ARTG>368530</ARTG>
            </ARTGs>
            <MinimumBenefit>8123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ231</BillingCode>
            <Name>Penta Leads</Name>
            <Description>Paddle leads (Penta Leads have a curved paddle instead of a conventional flat paddle)</Description>
            <Size>2-3mm, 30cm-110cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4486</SubGroupID>
            <Suffix>greater than 8 and less than 32 electrodes, Bifurcated proximal tail</Suffix>
            <ARTGs>
                <ARTG>170450</ARTG>
            </ARTGs>
            <MinimumBenefit>8123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS118</BillingCode>
            <Name>Precision SCS Lead Blanks</Name>
            <Description>Lead Blank</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4487</SubGroupID>
            <ARTGs>
                <ARTG>156757</ARTG>
            </ARTGs>
            <MinimumBenefit>438</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI137</BillingCode>
            <Name>Medtronic Vectris Neurostimulation Trial Lead</Name>
            <Description>Octad Compact Trial lead Kit Model 977D2 and Subcompact Model 977D1</Description>
            <Size>60cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1679</GroupID>
            <SubGroupID>4487</SubGroupID>
            <ARTGs>
                <ARTG>219258</ARTG>
                <ARTG>219259</ARTG>
            </ARTGs>
            <MinimumBenefit>438</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS111</BillingCode>
            <Name>Precision SCS Lead Extensions</Name>
            <Description>Lead Extensions</Description>
            <Size>25cm to 55cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>128679</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS158</BillingCode>
            <Name>Precision Connector M1</Name>
            <Description>Lead extension for Precision SCS System</Description>
            <Size>35. 55. 70 cm length</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>162422</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS169</BillingCode>
            <Name>Precision SCS Splitter</Name>
            <Description>Lead extension for connection of multiple leads</Description>
            <Size>Multiple Configurations</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>167101</ARTG>
                <ARTG>167102</ARTG>
                <ARTG>197908</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS323</BillingCode>
            <Name>Precision M8 Adaptor</Name>
            <Description>Designed to connect a Precision IPG or Precision Spectra IPG to another manufacturer's previously implanted compatible lead or lead extension</Description>
            <Size>15cm - 55cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>281250</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER007</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Lead Extension Kit</Name>
            <Description>The lead extender is intended to be used when the implant site for the Implantable Pulse Generator is too far from the stimulation site to directly connect the stimulation lead.</Description>
            <Size>Length: 15cm-60cm, in increments of 5cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>185993</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER102</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Pocket Adaptor Kit - S8</Name>
            <Description>The Pocket Adaptor is intended to be used when replacing a previously implanted Pulse Generator with the Nevro Implantable Pulse Generator. The Pocket Adaptor interfaces the Nevro Implantable Pulse Generator to another manufacturer's previously implanted compatible lead or lead extension.</Description>
            <Size>Length of 10cm to 60cm, in increments of 1cm.</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>199081</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER130</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Pocket Adaptor Kit - M8</Name>
            <Description>The Pocket Adaptor is intended to be used when replacing a previously implanted Pulse Generator with the Nevro Implantable Pulse Generator. The Pocket Adaptor interfaces the Nevro Implantable Pulse Generator to another manufacturer's previously implanted compatible lead or lead extension</Description>
            <Size>Length of 10cm to 60cm, in increments of 1cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>204062</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC733</BillingCode>
            <Name>Quadripolar Stretch-Coil Extensions</Name>
            <Description>Model 37083 Single, Silver and Silicone Rubber</Description>
            <Size>20cm - 60cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>239412</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC734</BillingCode>
            <Name>Quadripolar Stretch-Coil Extensions</Name>
            <Description>Model 37082 Bifurcated, Silver and Silicone Rubber</Description>
            <Size>20cm - 60cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>239412</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC941</BillingCode>
            <Name>Pocket Adaptors for Spinal Cord Stimulation</Name>
            <Description>Pocket Adaptors for Spinal Cord Stimulation (Single and Dual Channel)</Description>
            <Size>12.9cm, 25.5cm and 27.4cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>165114</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI445</BillingCode>
            <Name>Neurostimulation System - Extensions</Name>
            <Description>1 x 8 Extension Kit Model 37081</Description>
            <Size>20, 40 &amp; 60cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>239412</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ160</BillingCode>
            <Name>ANS Spinal Cord Stimulation System (SCS)</Name>
            <Description>Lead Extensions - in addition to 3341, 3342, 3343, 3382 and 3383, additional model 3346 - Dual Quad Extension and 3386 - single octrode extension</Description>
            <Size>60cm length</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>126001</ARTG>
                <ARTG>126078</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ358</BillingCode>
            <Name>Axium Neurostimulator System - Lead Extension Kit</Name>
            <Description>Lead extension kit.</Description>
            <Size>1 size (1 presentation)</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>203096</ARTG>
                <ARTG>301410</ARTG>
                <ARTG>333448</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY004</BillingCode>
            <Name>Evoke 12C Lead Extension Kit - 55cm</Name>
            <Description> A 12 contact lead extension.</Description>
            <Size>55cm</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1680</GroupID>
            <ARTGs>
                <ARTG>336571</ARTG>
            </ARTGs>
            <MinimumBenefit>1362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC689</BillingCode>
            <Name>Lead Revision Kits</Name>
            <Description>Sterile Revision Kit for Octad leads 45cm (3550-26), Sterile Revision Kit for Octad leads 60-75cm (3550-27)</Description>
            <Size>30 &amp; 45cm; 60 &amp; 75cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4499</SubGroupID>
            <ARTGs>
                <ARTG>240576</ARTG>
            </ARTGs>
            <MinimumBenefit>492</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI140</BillingCode>
            <Name>Revision kit Surescan MRI leads</Name>
            <Description>Sterile Revision Kit for Surescan MRI leads</Description>
            <Size>60cm, 75cm, 90cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4499</SubGroupID>
            <ARTGs>
                <ARTG>240576</ARTG>
            </ARTGs>
            <MinimumBenefit>492</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ356</BillingCode>
            <Name>Axium Neurostimulator System - Lead accessories kit</Name>
            <Description>Lead accessories kit.</Description>
            <Size>1 size (1 presentation)</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4499</SubGroupID>
            <ARTGs>
                <ARTG>197024</ARTG>
                <ARTG>297581</ARTG>
                <ARTG>329428</ARTG>
            </ARTGs>
            <MinimumBenefit>492</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ475</BillingCode>
            <Name>DRG Large Needle and Sheath Kit</Name>
            <Description>Lead Accessories Kit  </Description>
            <Size>1 size  </Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4499</SubGroupID>
            <ARTGs>
                <ARTG>329428</ARTG>
            </ARTGs>
            <MinimumBenefit>492</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY006</BillingCode>
            <Name>Evoke Spares Kit</Name>
            <Description>A sterile revision kit for the Evoke 12C Lead. </Description>
            <Size>N/A</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4499</SubGroupID>
            <ARTGs>
                <ARTG>336575</ARTG>
            </ARTGs>
            <MinimumBenefit>492</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS121</BillingCode>
            <Name>Precision SCS IPG Port</Name>
            <Description>IPG Port Plug</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4500</SubGroupID>
            <ARTGs>
                <ARTG>156761</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER042</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - IPG Port Plug Kit</Name>
            <Description>The Implantable Pulse Generator (IPG) Port Plug is provided to seal the port of the IPG that is not is use.</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4500</SubGroupID>
            <ARTGs>
                <ARTG>190837</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC687</BillingCode>
            <Name>Neurostimulation System - Accessory Kits</Name>
            <Description>Lead Accessory Plug and Closed Boot Kit Model 3550-29</Description>
            <Size>.</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4500</SubGroupID>
            <ARTGs>
                <ARTG>121280</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC825</BillingCode>
            <Name>Medtronic Percutaneous Quad extension</Name>
            <Description>Percutaneous extension (in line connector for quadripolar leads only)</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4500</SubGroupID>
            <ARTGs>
                <ARTG>239412</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ461</BillingCode>
            <Name>Port Plug</Name>
            <Description>Port Plug</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4500</SubGroupID>
            <ARTGs>
                <ARTG>333461</ARTG>
                <ARTG>279015</ARTG>
                <ARTG>278846</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS120</BillingCode>
            <Name>Clik Anchor Kit</Name>
            <Description>Clik, Clik X, Clik X MRI Anchors</Description>
            <Size>Two anchors</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>156760</ARTG>
            </ARTGs>
            <MinimumBenefit>303</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS246</BillingCode>
            <Name>Introducer Kit</Name>
            <Description>Introducer intended for the percutaneous introduction and placement of leads.</Description>
            <Size>Length: 13cm; 23cm.</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>166195</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS247</BillingCode>
            <Name>Stylet Kit</Name>
            <Description>Stylet Kit with steering cap and stiffer stylet</Description>
            <Size>Stiffer stylet length: Up to 74cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>156759</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS249</BillingCode>
            <Name>Medical Adhesive</Name>
            <Description>Medical adhesive is used to assist in fixing the lead to the suture sleeve.</Description>
            <Size>One size</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>156755</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS256</BillingCode>
            <Name>Tunnelling Tools</Name>
            <Description>Aid in placement of leads.</Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>156757</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS257</BillingCode>
            <Name>Wrenches</Name>
            <Description>Used to secure leads and anchors.</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>157487</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS258</BillingCode>
            <Name>Insertion Needles</Name>
            <Description>Aid in placement of leads.</Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>156758</ARTG>
                <ARTG>254954</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS259</BillingCode>
            <Name>Passing Elevators and Paddle Blanks</Name>
            <Description>Aid in placement of leads, helps verify that the epidural space is cleared.</Description>
            <Size>Various</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>156762</ARTG>
                <ARTG>218730</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER036</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Coiled Lead Blank Kit</Name>
            <Description>The Coiled Lead Blank made out of stainless steel is optionally used during surgery to clear a path for the introduction of the SCS Lead into the epidural space. The coiled lead blank is a tool used to help clear obstructions within the cannula of the insertion needle and may be used by the physician to verify access to the epidural space.</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>181179</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER037</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Insertion Needle Kit</Name>
            <Description>The Insertion Needle is used during implant surgery to introduce the Lead between the vetebra into the epidural space. The insertion needle is a two part needle that contains a cannula and stylet to facilitate access to the spinal canal for lead placement</Description>
            <Size>Length: 5-15cm, in increments of 1cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>180426</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER038</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Tunneling Tool Kit</Name>
            <Description>The Tunneling Tool creates a subcutaneous tunnel from the Implantable Pulse Generator (IPG) site to the midline incision. The tunneling tool is passed subcutanously to deliver the leads from needle insertion site to the IPG site</Description>
            <Size>Length: 20-50cm, in increments of 1cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>180556</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER039</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Cable Kit</Name>
            <Description>The cables are used during the Lead implant procedure and patient trial to make electrical and mechanical connections between the Trial Stimulator and the Lead or Lead extension. There is a separate adaptor cable that allows the use of the Medtronic lead with the Nevro Senza System</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>181180</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER041</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Torque Wrench Kit</Name>
            <Description>The Torque Wrench is used to tighten the set screws that lock the lead into the Implantable Pulse Generator or to lock the lead into a lead extension</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>181181</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER043</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - IPG Template Kit</Name>
            <Description>The Implantable Pulse Generator (IPG) Template is an aid for the physician to assist in the proper sizing of the IPG pocket.</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>185414</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER044</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) - Stylet Kit</Name>
            <Description>The Stylets are used to push and "steer" the stimulation Lead into place. These are standard configurations offered across industry offering the implanter the flexibility to maneuver the leads through the epidural space to the desired implant location.</Description>
            <Size>Offered in Straight, Curved or Tapered versions.  Diameter:  0.35, 0.40 mm   Length: 50,70,90 cm;   Angle: 15-30 degrees </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>180653</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER511</BillingCode>
            <Name>Senza II IPG Template</Name>
            <Description>Aid for physicians in proper sizing of the IPG implant pocket</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>186043</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER557</BillingCode>
            <Name>Nevro Passing Elevator Tool</Name>
            <Description>Passing elevator tool</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>337490</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER562</BillingCode>
            <Name>Nevro Spinal Cord Stimulation System (SCSS) – Lead Anchor Kit</Name>
            <Description>The Lead Anchors are used to anchor the lead to the fascia or supraspinous ligament. Lead Anchors are designed to slide freely over the lead length to the required fixation position and sutures are then tied around the anchor clamping the sleeve in place on the lead or a torque wrench is used to tighten the anchor to the lead.</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>180541</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC930</BillingCode>
            <Name>3550-P4 Passing Elevator Accessory Kit</Name>
            <Description>Kit Contents: 4 Passing Elevators compatible with various leads</Description>
            <Size>One size</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>121280</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC931</BillingCode>
            <Name>3550-63 Percutaneous Lead Introducer Accessory Kit</Name>
            <Description>Percutaneous Lead Introducer Accessory Kit</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>121280</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC951</BillingCode>
            <Name>Multi-Lead Trialing Cable</Name>
            <Description>Connector for implanted lead to External Neurostimulator</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>119991</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI038</BillingCode>
            <Name>Medtronic Neurostimulation Accessories (Wrenches and screws)</Name>
            <Description>Accessories for implant of neurostimulation lead</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>121280</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI039</BillingCode>
            <Name>Medtronic Neurostimulation Accessories (Needles)</Name>
            <Description>Accessories for implant of neurostimulation lead</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>121280</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI051</BillingCode>
            <Name>Medtronic Neurostimulation Tunnelling Tools</Name>
            <Description>Tunnelling Tools</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>121281</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI052</BillingCode>
            <Name>Medtronic Neurostimulation Accessory Kits</Name>
            <Description>EZ Anchor, Boot and Anchor Kit</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>240576</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI067</BillingCode>
            <Name>Injex Anchor Kit</Name>
            <Description>Neurostimulation Anchor Kit</Description>
            <Size>One Size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>133358</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PQ002</BillingCode>
            <Name>Reactiv8 Torque Wrench</Name>
            <Description>A tool used to set or release the Implantable Pulse Generator (IPG) set screw  that connects an implanted lead to the IPG header.</Description>
            <Size>One size</Size>
            <SupplierCode>PQ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>284000</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PQ006</BillingCode>
            <Name>Mainstay Tunneller</Name>
            <Description>Catheter tunnellng tool to establish subcutaneous lead delivery pathway</Description>
            <Size>One size</Size>
            <SupplierCode>PQ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>283718</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ285</BillingCode>
            <Name>Strain Relief</Name>
            <Description>Strain Relief</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>134307</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ286</BillingCode>
            <Name>Anchor (Swift Lock)</Name>
            <Description>Swift Lock Anchor</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>129858</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ287</BillingCode>
            <Name>Anchor (Cinch)</Name>
            <Description>Cinch Anchor</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>129858</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ288</BillingCode>
            <Name>Anchor (Butterfly)</Name>
            <Description>Lead Anchor (Butterfly)</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>129858</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ289</BillingCode>
            <Name>Anchor (long)</Name>
            <Description>Lead Anchor (Long)</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>129858</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ302</BillingCode>
            <Name>Epidural Needle</Name>
            <Description>A tool used to introduce a lead percutaneously.</Description>
            <Size>14-15 Gauge, 4-6 inch</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>133910</ARTG>
                <ARTG>352928</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ304</BillingCode>
            <Name>Introde-AK Lead Introducer</Name>
            <Description>A flexible tool passed over a partially-implanted lead or guide wire in order to establish the appropriate pathway for a lead to follow in the epidural space despite obstructions.</Description>
            <Size>4" and 9"</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>133910</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ305</BillingCode>
            <Name>Tunneling Tool</Name>
            <Description>A tool used to creat a subcutaneous passage to pass the lead from the lead implant site to the IPG pocket site.</Description>
            <Size>12", 20"</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>134305</ARTG>
                <ARTG>353157</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ307</BillingCode>
            <Name>Straight and Curved Stylet</Name>
            <Description>A tool used to aid in positioning and repositioning the lead intra-operatively to ensure accurate placement.</Description>
            <Size>30cm - 90cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>124057</ARTG>
                <ARTG>353082</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ308</BillingCode>
            <Name>Torque Wrench</Name>
            <Description>A tool to set or release the IPG setscrew that connects an implanted lead to the IPG header.</Description>
            <Size>One size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>353637</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ315</BillingCode>
            <Name>Standard Trial Cable Octrode and Quattrode</Name>
            <Description>Connector which connects implanted lead to external stimulator</Description>
            <Size>One size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>133958</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ357</BillingCode>
            <Name>Axium Neurostimulator System - Connector Cable Kit</Name>
            <Description>Connector cable kit.</Description>
            <Size>1 size (1 presentation)</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>197025</ARTG>
                <ARTG>296963</ARTG>
                <ARTG>329119</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ360</BillingCode>
            <Name>Axium Neurostimulator System - Tunneling Tool</Name>
            <Description>Tunneling tool.</Description>
            <Size>30cm or 51cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>197024</ARTG>
                <ARTG>296964</ARTG>
                <ARTG>329360</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ361</BillingCode>
            <Name>Axium Neurostimulator System - Curved Needle</Name>
            <Description>A curved needle (one size 14G,4.5in), a single use accessory, providing access to the epidural space during the surgical procedure of inserting a Neurostimulation System.</Description>
            <Size>One Size - (14G, 4.5in)</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>296962</ARTG>
                <ARTG>338752</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ411</BillingCode>
            <Name>Abbott IPG Pocket Sizer</Name>
            <Description>Implant accessory designed to aid in the creation of a pocket for Abbott implantable neurostimulators</Description>
            <Size>55-58mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>278847</ARTG>
                <ARTG>279015</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ428</BillingCode>
            <Name>Guide Wire for Percutaneous Leads</Name>
            <Description>A tool used to establish and/or access the appropriate pathway in the epidural space before implanting the lead. </Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>196837</ARTG>
                <ARTG>352921</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ469</BillingCode>
            <Name>DRG Tunneling Tool</Name>
            <Description>Tunneling Tool </Description>
            <Size>30cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>329360</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ470</BillingCode>
            <Name>DRG Torque Wrench</Name>
            <Description>A tool to set or release the IPG setscrew that connects an implanted lead to the IPG header.  </Description>
            <Size>One Size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>353637</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ471</BillingCode>
            <Name>Hex Key</Name>
            <Description>Hex Key</Description>
            <Size>One Size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>329360</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ472</BillingCode>
            <Name> Straight Stylet</Name>
            <Description>Straight Stylet</Description>
            <Size>50-90 cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>353082</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ473</BillingCode>
            <Name>DRG guidewire</Name>
            <Description>Guide Wire for Percutaneous Leads</Description>
            <Size>one size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>352921</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ476</BillingCode>
            <Name>DRG Anchor</Name>
            <Description>Lead Anchor</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>329428</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ477</BillingCode>
            <Name>DRG Straight Needle</Name>
            <Description>Straight needle  </Description>
            <Size>4.5 inch  </Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>329428</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY001</BillingCode>
            <Name>Evoke Epidural Needle 6.5"</Name>
            <Description>Epidural needle for the introduction of percutaneous leads.  </Description>
            <Size> 6.5"</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>323172</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY008</BillingCode>
            <Name>Evoke Tunneling Tool  </Name>
            <Description>Surgical tool to aid the implantation of an SCS system.</Description>
            <Size>N/A</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4501</SubGroupID>
            <ARTGs>
                <ARTG>323171</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ283</BillingCode>
            <Name>Epiducer - Lead Delivery System</Name>
            <Description>Lead Delivery System</Description>
            <Size>13cm, 19cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4502</SubGroupID>
            <ARTGs>
                <ARTG>133910</ARTG>
            </ARTGs>
            <MinimumBenefit>658</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ354</BillingCode>
            <Name>Axium Neurostimulator System - 22cm Delivery Sheath Kit - small curve and big curve</Name>
            <Description>22cm delivery sheath kit - small curve and big curve.</Description>
            <Size>2 sizes (2 presentations)  1 x Big Curve -MN23950AU  1 x Small Curve - MN23850AU</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4502</SubGroupID>
            <ARTGs>
                <ARTG>197024</ARTG>
                <ARTG>296964</ARTG>
                <ARTG>329240</ARTG>
                <ARTG>329301</ARTG>
            </ARTGs>
            <MinimumBenefit>658</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ468</BillingCode>
            <Name>DRG Delivery Sheath  </Name>
            <Description>Small and Big Curve</Description>
            <Size>22cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>4502</SubGroupID>
            <ARTGs>
                <ARTG>329240</ARTG>
                <ARTG>329301</ARTG>
            </ARTGs>
            <MinimumBenefit>658</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS248</BillingCode>
            <Name>OR Cable</Name>
            <Description>OR Cable</Description>
            <Size>Lengths up to 65cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>5484</SubGroupID>
            <ARTGs>
                <ARTG>157994</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI049</BillingCode>
            <Name>Medtronic Neurostimulation Screening Cable</Name>
            <Description>Screening Cable</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>5484</SubGroupID>
            <ARTGs>
                <ARTG>119991</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ371</BillingCode>
            <Name>St Jude neurostimulation screening cable</Name>
            <Description>MultiLead screening cable</Description>
            <Size>one size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>5484</SubGroupID>
            <ARTGs>
                <ARTG>133958</ARTG>
                <ARTG>343673</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ372</BillingCode>
            <Name>St Jude neurostimulation trial header connector</Name>
            <Description>Trial System Header Connector</Description>
            <Size>one size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>5484</SubGroupID>
            <ARTGs>
                <ARTG>238692</ARTG>
                <ARTG>342819</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UY002</BillingCode>
            <Name>Evoke Lead Adapter Kit  </Name>
            <Description>Sterile cable to connect the Evoke 12C Lead to an external stimulator. </Description>
            <Size>N/A</Size>
            <SupplierCode>UY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>222</SubCategoryID>
            <GroupID>1690</GroupID>
            <SubGroupID>5484</SubGroupID>
            <ARTGs>
                <ARTG>323488</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC313</BillingCode>
            <Name>Synchro Med II Pump</Name>
            <Description>Model No's 8637-20 &amp; 8637-40, Composition - Titanium</Description>
            <Size>20 ml &amp; 40 ml</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1681</GroupID>
            <Suffix>Variable Flow Rate</Suffix>
            <ARTGs>
                <ARTG>97770</ARTG>
            </ARTGs>
            <MinimumBenefit>14666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC944</BillingCode>
            <Name>8835 Personal Therapy Manager for Synchromed Pumps</Name>
            <Description>Personal Therapy Manager for SynchroMed II implantable infusion pumps</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1682</GroupID>
            <ARTGs>
                <ARTG>151719</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI450</BillingCode>
            <Name>Medtronic myPTM™ Patient Programmer</Name>
            <Description>Patient Programmer for SynchroMed™ II</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1682</GroupID>
            <ARTGs>
                <ARTG>358310</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI027</BillingCode>
            <Name>Medtronic Ascenda Intrathecal Catheter</Name>
            <Description>Intrathecal Catheter</Description>
            <Size>114cm, 140cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1683</GroupID>
            <SubGroupID>4492</SubGroupID>
            <Suffix>Reinforced</Suffix>
            <ARTGs>
                <ARTG>192057</ARTG>
                <ARTG>192058</ARTG>
            </ARTGs>
            <MinimumBenefit>993</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC774</BillingCode>
            <Name>8578 Sutureless Pump Connector</Name>
            <Description>Sutureless Pump Connector: Material radiopaque silicon titanium, nylon</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <SubGroupID>4503</SubGroupID>
            <ARTGs>
                <ARTG>133523</ARTG>
            </ARTGs>
            <MinimumBenefit>542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC817</BillingCode>
            <Name>Medtronic Intrathecal Catheter Revision Kit (Proximal)</Name>
            <Description>Revision kit to repair proximal end of intrathecal catheter (8596SC)</Description>
            <Size>66cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <SubGroupID>4503</SubGroupID>
            <ARTGs>
                <ARTG>153487</ARTG>
            </ARTGs>
            <MinimumBenefit>542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC818</BillingCode>
            <Name>Medtronic Intrathecal Catheter Revision Kit (Distal)</Name>
            <Description>Revision kit to repair distal end of intrathecal catheter (8598A)</Description>
            <Size>38.1cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <SubGroupID>4503</SubGroupID>
            <ARTGs>
                <ARTG>153486</ARTG>
            </ARTGs>
            <MinimumBenefit>542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI029</BillingCode>
            <Name>Medtronic Ascenda Spinal Segment Revision Kit</Name>
            <Description>Intrathecal Catheter Spinal Segment Revision Kit</Description>
            <Size>One Size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <SubGroupID>4503</SubGroupID>
            <ARTGs>
                <ARTG>192043</ARTG>
            </ARTGs>
            <MinimumBenefit>542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI030</BillingCode>
            <Name>Medtronic Ascenda Pump Segment Revision Kit</Name>
            <Description>Intrathecal Catheter Pump Segment Revision Kit</Description>
            <Size>One Size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <SubGroupID>4503</SubGroupID>
            <ARTGs>
                <ARTG>192044</ARTG>
            </ARTGs>
            <MinimumBenefit>542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI040</BillingCode>
            <Name>Medtronic Infusion Pump Accessories</Name>
            <Description>Accessories for refill/catheter access of infusion pumps</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <SubGroupID>5483</SubGroupID>
            <ARTGs>
                <ARTG>133764</ARTG>
            </ARTGs>
            <MinimumBenefit>36</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI164</BillingCode>
            <Name>Medtronic Infusion Pump Refill Kit</Name>
            <Description>Bulk Refill Kit containing 8 refill packs</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <SubGroupID>5483</SubGroupID>
            <ARTGs>
                <ARTG>133764</ARTG>
            </ARTGs>
            <MinimumBenefit>146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI028</BillingCode>
            <Name>Medtronic Ascenda Component Accessory Kits</Name>
            <Description>Accessories for implantable drug pumps&#xD;
&#xD;
The Ascenda Kit consists of single-use aids integral for implanting the Intrathecal Catheter (App 028), which are only suitable for use with the patient in whom the intrathecal catheter is implanted.&#xD;
&#xD;
Kit includes:&#xD;
- Anchor with anchor dispenser&#xD;
- Anchor removal tool&#xD;
- Catheter connector with 2 attached coils.&#xD;
&#xD;
The Ascenda provides better stabilization and reduced catheter dislodgement due to a newly designed anchor and dispensing tool.</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <ARTGs>
                <ARTG>133523</ARTG>
                <ARTG>133763</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI048</BillingCode>
            <Name>Intrathecal catheter accessory</Name>
            <Description>Tunnelling rods - Stainless steel</Description>
            <Size>38-60cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>223</SubCategoryID>
            <GroupID>1684</GroupID>
            <ARTGs>
                <ARTG>121281</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA174</BillingCode>
            <Name>VNS Therapy Pulse/Pulse Duo</Name>
            <Description>Model 102/102R Generator</Description>
            <Size>One size only</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>224</SubCategoryID>
            <GroupID>1685</GroupID>
            <SubGroupID>4493</SubGroupID>
            <ARTGs>
                <ARTG>130202</ARTG>
                <ARTG>130203</ARTG>
                <ARTG>131044</ARTG>
                <ARTG>131045</ARTG>
                <ARTG>131046</ARTG>
                <ARTG>131047</ARTG>
                <ARTG>168817</ARTG>
                <ARTG>169837</ARTG>
                <ARTG>192080</ARTG>
                <ARTG>192081</ARTG>
            </ARTGs>
            <MinimumBenefit>11435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA185</BillingCode>
            <Name>VNS Therapy Demipulse Generator 103</Name>
            <Description>The generator is an implantable multiprogrammable pulse generator that delivers electrical signals to the vagus nerve. The pulse generator is housed in a hermetically sealed titanium case and is powered by a single battery. Electrical signals are transmitted from the pulse generator to the vagus nerve&#xD;
by the lead. The VNS Therapy System is indicated for use as an adjunctive&#xD;
therapy in reducing the frequency of seizures in patients whose epileptic disorder is dominated by partial seizures (with or without secondary generalization) or generalized seizures that are refractory to seizure medications.</Description>
            <Size>Lead Receptacle 0.126 in (3.2 mm)&#xD;
Dimension 1.8 in x 1.3 in x 0.27 in (45 mm x 32 mm x 6.9mm)&#xD;
Weight 0.56 oz (16 g)&#xD;
&#xD;
The 103 is smaller than previous devices, and fits in the palm of your hand and may be used in pediatric patients</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>224</SubCategoryID>
            <GroupID>1685</GroupID>
            <SubGroupID>4493</SubGroupID>
            <ARTGs>
                <ARTG>168817</ARTG>
            </ARTGs>
            <MinimumBenefit>11435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA186</BillingCode>
            <Name>Aspire SR Pulse Generator Model 106</Name>
            <Description>The 106 VNS therapy system is indicated for use as a adjunctive therapy in reducing the frequency of seizures in patients whose epileptic disorder is dominated by partial seizures (with or without secondary generalization) or generalized seizures that are refractory to seizure medications. Model 106 has the added feature of Autostim. In patients who experience Ictal Tachycardia which is defined as an increase in heart rate during a seizure specifically from baseline to a rate greater than 100 BPM and is at least 55% increase or 35 BPM increase from baseline delivering a therapeutic stimulation automatically delivered on detection of a physiological signal indicative of the onset of a seizure.</Description>
            <Size>Lead receptacle -  0.126 in (3.2 mm) nominal&#xD;
Dimensions -2.0 in x 2.0 in x 0.27 in (52 mm x 52 mm x 6.9 mm)&#xD;
Weight- 0.88 oz (25 g)</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>224</SubCategoryID>
            <GroupID>1685</GroupID>
            <SubGroupID>4493</SubGroupID>
            <ARTGs>
                <ARTG>275135</ARTG>
            </ARTGs>
            <MinimumBenefit>11435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA190</BillingCode>
            <Name>LivaNova Demipulse Duo Model 104 Generator for Vagus Nerve Stimulation</Name>
            <Description>The LivaNova Demipulse Duo Model 104 is an implantable, dual pin lead compatible and multiprogrammable pulse generator that delivers electrical signals to the vagus nerve.</Description>
            <Size>one size only</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>224</SubCategoryID>
            <GroupID>1685</GroupID>
            <SubGroupID>4493</SubGroupID>
            <ARTGs>
                <ARTG>169837</ARTG>
            </ARTGs>
            <MinimumBenefit>11435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA175</BillingCode>
            <Name>VNS Therapy Lead</Name>
            <Description>Model 302</Description>
            <Size>One size only</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>224</SubCategoryID>
            <GroupID>1685</GroupID>
            <SubGroupID>5351</SubGroupID>
            <ARTGs>
                <ARTG>131047</ARTG>
            </ARTGs>
            <MinimumBenefit>3069</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA187</BillingCode>
            <Name>VNS Therapy PerenniaFLEX Model 304.2 &amp; 304.3</Name>
            <Description>Model 304 lead is a silicone insulated implantable patient lead, delivering the electrical signal from the Pulse Generator to the Vagus Nerve.</Description>
            <Size>Lead Body &#xD;
Diameter : 2mm (.08 in)&#xD;
Insulation: Silicone&#xD;
Overall Length: 43cm&#xD;
&#xD;
Inner Diameter of Helix&#xD;
Model 304.20 ; 2mm (.08 in) inner diameter&#xD;
Model 304.30 ; 3mm (.12 in) inner diameter</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>224</SubCategoryID>
            <GroupID>1685</GroupID>
            <SubGroupID>5351</SubGroupID>
            <ARTGs>
                <ARTG>192081</ARTG>
            </ARTGs>
            <MinimumBenefit>3069</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA191</BillingCode>
            <Name>LivaNova PerenniaDURA Lead Model 303 for Vagus Nerve Stimulation</Name>
            <Description>The PerenniaDURA Lead Model 303 is a silicone insulated implantable patient lead, delivering the electrical signal from the VNS Generators to the left vagus nerve.</Description>
            <Size>Available in two sizes: Model 303.20 (2.0 millimeter inner diameter of helical coil) and Model 303.30 (3.0 millimeter inner diameter of helical coil).</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>224</SubCategoryID>
            <GroupID>1685</GroupID>
            <SubGroupID>5351</SubGroupID>
            <ARTGs>
                <ARTG>192080</ARTG>
            </ARTGs>
            <MinimumBenefit>3069</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS196</BillingCode>
            <Name>Solitaire</Name>
            <Description>Solitaire Neurovascular Remodelling Device is a self-expanding, fully retrievable device which can be delivered and deployed by a single operator.</Description>
            <Size>Diameter: 3-6mm&#xD;
Length: 15-40mm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1687</GroupID>
            <ARTGs>
                <ARTG>155038</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB012</BillingCode>
            <Name>LVIS Intraluminal Support Device</Name>
            <Description>Self-expanding intracranial vascular stent</Description>
            <Size>Diameters: 2.5, 3.0, 3.5, 4.0, 4.5, 5.5mm  Lengths: 8-67mm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1687</GroupID>
            <ARTGs>
                <ARTG>194409</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW470</BillingCode>
            <Name>Wingspan Stent System</Name>
            <Description>Wingspan Self Expanding Nitonol Stent and delivery catheter</Description>
            <Size>Stent diameters: 2.5mm to 4.5mm; Stent lengths: 9.0mm to 20.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1687</GroupID>
            <ARTGs>
                <ARTG>128926</ARTG>
                <ARTG>130061</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW567</BillingCode>
            <Name>Neuroform ATLAS Stent System</Name>
            <Description>The Neuroform Atlas (Atlas) Stent System is intended to be used for stent assisted embolization for intracranial aneurysm therapy. The purpose of the stent is to retain the occlusive devices within the aneurysm. Occlusive devices can be delivered prior to stent placement or after stent placement. The Atlas Stent System consists of a self-expanding, sterile, nitinol stent preloaded over a delivery wire inside an introducer sheath.  The sheath and delivery wire are used to transfer the stent into a 0.0165 to 0.017 inch internal diameter microcatheter.  After transferring the stent, the sheath is removed from the proximal end of the delivery wire. The delivery wire is then used to advance the stent to the distal end of the microcatheter. The microcatheter and stent system are repositioned as a unit to ensure the stent is located across the aneurysm. The stent is deployed by stabilizing the delivery wire and withdrawing the microcatheter. The Neuroform Atlas stent cannot be repositioned or captured once deployed.</Description>
            <Size>Stent Diameter (mm): 3.0, 4.0, 4.5&#xD;
Stent Length (mm): 15, 21, 24, 30</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1687</GroupID>
            <ARTGs>
                <ARTG>278675</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME209</BillingCode>
            <Name>Leo+</Name>
            <Description>Leo+ Stent</Description>
            <Size>D 2.0mm L 12mm, 18mm, 25mm.&#xD;
D 2.5mm L 12mm, 18mm, 25mm, 30mm, 35mm.&#xD;
D 3.0mm L 12mm, 18mm, 25mm, 35mm &#xD;
D 3.5mm L 12mm, 18mm, 25mm, 30mm, 35mm, 50mm.&#xD;
D 4.5mm L 15mm, 20mm, 25mm, 30mm, 40mm, 50mm, 75mm.&#xD;
D 5.5mm L 25mm, 30mm, 35mm, 50mm, 60mm, 75mm.</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1687</GroupID>
            <ARTGs>
                <ARTG>197947</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN022</BillingCode>
            <Name>ACCLINO Flex Plus Stent</Name>
            <Description>Acclino Flex Plus Stent is a self-expanding lasercut Nitinol stent for aneurysm neck bridging in case of stent assisted coiling procedures. It is intended for use with embolisation materials for the treatment of intracranial aneurysms. It provides an increased range and is suitable for vessel diameters from 1.5 to 6.0 mm. For an easy handling all sizes from 3.0  - 5.5 mm are deliverable through microcatheters with 0.0165 -   0.017  ID. This allows a sequential stent and coil placement without the changing of the microcatheter. The 6.5 mm diameter devices are deliverable through  microcatheters with 0.021   ID.</Description>
            <Size>Diameter: 3.0 - 6.5mm    Length: 15 - 35 mm</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1687</GroupID>
            <ARTGs>
                <ARTG>281032</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN023</BillingCode>
            <Name>ACCERO Stent</Name>
            <Description>ACCERO Stent is a highly visible,braided self-expanding stent with BlueXide® surface technology.The self-expanding braided stent is characterised by an excellent opening behaviour,  superior wall apposition and a very smooth surface. It is intended for use with embolization materials in the treatment of intracranial aneurysms. Accero’s full range of sizes can be delivered through a small 0.0170” microcatheter and can be resheathed up to 95%.    </Description>
            <Size>Stent Diameter (mm): 2.5, 3.0, 3.5,4.0, 4.5           Stent Length (mm): 10, 15, 20, 25</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1687</GroupID>
            <ARTGs>
                <ARTG>321603</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS193</BillingCode>
            <Name>Axium Detachable Coil System</Name>
            <Description>Platinum alloy coils (including coils enlaced with PGLA filaments and Nylon Fibers)  attached to a composite implant delivery pusher with a radiopaque positioning marker.  The proximal end of the pusher is loaded into the Actuator which detaches the coil.</Description>
            <Size>Diameter:  1.5 - 25mm; Length:  1 - 50cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>149398</ARTG>
                <ARTG>162494</ARTG>
                <ARTG>162495</ARTG>
                <ARTG>194132</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB010</BillingCode>
            <Name>Hydrocoils</Name>
            <Description>Framing and filling coils with Hydrogel.</Description>
            <Size>Diam: 1-24mm&#xD;
Length: 1-50cm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>137933</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB011</BillingCode>
            <Name>Microplex Coils</Name>
            <Description>Framing and filling coils</Description>
            <Size>Diam: 1-24mm&#xD;
Length: 1-68cm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>137934</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW467</BillingCode>
            <Name>Target Detachable Coils</Name>
            <Description>Detachable Platinum coils</Description>
            <Size>Coil Diameter: 1mm to 24mm  Coil Length: 1cm to 50cm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>170214</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ960</BillingCode>
            <Name>Galaxy G3</Name>
            <Description>Stretch Resistant Coil</Description>
            <Size>Length 1.5 to 30cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>219194</ARTG>
                <ARTG>219195</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME226</BillingCode>
            <Name>Optima Coil System</Name>
            <Description>Implantable embolization Coil comprised of platinum-tungsten alloy attached to a proximal stainless steel hypo-tube and distal body coil delivery pusher with a radiopaque distal positioning marker and a proximal fluorosafe marker.</Description>
            <Size>Various sizes as attached.</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>302253</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI240</BillingCode>
            <Name>Axium Prime Detachable Coil - Extra Soft</Name>
            <Description>Platinum alloy embolization coil attached to a composite implant delivery pusher with a radiopaque positioning marker and hand-held Instant Detacher, which when activated, mechanically detaches the coil from the delivery pusher tip.</Description>
            <Size>3D Shape: diameter 1 to 3.5 mm;  length 2 to 10 cm; Volume 1.34 to 6.70 mm3&#xD;
Helical Shape: diameter 1 to 3 mm;  length 1 to 10 cm; Volume 0.67  to 6.70 mm3</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>287418</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN137</BillingCode>
            <Name>Ultipaq Microcoil System</Name>
            <Description>Platinum Coil</Description>
            <Size>2 to 4mm loop diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201672</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN139</BillingCode>
            <Name>Helipaq Microcoil System</Name>
            <Description>Platinum Coil</Description>
            <Size>2 to 20mm coil diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201605</ARTG>
                <ARTG>201607</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN140</BillingCode>
            <Name>Micrusframe</Name>
            <Description>Stretch Resistant Coil</Description>
            <Size>2 to 18mm loop diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201612</ARTG>
                <ARTG>201635</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN142</BillingCode>
            <Name>Helipaq Microcoil System</Name>
            <Description>Cerecyte coils</Description>
            <Size>2 to 20mm loop diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>202314</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN143</BillingCode>
            <Name>Ultipaq Microcoil System</Name>
            <Description>Cerecyte coils</Description>
            <Size>2 to 4mm loop diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201674</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN144</BillingCode>
            <Name>Micrusphere Microcoil System</Name>
            <Description>Cerecyte coils</Description>
            <Size>2 to 18mm loop diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201606</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN145</BillingCode>
            <Name>Presidio Microcoil System</Name>
            <Description>Cerecyte coils</Description>
            <Size>4 to 20mm loop diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201922</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN146</BillingCode>
            <Name>Cashmere Microcoil System</Name>
            <Description>Platinum and Cerecyte coils</Description>
            <Size>2 to 12mm loop diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201636</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN165</BillingCode>
            <Name>Delta Coiling Systems</Name>
            <Description>Stretch Resistant Coiling</Description>
            <Size>1.5 to 24mm diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>201609</ARTG>
                <ARTG>201610</ARTG>
                <ARTG>203283</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN003</BillingCode>
            <Name>Penumbra Coil System / Penumbra Complex Standard Coil 400</Name>
            <Description>Frame configuration coil, three-dimensional complex shape, stiffest coil within the system, first coil to be placed, frames area of embolisation and holds subsequent coils within this zone.</Description>
            <Size>Diameters: 3-24mm&#xD;
Lengths: 6-57cm</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>182354</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN004</BillingCode>
            <Name>Penumbra Coil System / Penumbra Complex Soft Coil 400</Name>
            <Description>Fill configuration coil is used to fill empty space within the frame coil. The stiffness allows for a traumatic interaction with the aneurysm wall and primary packing of the occlusion site (aneurysm).</Description>
            <Size>Diameters: 3-24mm&#xD;
Lengths: 6-57cm</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>182354</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN005</BillingCode>
            <Name>Penumbra Coil System / Penumbra J Soft Coil 400</Name>
            <Description>Finish Coil Implant (J Soft) fills small empty pockets remaining within the occlusion site. The J shaped tip and stiffness allows the coils to manoeuvre and fill the remaining pockets after use of the primary Fill Coils.</Description>
            <Size>Lengths: 1-15cm</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>182354</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN006</BillingCode>
            <Name>Penumbra Coil System / Penumbra Curve Extra Soft 400</Name>
            <Description>The Soft Finish Coil Implant (Curve Extra Soft) is used for final packing of the aneurysm. The serpentine shape and the lowest stiffness allow the coils to manoeuvre and fill any remaining pockets after use of the other coil types.</Description>
            <Size>Diameters: 2-4mm&#xD;
Lengths: 1-20cm</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>182354</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN009</BillingCode>
            <Name>Penumbra Complex Extra Soft Coil 400</Name>
            <Description>The Soft Finish Coil Implants (Complex Extra Soft) are used for final packing of the aneurysm. The coil combines the shape of the complex standard coil, with the lowest stiffness of the Curve Extra Soft coil. The Soft Finish Coil Implants are available in varying diameters and lengths to accommodate physician need.</Description>
            <Size>Secondary diameters: 2-4mm; Lengths: 2-10mm</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>182354</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN014</BillingCode>
            <Name>Penumbra Smart Coil</Name>
            <Description>The Penumbra Smart Coil System is comprised of the The Penumbra Smart Coil, a platinum embolization coil attached to a composite delivery pusher with a radiopaque positioning marker and the Penumbra Smart Coil Detachment Handle.</Description>
            <Size>Standard: Diameter 3-18mm, Length 3-60cm;&#xD;
Soft: Diameter 1-14mm, Length 2-45cm;&#xD;
Extra Soft: Diameter 1-6mm, Length 1-20cm;&#xD;
Helical Extra Soft: Diameter 1-6mm, Length 1-20cm.</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1688</GroupID>
            <ARTGs>
                <ARTG>242752</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS201</BillingCode>
            <Name>Marksman Microcatheters</Name>
            <Description>The MARKSMAN Microcatheter is a variable stiffness, single lumen catheter designed to access small, tortuous vascular areas.  The outer surface of the catheter's distal segment is coated with a hydrophilic material to provide lubricity during use. The catheter also incorporates a PTFE liner to facilitate movement of delivery devices passed through its lumen and has a radiopaque marker at the distal tip to facilitate fluoroscopic visualization. The distal tip of the catheter is shapeable.</Description>
            <Size>Outer Diameter: 2.8F  Inner Diameter: 0.027"  Length: 105-160 cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>193795</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS202</BillingCode>
            <Name>Apollo Micro Catheters</Name>
            <Description>For the delivery of therapeutic agents (e.g. embolisation coils and liquid embolics); and diagnostic agents such as contrast media.</Description>
            <Size>Proximal outer  diameter 2.7F; distal outer diameter 1.5F; inner diameter 0.013 inch; total length 165 cm; tip length 1.5, 3 or 5 cm.</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>215658</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS208</BillingCode>
            <Name>Navien Intracranial Catheter</Name>
            <Description>The Navien Intracranial Support Catheter is a single lumen, flexible, variable stiffness composite catheter. The catheter shaft has a hydrophilic coating to reduce friction during use. The Navien Intracranial Support Catheter is visible under fluoroscopy.</Description>
            <Size>105 - 130cm length; 5.0 - 6.3 Fr gauge</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>218532</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB014</BillingCode>
            <Name>Headway Microcatheter</Name>
            <Description>Single lumen microcatheter</Description>
            <Size>Internal diameter: 0.42mm - 0.69mm&#xD;
Outside diameter - distal: 1.6 - 2.6 Fr&#xD;
Outside diameter - proximal 2.1 -3.1 Fr&#xD;
Length: 150cm to 167cm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>162633</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB021</BillingCode>
            <Name>Headway Duo</Name>
            <Description>Single Lumen Microcatheter</Description>
            <Size>Proximal&#xD;
ID = .0165in min. (0.42 mm)&#xD;
OD =  .027in (0.70 mm)&#xD;
Distal&#xD;
ID = .0165in min. (0.42 mm)&#xD;
OD = .023in (0.58 mm)&#xD;
&#xD;
Length: 156cm and 167cm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>296334</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB022</BillingCode>
            <Name>Chaperon Guiding Catheter System</Name>
            <Description>Guiding Catheter</Description>
            <Size>Guiding Catheter:	5Fr - 0.059”/1.5mm ID &amp; 6Fr - 0.071"/1.8mm ID&#xD;
Inner Catheter:	4Fr - 0.041”/1.05mm ID &amp; 5Fr - 0.048"/1.22mm ID</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>162770</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW468</BillingCode>
            <Name>Neuro Renegade Hi-Flo Microcatheter</Name>
            <Description>Microcatheter for deployment of neuroform stent system</Description>
            <Size>2.5-4.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>171934</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW488</BillingCode>
            <Name>Excelsior SL-10 &amp; Excelsior 1018</Name>
            <Description>Excelsior SL-10 &amp; the Excelsior 1018 Microcatheter is indicated to assist in the delivery of diagnostic agents, such as contrast media, and therapeutic agents, such as occlusion coils, into the peripheral, coronary and neurovasculature.</Description>
            <Size>Length: 150cm  Outer Diameter: 2.4F - 2.6F  Inner Diameter: 0.165" - 0.019"</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>147430</ARTG>
                <ARTG>149440</ARTG>
                <ARTG>174576</ARTG>
                <ARTG>177031</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW530</BillingCode>
            <Name>Excelsior XT27</Name>
            <Description>Stryker Neurovascular Excelsior XT-27 Microcatheter is intended to assist in the delivery of diagnostic agents, such as contrast media, therapeutic agents and interventional devices, into the neurovasculature</Description>
            <Size>Length: 150cm / 135cm&#xD;
Distal Lengths: 6cm / 18cm&#xD;
Outer Diameter: 2.7F - 2.9F&#xD;
Inner Diameter: 0.027"</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>202911</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW585</BillingCode>
            <Name>Excelsior XT-17 Microcatheter</Name>
            <Description>Excelsior XT-17 Microcatheter - single lumen devices</Description>
            <Size>Outer Diameter: 2.4F (Proximal) &amp; 1.7F (Distal)&#xD;
Inner Diameter: 0.017 inches&#xD;
Length: 150cm&#xD;
Shapes: Straight 45, 90 &amp; J</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>285509</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW635</BillingCode>
            <Name>AXS Infinity LS Long Sheath</Name>
            <Description>AXS Infinity LS Long Sheath</Description>
            <Size>Outer Diameter: 8F (max 0.109 inches)&#xD;
Inner Diameter: 0.088 inches&#xD;
Length: 70cm, 80cm, 90cm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>291432</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ488</BillingCode>
            <Name>Prowler Infusion Catheters</Name>
            <Description>Braid/coil catheter</Description>
            <Size>Size:  50cm - 170cm.</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>138704</ARTG>
                <ARTG>138705</ARTG>
                <ARTG>138706</ARTG>
                <ARTG>138708</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME212</BillingCode>
            <Name>VASCO+</Name>
            <Description>A progressive step braided micro-catheter with radio-opaque markers on the distal tip used to assist in the treatment of aneurysms and other neurological disorders.</Description>
            <Size>Distal outer Diameter: 1.5 - 5F&#xD;
Proximal Outer Diameter: 2.4F - 5F&#xD;
Length: 135 - 155mm</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>155391</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME213</BillingCode>
            <Name>Fargo</Name>
            <Description>Guiding Catheters</Description>
            <Size>Outer Ø Proximal . 4.2F - 6.0F&#xD;
Outer Ø Distal : 3.9F - 6.0F&#xD;
Inner Ø: 1.02mm (.040") - 1.78mm (.070")&#xD;
Total Length: 95cm - 135cm&#xD;
Distall tip Length: 2.5cm -15cm</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>161937</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI198</BillingCode>
            <Name>Rebar microcatheter (Rebar-10; Rebar-14; Rebar-18; Rebar-27)</Name>
            <Description>For the delivery of therapeutic agents (e.g. embolisation coils and liquid embolics) and diagnostic agents such as contrast media.</Description>
            <Size>Proximal OD/Distal OD (F): 2.3, 2.4, 2.8/1.7, 1.9, 2.7, 2.8; distal ID (in) 0.015, 0.017, 0.021, 0.027; total length (cm): 158, 135, 115.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>274593</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI207</BillingCode>
            <Name>Marathon Flow Directed Micro Catheter (with or without stylet)</Name>
            <Description>For the delivery of therapeutic agents (e.g. embolisation coils and liquid embolics) and diagnostic agents such as contrast media.</Description>
            <Size>OD 2.7-1.5 Fr; Distal ID 0.013 in; total length 170 cm; usable &#xD;
Length 165 cm; distal length 25 cm; max. guidewire 0.010 in.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>274595</ARTG>
                <ARTG>274596</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI211</BillingCode>
            <Name>Echelon Microcatheter (Echelon-10; Echelon-14)</Name>
            <Description>For the delivery of therapeutic agents (e.g. embolisation coils and liquid embolics) and diagnostic agents such as contrast media</Description>
            <Size>Tip configuration: straight; 450, 900; tip length: 3 mm, 5 mm; total length/usable length: 155 cm/150 cm; proximal OD/distal OD: 2.1F/1.7F; proximal ID/distal ID: 0.017”/0.017”</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>274594</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN136</BillingCode>
            <Name>Envoy Guiding Catheters</Name>
            <Description>Guiding Catheters</Description>
            <Size>90 to 105cm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>141866</ARTG>
                <ARTG>204770</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN166</BillingCode>
            <Name>Transit Microcatheter System</Name>
            <Description>Transit and Rapidtransit Microcatheters</Description>
            <Size>75 to 175cm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>162995</ARTG>
                <ARTG>162996</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN013</BillingCode>
            <Name>Penumbra Neuron Max Intracranial Access System</Name>
            <Description>The Neuron MAX System is a three-component system comprised of the Neuron MAX Delivery Catheter, Neuron 6F Select Catheter, and a Dilator. The Neuron MAX Delivery Catheter can be used individually with a 0.038in guidewire or together with the Neuron 6F Select Catheter to access the desired anatomy. Neuron MAX Delivery Catheter: The Neuron MAX Delivery Catheter is a single lumen, braid-reinforced, variable stiffness catheter with a radiopaque zone on the distal end and a Luerhub on the proximal end. The Neuron MAX Delivery Catheter dimensions are included on the individual device label. The Neuron MAX Delivery Catheter is compatible with introducer sheaths appropriately sized for the outer diameter of Neuron MAX.</Description>
            <Size>Delivery Catheter: Length 80 &amp; 90cm, Outer Diameter Proximal 8F, Distal 8F.&#xD;
Select Catheter: Length 105 &amp; 125cm, Outer Diameter 5.6F, Proximal 6F, Distal 5F.&#xD;
Long Sheath: Length 80 &amp; 90cm, Outer Diameter Proximal 8F, Distal 8F.</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>202250</ARTG>
                <ARTG>202251</ARTG>
                <ARTG>216374</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN018</BillingCode>
            <Name>Penumbra Lantern Delivery Microcatheter</Name>
            <Description>Delivery Microcatheter</Description>
            <Size>115cm, 135cm, 150cm length &#xD;
Tip - Straight, 45 degree and 90 degree</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>290962</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN019</BillingCode>
            <Name>Benchmark</Name>
            <Description>The Benchmark Delivery Catheter is a guide catheter used to support other diagnostic or therapeutic devices.</Description>
            <Size>95cm &amp; 105cm Straight &amp; Multi Purpose</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4494</SubGroupID>
            <ARTGs>
                <ARTG>292315</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS197</BillingCode>
            <Name>LRS Actuator</Name>
            <Description>LRS Actuator is a sterile, hand held mechanical unit with a thumb slide that detaches the coil. When the slider is retracted while the pusher is loaded, it releases the coil into the targeted vaculature. Coils cannot be deployed without the use of the actuator.</Description>
            <Size>Length 5.75", Diameter 1", Weight 28 grams</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4495</SubGroupID>
            <ARTGs>
                <ARTG>150013</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB015</BillingCode>
            <Name>V-Grip Detachment Controller</Name>
            <Description>A battery powered device used to control detachment of an implantable embolisation coil from a delivery pusher.</Description>
            <Size>One size only</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4495</SubGroupID>
            <ARTGs>
                <ARTG>148674</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW466</BillingCode>
            <Name>InZone Detachment System</Name>
            <Description>InZone Detachment System is specifically designed for use with the Target Detachable Coils</Description>
            <Size>One size</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4495</SubGroupID>
            <ARTGs>
                <ARTG>208838</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME227</BillingCode>
            <Name>Optima XCEL Detachment Controller</Name>
            <Description>The EXCEL Detachment Controller is used to detach the Pusher from the Coil after the coil is deployed, it is compatible with all Optima Coil configurations and is used to detach all coils needed for a single patient.</Description>
            <Size>one size</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4495</SubGroupID>
            <ARTGs>
                <ARTG>312282</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN168</BillingCode>
            <Name>EnPOWER Detachment Control System</Name>
            <Description>Sterile Field Coil Detachment Control</Description>
            <Size>Single unit</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4495</SubGroupID>
            <ARTGs>
                <ARTG>132921</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN008</BillingCode>
            <Name>Penumbra Coil System / Penumbra Coil Detachment Handle</Name>
            <Description>A single detachment handle which is compatible with all Penumbra Coil configurations and can be used to detach all coils needed for a single patient.</Description>
            <Size>One size only</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4495</SubGroupID>
            <ARTGs>
                <ARTG>193558</ARTG>
            </ARTGs>
            <MinimumBenefit>262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN015</BillingCode>
            <Name>Penumbra Smart Coil Detachment Handle</Name>
            <Description>The Penumbra Smart Coil System is comprised of the Penumbra Smart Coil and the Penumbra Smart Coil Detachment Handle. The SMART Coil Detachment Handle is a plastic handle used to mechanically detach the Penumbra SMART Coil Implant. The Detachment Handle is a sterile, single patient device</Description>
            <Size>One size only</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>4495</SubGroupID>
            <ARTGs>
                <ARTG>233479</ARTG>
            </ARTGs>
            <MinimumBenefit>232</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS198</BillingCode>
            <Name>ev3 Occlusion Balloon Catheters</Name>
            <Description>Single lumen balloon catheter to temporarily occlude the central lumen allowing inflation of the balloon during neurosurgical and vascular procedures.</Description>
            <Size>3-7mm diameter; 7-30mm length</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>6022</SubGroupID>
            <ARTGs>
                <ARTG>152746</ARTG>
            </ARTGs>
            <MinimumBenefit>1501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB013</BillingCode>
            <Name>Scepter Occlusion Balloon Catheter</Name>
            <Description>Intravascular occlusion balloon catheter</Description>
            <Size>Balloon diameter: 4mm&#xD;
Balloon lengths: 10 - 20mm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>6022</SubGroupID>
            <ARTGs>
                <ARTG>194400</ARTG>
            </ARTGs>
            <MinimumBenefit>1501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW558</BillingCode>
            <Name>TransForm Occlusion Balloon Catheters</Name>
            <Description>The TransForm Occlusion Balloon Catheter consists of a single lumen catheter shaft with a balloon attached at the distal end. The balloon is available in a compliant version and a super compliant version. Radiopaque markers are located at the proximal and distal ends of the balloon to facilitate fluoroscopic visualization. The balloon catheter is recommended for use with a Stryker Neurovascular 0.014 in (0.36 mm) guidewire to seal the distal segment of the catheter lumen allowing inflation of the balloon. The guidewire can be moved distally or proximally once beyond the distal tip (seal portion) of the catheter and still maintain a positive seal for inflating the balloon. The distal outer segment of the catheter shaft is coated with a hydrophilic material that reduces friction during manipulation in the vessel. A luer fitting hub at the proximal end of the catheter is used for the attachment of accessories.</Description>
            <Size>Effective Length: 150 cm  Balloon Outer Diameter: 3 mm - 7 mm  Balloon Nominal Length: 5 mm - 30 mm  Maximum Catheter Shaft Outer Diameter: 2.8 F</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>6022</SubGroupID>
            <ARTGs>
                <ARTG>223661</ARTG>
            </ARTGs>
            <MinimumBenefit>1501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME215</BillingCode>
            <Name>Copernic RC</Name>
            <Description>Venous remodelling balloon</Description>
            <Size>Diameter:  8.0 - 10mm&#xD;
Balloon Length:  80mm&#xD;
Catheter Length:  160mm</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>225</SubCategoryID>
            <GroupID>1689</GroupID>
            <SubGroupID>6022</SubGroupID>
            <ARTGs>
                <ARTG>170159</ARTG>
            </ARTGs>
            <MinimumBenefit>1501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT086</BillingCode>
            <Name>NEUROVENT-P catheter</Name>
            <Description>RAUMEDIC NEUROVENT-P catheter for the continuous measurement of ICP (intracranial pressure) within the parenchyma.</Description>
            <Size>5F</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>253</SubCategoryID>
            <GroupID>1794</GroupID>
            <Suffix>Catheter</Suffix>
            <ARTGs>
                <ARTG>282695</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG181</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ906</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MicroSensor Monitoring System</Name>
            <Description>Ventricular catheter with transducer</Description>
            <Size>Catheter length 38cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>253</SubCategoryID>
            <GroupID>1794</GroupID>
            <Suffix>Catheter</Suffix>
            <ARTGs>
                <ARTG>150087</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM449</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK101</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Intracranial Pressure and Temperature Catheter</Name>
            <Description>Intracranial Pressure and Temperature Catheter</Description>
            <Size>Suitable for all patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>253</SubCategoryID>
            <GroupID>1794</GroupID>
            <Suffix>Catheter</Suffix>
            <ARTGs>
                <ARTG>308492</ARTG>
                <ARTG>308491</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG189</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MN158</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MicroSensor Monitoring System</Name>
            <Description>Skull bolt with ICP transducer</Description>
            <Size>0.7mm sensor lead diameter</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>253</SubCategoryID>
            <GroupID>1794</GroupID>
            <Suffix>Skull Bolt</Suffix>
            <ARTGs>
                <ARTG>149558</ARTG>
            </ARTGs>
            <MinimumBenefit>948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG183</BillingCode>
            <Name>Codman Bactiseal External Ventricular Drain (EVD) Catheter</Name>
            <Description>Antibiotic impregated External Ventricular Drain</Description>
            <Size>1.5mm &amp; 1.9mm lumen diameter</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>255</SubCategoryID>
            <GroupID>1796</GroupID>
            <Suffix>Antibiotics</Suffix>
            <ARTGs>
                <ARTG>343680</ARTG>
                <ARTG>343681</ARTG>
            </ARTGs>
            <MinimumBenefit>424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG182</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ907</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Codman External Ventricular Drain (EVD) Catheter</Name>
            <Description>External Ventricular Drain</Description>
            <Size>1.5mm &amp; 1.9mm diameter</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>255</SubCategoryID>
            <GroupID>1796</GroupID>
            <ARTGs>
                <ARTG>123031</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI123</BillingCode>
            <Name>EDM Ventricular Catheter</Name>
            <Description>External drainage ventricular catheter, non metallic latex free. Barium impregnated, includes stainless steel stylet.</Description>
            <Size>35cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>255</SubCategoryID>
            <GroupID>1796</GroupID>
            <ARTGs>
                <ARTG>141103</ARTG>
            </ARTGs>
            <MinimumBenefit>167</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM050</BillingCode>
            <Name>Urinary Control System Pump</Name>
            <Description>Pump with InhiboZone Antibiotic Surface Treatment</Description>
            <Size>One size only.</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5306</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>165326</ARTG>
            </ARTGs>
            <MinimumBenefit>5076</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO008</BillingCode>
            <Name>Conti Artificial Urinary Sphincter Control Pump (HydroShield coated)</Name>
            <Description>Conti Artificial Urinary Sphincter Control Pump with HydroShield Hydrophilic coating for Conti Artificial Urinary Sphincter</Description>
            <Size>Two models.</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5306</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>338270</ARTG>
            </ARTGs>
            <MinimumBenefit>5076</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM029</BillingCode>
            <Name>AMS 800 Artificial Urinary Sphincter Pump</Name>
            <Description>Control Pump</Description>
            <Size>One size</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5306</SubGroupID>
            <ARTGs>
                <ARTG>131706</ARTG>
            </ARTGs>
            <MinimumBenefit>4700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET085</BillingCode>
            <Name>VICTO Adjustable Artificial Sphincter Pump Replacement Kit</Name>
            <Description>A replacement control pump for the VICTO Adjustable Artificial Sphincter, artificial urinary sphincter.</Description>
            <Size>1 size.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5306</SubGroupID>
            <ARTGs>
                <ARTG>203685</ARTG>
            </ARTGs>
            <MinimumBenefit>4700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM051</BillingCode>
            <Name>AMS 800 Urinary Control System with InhibiZone - cuff</Name>
            <Description>Occlusive Cuff with InhibiZone Antibiotic Surface Treatment</Description>
            <Size>13 Cuff sizes from 3.5 to 11.0 cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5307</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>165326</ARTG>
            </ARTGs>
            <MinimumBenefit>2708</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO003</BillingCode>
            <Name>Conti Artificial Urinary Sphincter Occlusive Cuff (HydroShield coated)</Name>
            <Description>Conti Artificial Urinary Sphincter Occlusive Cuff with HydroShield Hydrophilic coating for Conti Artificial Urinary Sphincter</Description>
            <Size>3.5, 3.75, 4.0, 4.25, 4.5, 4.75. 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5, 10, 11, 12, 13cm.</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5307</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>338270</ARTG>
            </ARTGs>
            <MinimumBenefit>2708</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM001</BillingCode>
            <Name>AMS 800 Artificial Urinary Sphincter Cuff</Name>
            <Description>Occlusive Cuff</Description>
            <Size>13 Cuff sizes from 3.5 to 11.0 cm: Size: 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 9, 10, 11cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5307</SubGroupID>
            <ARTGs>
                <ARTG>131706</ARTG>
            </ARTGs>
            <MinimumBenefit>2483</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM021</BillingCode>
            <Name>AMS 800 Artificial Urinary Sphincter Cuff</Name>
            <Description>Silicone cuff for artificial urinary sphincter. For the implantation of the second cuff for the AMS 800</Description>
            <Size>13 Cuff sizes from 3.5 to 11.0 cm: Size: 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 9, 10, 11cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5307</SubGroupID>
            <ARTGs>
                <ARTG>131706</ARTG>
            </ARTGs>
            <MinimumBenefit>2483</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET087</BillingCode>
            <Name>VICTO Adjustable Artificial Sphincter Cuff Replacement Kit</Name>
            <Description>A replacement cuff for a VICTO Adjustable Artificial Sphincter, artificial urinary sphincter.</Description>
            <Size>3.7cm, 4.0cm, 4.5cm, and 5.0cm.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5307</SubGroupID>
            <ARTGs>
                <ARTG>203685</ARTG>
            </ARTGs>
            <MinimumBenefit>2483</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM028</BillingCode>
            <Name>AMS 800 Artificial urinary sphincter Pressure Regulating Balloon</Name>
            <Description>Pressure Regulating Balloon</Description>
            <Size>51 - 60cm, 61 -70cm, 71 - 80cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5308</SubGroupID>
            <ARTGs>
                <ARTG>131706</ARTG>
            </ARTGs>
            <MinimumBenefit>1954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET086</BillingCode>
            <Name>VICTO Adjustable Artificial Sphincter Balloon Replacement Kit</Name>
            <Description>A replacement pressure regulating balloon for the VICTO Adjustable Artificial Sphincter, artificial urinary sphincter.</Description>
            <Size>1 size.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5308</SubGroupID>
            <ARTGs>
                <ARTG>203685</ARTG>
            </ARTGs>
            <MinimumBenefit>1954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO009</BillingCode>
            <Name>Conti Artificial Urinary Sphincter Pressure Regulating Balloon (HydroShield coated) </Name>
            <Description>Conti Artificial Urinary Sphincter Pressure Regulating Balloon with HydroShield Hydrophilic coating for Conti Artificial Urinary Sphincter</Description>
            <Size>40-49cm, 50-59cm, 60-69cm, 70-79cm, 80-89cm.</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5308</SubGroupID>
            <ARTGs>
                <ARTG>338270</ARTG>
            </ARTGs>
            <MinimumBenefit>1954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM030</BillingCode>
            <Name>AMS 800 Artificial Urinary Sphincter Accessory Kit</Name>
            <Description>Accessory Kit</Description>
            <Size>One Size</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5310</SubGroupID>
            <ARTGs>
                <ARTG>131706</ARTG>
            </ARTGs>
            <MinimumBenefit>655</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO010</BillingCode>
            <Name>Conti Artificial Urinary Sphincter Accessory Kit</Name>
            <Description>Accessory Kit for Conti Artificial Urinary Sphincters with HydroShield coated connectors</Description>
            <Size>One size</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5310</SubGroupID>
            <ARTGs>
                <ARTG>338270</ARTG>
            </ARTGs>
            <MinimumBenefit>655</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET057</BillingCode>
            <Name>VICTO Artificial Urinary Sphincter</Name>
            <Description>VICTO Artificial Urinary Sphincter with conditional occlusion, inflatable hydraulic device.</Description>
            <Size>Four cuff sizes: 3.7cm, 4.0cm, 4.5cm, and 5.0cm.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5311</SubGroupID>
            <ARTGs>
                <ARTG>203685</ARTG>
            </ARTGs>
            <MinimumBenefit>9500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET084</BillingCode>
            <Name>ATOMS with Integrated Scrotal Port</Name>
            <Description>The ATOMS with Integrated Scrotal Port is a long-term hydraulically adjustable substitute urinary sphincter. The implant is supplied as a single piece system which includes a hydraulically adjusted urethral cuff and a silicone coated adjustment port which rests in the patient's scrotum. The pressure applied by the cuff is evenly distributed over the bulbar urethra, providing ventral closure in order to achieve continence. The adjustment port is designed to allow for non-surgical postoperative adjustment of cuff pressure.</Description>
            <Size>1 size only  Width of tape: 12mm  Dimensions of cushion: 40 x 45mm  Port Diameter: 11mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1696</GroupID>
            <SubGroupID>5311</SubGroupID>
            <ARTGs>
                <ARTG>154803</ARTG>
            </ARTGs>
            <MinimumBenefit>9500</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB003</BillingCode>
            <Name>Adjustable Continence Therapy for Women</Name>
            <Description>ACT Device: Prosthesis designed for the treatment of female SUI comprising of a single silicone balloon attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description>
            <Size>6 - 14cm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1786</GroupID>
            <SubGroupID>5450</SubGroupID>
            <ARTGs>
                <ARTG>163939</ARTG>
            </ARTGs>
            <MinimumBenefit>3938</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB006</BillingCode>
            <Name>Adjustable Continence Therapy for Men</Name>
            <Description>ProACT Device: Prosthesis designed for the treatment of male SUI comprising of a single silicone balloon attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description>
            <Size>6 - 14cm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1786</GroupID>
            <SubGroupID>5450</SubGroupID>
            <ARTGs>
                <ARTG>163939</ARTG>
            </ARTGs>
            <MinimumBenefit>3938</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET074</BillingCode>
            <Name>ATOMS System</Name>
            <Description>The ATOMS System is a long term, adjustable prostheses that substitutes urinary sphincter function in incontinent males. It is a hydraulic system comprising of a suburethral sphincter cushion/cuff which can be adjusted hydraulically intra-operatively or post-operatively through an implanted titanium port. Fixation arms and attachment sutures hold the implant in situ.</Description>
            <Size>1 size only - ATS 5011 (Length of Implant 560mm, width of tape 12mm, dimensions of cushion 40x45mm, max. filling volume of cushion 25mL). Titanium port-reservoir with hydraulic tubing, one size.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1786</GroupID>
            <SubGroupID>5451</SubGroupID>
            <ARTGs>
                <ARTG>154803</ARTG>
            </ARTGs>
            <MinimumBenefit>7876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB004</BillingCode>
            <Name>Adjustable Continence Therapy device for women</Name>
            <Description>ACT Device: prosthesis designed for the treatment of female SUI comprising of silicone balloons x 2 attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description>
            <Size>6 - 14cm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1786</GroupID>
            <SubGroupID>5451</SubGroupID>
            <ARTGs>
                <ARTG>163939</ARTG>
            </ARTGs>
            <MinimumBenefit>7876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB005</BillingCode>
            <Name>Adjustable Continence Therapy for Men</Name>
            <Description>ProACT Device: prosthesis designed for the treatment of male SUI comprising of silicone balloons x2 attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description>
            <Size>6 - 14cm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1786</GroupID>
            <SubGroupID>5451</SubGroupID>
            <ARTGs>
                <ARTG>163939</ARTG>
            </ARTGs>
            <MinimumBenefit>7876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET075</BillingCode>
            <Name>AMI ATOMS Infusion Port</Name>
            <Description>Hydraulic Infusion port for use with AMI ATOMS System - seperate</Description>
            <Size>22mm Diameter, 9.8mm High</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1786</GroupID>
            <SubGroupID>5987</SubGroupID>
            <ARTGs>
                <ARTG>148776</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM048</BillingCode>
            <Name>AdVance XP Male Sling System</Name>
            <Description>Sub-urethral sling implant for treatment of male stress urinary incontinence. Made from polypropylene monofilament mesh</Description>
            <Size>Arm width: 1.2cm, Centre width: 3.55cm, Total Length: 35.5cm, 43.5cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5314</SubGroupID>
            <ARTGs>
                <ARTG>388078</ARTG>
                <ARTG>388082</ARTG>
            </ARTGs>
            <MinimumBenefit>5432</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET050</BillingCode>
            <Name>ARGUS</Name>
            <Description>Adjustable Male Sling made of silicone adjustable self fixating columns and urethral cushion</Description>
            <Size>One size only</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5314</SubGroupID>
            <ARTGs>
                <ARTG>118082</ARTG>
            </ARTGs>
            <MinimumBenefit>5432</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS402</BillingCode>
            <Name>Advantage </Name>
            <Description>Transvaginal Mid-Urethral Sling System with Blue Prolene Polypropylene Mesh</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5315</SubGroupID>
            <ARTGs>
                <ARTG>373424</ARTG>
            </ARTGs>
            <MinimumBenefit>822</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS403</BillingCode>
            <Name>Obtryx II </Name>
            <Description>Transobturator Mid-Urethral Sling System with Blue Prolene Polypropylene Mesh</Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5315</SubGroupID>
            <ARTGs>
                <ARTG>373426</ARTG>
            </ARTGs>
            <MinimumBenefit>822</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS404</BillingCode>
            <Name>Advantage Fit</Name>
            <Description>Transvaginal Mid-Urethral Sling System with Blue Prolene Polypropylene Mesh    </Description>
            <Size>One size only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5315</SubGroupID>
            <ARTGs>
                <ARTG>373425</ARTG>
            </ARTGs>
            <MinimumBenefit>822</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ070</BillingCode>
            <Name>GYNECARE TVT™: Device Tension Free Vaginal Tape / EXACT™ Continence System</Name>
            <Description>Female stress urinary incontinence surgical mesh</Description>
            <Size>Tape - 133 mm (W) x 190 mm (H); EXACT™ - Flat:460 mm (W) x 546 mm (H)</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5315</SubGroupID>
            <ARTGs>
                <ARTG>351636</ARTG>
                <ARTG>351635</ARTG>
            </ARTGs>
            <MinimumBenefit>822</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ442</BillingCode>
            <Name>GYNECARE TVT™ Obturator System</Name>
            <Description>Female stress urinary incontinence surgical mesh</Description>
            <Size>461.86 mm X 548.96 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5315</SubGroupID>
            <ARTGs>
                <ARTG>351637</ARTG>
            </ARTGs>
            <MinimumBenefit>822</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN039</BillingCode>
            <Name>GYNECARE TVT™ ABBREVO™ Continence System</Name>
            <Description>Female stress urinary incontinence surgical mesh</Description>
            <Size>459.91 mm X 545.9 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1698</GroupID>
            <SubGroupID>5315</SubGroupID>
            <ARTGs>
                <ARTG>351638</ARTG>
            </ARTGs>
            <MinimumBenefit>822</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GN001</BillingCode>
            <Name>Opsys Injectable SUI</Name>
            <Description>Opsys is a manually injectable, non-absorbable, permanent, synthetic tissue bulking agent used in the endoscopic treatment of female Stress Urinary Incontinence.</Description>
            <Size>Opsys Kit contains 5 x 1ml syringes.</Size>
            <SupplierCode>GN</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1699</GroupID>
            <SubGroupID>5316</SubGroupID>
            <ARTGs>
                <ARTG>169958</ARTG>
            </ARTGs>
            <MinimumBenefit>504</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GN002</BillingCode>
            <Name>Opsys Injectable SUI</Name>
            <Description>Opsys is a manually injectable, non-absorbable, permanent, synthetic tissue bulking agent used in the endoscopic treatment of female Stress Urinary Incontinence.</Description>
            <Size>1 x 1ml syringe.</Size>
            <SupplierCode>GN</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1699</GroupID>
            <SubGroupID>5316</SubGroupID>
            <ARTGs>
                <ARTG>169958</ARTG>
            </ARTGs>
            <MinimumBenefit>504</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SC001</BillingCode>
            <Name>BULKAMID Urethral Bulking System</Name>
            <Description>Transparent polyacrylamide gel for female urinary incontinence. Kit comprises 2 syringe, 2 needles, 1 applicator</Description>
            <Size>2 x 1ml syringes, 2 x BULKAMID 23G needles, 1 x disposable sheath</Size>
            <SupplierCode>SC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1699</GroupID>
            <SubGroupID>5318</SubGroupID>
            <ARTGs>
                <ARTG>152085</ARTG>
            </ARTGs>
            <MinimumBenefit>1009</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET053</BillingCode>
            <Name>Macroplastique</Name>
            <Description>Sterile, textured, highly cross linked polydimethylsiloxane elastomer implants suspended in a bio-excretable carrier gel.</Description>
            <Size>2.5ml Implants</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>226</SubCategoryID>
            <GroupID>1699</GroupID>
            <SubGroupID>5319</SubGroupID>
            <ARTGs>
                <ARTG>146732</ARTG>
            </ARTGs>
            <MinimumBenefit>1262</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC022</BillingCode>
            <Name>C-Flex Double Pigtail Ureteric Stent Set</Name>
            <Description>Set includes: Stent, Wire, Positioner</Description>
            <Size>Multiple French Sizes, Multi-length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <Suffix>P</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC236</BillingCode>
            <Name>Paterson-Forrester Subcutaneous Urinary Diversion Stent</Name>
            <Description>Subcutaneous Urinary Diversion Stent</Description>
            <Size>Stent 8.5 French, 65cm long</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <Suffix>SP</Suffix>
            <ARTGs>
                <ARTG>218155</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY012</BillingCode>
            <Name>Ex-Stent Tumour Ureteral Stent Set</Name>
            <Description>Open end stent with guide wire and pusher</Description>
            <Size>Diameter: 6Fr-8Fr&#xD;
Length: 26cm-36cm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <Suffix>T</Suffix>
            <ARTGs>
                <ARTG>171564</ARTG>
            </ARTGs>
            <MinimumBenefit>187</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX004</BillingCode>
            <Name>Ureteric Stent Set</Name>
            <Description>Open end for coaxial applications. Polyurethane stents with hydrogel coating with introducer and with/without guidewires. </Description>
            <Size>12 - 28cm</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <Suffix>T</Suffix>
            <ARTGs>
                <ARTG>277254</ARTG>
            </ARTGs>
            <MinimumBenefit>187</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX005</BillingCode>
            <Name>Paediatric Ureteric Valve Stent Set</Name>
            <Description>Fixed length wirthan stent</Description>
            <Size>12 - 22cm</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <Suffix>T</Suffix>
            <ARTGs>
                <ARTG>136657</ARTG>
            </ARTGs>
            <MinimumBenefit>187</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC214</BillingCode>
            <Name>Cook Ureteral Stents</Name>
            <Description>Amplatz Ureteral Stent Set, Ultrathane RB Design Radioplaque Band and AQ Hydrophilic Coating Set includes one stent positioner with flexible stent introducer catheter</Description>
            <Size>8.5Fr - 12,20,22,24,26,28cm and 10.2Fr - 22,24,26,28cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <Suffix>T</Suffix>
            <ARTGs>
                <ARTG>137913</ARTG>
            </ARTGs>
            <MinimumBenefit>187</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT024</BillingCode>
            <Name>PU-R Double Loop Ureteral Stents</Name>
            <Description>Double Loop Ureteral Stents in Rigid Polyurethane, with pusher. With or without guidewire depending on the model.</Description>
            <Size>Various in 4.8, 6, 7, 8Fr.&#xD;
Various in 24, 26, 28, 30cm lengths.&#xD;
Various in O/O or O/C.&#xD;
Various with or without guidewire.&#xD;
With either streerable or simple pusher</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <ARTGs>
                <ARTG>142907</ARTG>
            </ARTGs>
            <MinimumBenefit>114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT034</BillingCode>
            <Name>PU-S Double Loop Ureteral Stents</Name>
            <Description>Double Loop Ureteral Stents in Soft Polyurethane, with pusher and guidewire.</Description>
            <Size>Various in 6 and 7Fr.&#xD;
Various in 24, 26, 28 cm lengths.&#xD;
Various in O/O or O/C.&#xD;
With either Steerable or simple pusher.</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <ARTGs>
                <ARTG>142907</ARTG>
            </ARTGs>
            <MinimumBenefit>114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MH010</BillingCode>
            <Name>Silhouette Ureteral Stent</Name>
            <Description>The Silhouette Ureteric Stent is manufactured with a soft material that provides superior comfort.  It has superior column strength through a coil-reinforced body providing effortless placement.  The tight coils prevent migration.  The smaller outside dia</Description>
            <Size>Multiple French Sizes &amp; Lengths</Size>
            <SupplierCode>MH</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <ARTGs>
                <ARTG>116728</ARTG>
            </ARTGs>
            <MinimumBenefit>114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY011</BillingCode>
            <Name>Optimed Opti-J Stents</Name>
            <Description>Dual Use directional Double J stent and delivery system. Can also be used as urinary diversion stent.</Description>
            <Size>4.5Fr to 8Fr&#xD;
Length:  22cm to 36cm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5321</SubGroupID>
            <ARTGs>
                <ARTG>171564</ARTG>
            </ARTGs>
            <MinimumBenefit>114</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MH013</BillingCode>
            <Name>Paediatric Silhouette System Set</Name>
            <Description>Coil reinforced body.  SL-6 hydrophilic coating.  UroWire 0.035" 3-in-1 guidewire with kink resistant nitinol core.  Design divided into 3 sections: silver section (front end) floppy SL - 6 hydrophilic coating; Blue section (mid) super stiff PTFE (not hydrophilicaly coated); and Green section (back) flexible</Description>
            <Size>4F, 8 - 12cm</Size>
            <SupplierCode>MH</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>P</Suffix>
            <ARTGs>
                <ARTG>116727</ARTG>
                <ARTG>116728</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT025</BillingCode>
            <Name>Stenostent Double Loop Ureteral Stents</Name>
            <Description>STENOSTENT® Double loop ureteral stent in silicone open/open, total reinforcement with connectable pusher and fixed core guidewire</Description>
            <Size>16 - 30cm</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>SP</Suffix>
            <ARTGs>
                <ARTG>142923</ARTG>
            </ARTGs>
            <MinimumBenefit>212</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT028</BillingCode>
            <Name>Pyelostent Double Loop Ureteral Stent</Name>
            <Description>Pyelostent, Silicone stent for long-term implantation (up to 12 months)</Description>
            <Size>26 - 30cm</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>SP</Suffix>
            <ARTGs>
                <ARTG>142923</ARTG>
            </ARTGs>
            <MinimumBenefit>212</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY001</BillingCode>
            <Name>Optimed Ureteral Stents</Name>
            <Description>Soft-Polyurethane. Ureteral. Paediatric Ureteral. Renal Transplantation. Urinary Diversion.</Description>
            <Size>Ureteral -&#xD;
Diameter: 4.5Fr-8Fr&#xD;
Length: 22cm-36cm&#xD;
Paediatric Ureteral - Diameter: 3Fr-4Fr &#xD;
Length: 10cm-16cm&#xD;
Renal Transplantation -  &#xD;
Diameter: 6Fr-8Fr&#xD;
Length:8cm-18cm&#xD;
Urinary Diversion -&#xD;
Diameter: 4.5Fr-9Fr &#xD;
Length: 70cm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>SP</Suffix>
            <ARTGs>
                <ARTG>171564</ARTG>
            </ARTGs>
            <MinimumBenefit>212</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC024</BillingCode>
            <Name>Ultrathane Endoureteratomy Stent Set</Name>
            <Description>Ultrathane Endoureteratomy Stent Set</Description>
            <Size>6/9.5 Fr &amp; 7/14.0Fr , Multiple Length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>SP</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>212</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WJ002</BillingCode>
            <Name>Roca Endo-Sil</Name>
            <Description>Silicone Ureteral Stent &amp; Simple / Connectable Pusher &amp; Without / With GuideWire</Description>
            <Size>6Fr / 7Fr / 8Fr ( 24cm-30cm )</Size>
            <SupplierCode>WJ</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>SP</Suffix>
            <ARTGs>
                <ARTG>381055</ARTG>
            </ARTGs>
            <MinimumBenefit>212</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA309</BillingCode>
            <Name>InLay Optima® Ureteral Stent</Name>
            <Description>The ureteral stent is intended to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter in order to pass fluids to or from the ureter.</Description>
            <Size>4.7Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm  6Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm   7Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm   8Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>235658</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS086</BillingCode>
            <Name>Polaris Ultra Ureteral Stent</Name>
            <Description>Dual durometer ureteral stent with attached suture</Description>
            <Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>104324</ARTG>
                <ARTG>129379</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS091</BillingCode>
            <Name>Percuflex; Percuflex Plus; Percuflex Plus SureDrive</Name>
            <Description>Ureteral stent with attached suture</Description>
            <Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>104324</ARTG>
                <ARTG>132306</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS092</BillingCode>
            <Name>Contour Ureteral Stent, Contour SureDrive Ureteral Stent</Name>
            <Description>Ureteral stent with attached suture</Description>
            <Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>104324</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS093</BillingCode>
            <Name>Retromax Plus Ureteral Stent</Name>
            <Description>Ureteral stent</Description>
            <Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>104324</ARTG>
                <ARTG>129379</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS116</BillingCode>
            <Name>Polaris Loop Ureteral Stent</Name>
            <Description>Dual durometer ureteral stent with attached suture</Description>
            <Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>104324</ARTG>
                <ARTG>129376</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS192</BillingCode>
            <Name>Percuflex® Helical</Name>
            <Description>Ureteral Stent with Hydro Plus™ Coating</Description>
            <Size>6fr to 8fr and 10cm to 30cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>129376</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS363</BillingCode>
            <Name>Tria Ureteral Stent</Name>
            <Description>Tria Firm ureteral stent with attached suture</Description>
            <Size>Diameters up to 8Fr &amp; lengths up to 30cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>129376</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB029</BillingCode>
            <Name>YellowStar Ureteric Stent</Name>
            <Description>PUR ureteral stent with PC treatment (Phosphorylcholine-coating) and Dirigenta Steering Device</Description>
            <Size>4.7-8Fr   Lengths 24-30cm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>327784</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC130</BillingCode>
            <Name>Ureteric Stent Set</Name>
            <Description>Set includes Aqueous Coated (AQ) firm fixed length ureteric stent, positioner, with or without wire guide</Description>
            <Size>Multiple French Sizes, and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WJ003</BillingCode>
            <Name>Roca JJ</Name>
            <Description>Soft / Firm Ureteral Stent &amp; Simple / Connectable Pusher &amp; Without / With GuideWire</Description>
            <Size>4.8Fr / 6Fr / 7Fr / 8Fr ( 24cm - 30cm )  </Size>
            <SupplierCode>WJ</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>381055</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT026</BillingCode>
            <Name>Biosoft Duo Double Loop Ureteral Stents</Name>
            <Description>Biosoft Duo double loop ureteral stents supplied with simple or steerable pusher, with or without guidewire and with or without flush catheter depending on the model. Duration of Implantation: 12 months</Description>
            <Size>6 - 9 Fr&#xD;
20 - 30 cm&#xD;
Either O/O or O/C</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>142925</ARTG>
                <ARTG>224254</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT027</BillingCode>
            <Name>Vortek Single Loop Ureteral Stents</Name>
            <Description>Vortek Single Loop Ureteral Stents for drainage and urine collection</Description>
            <Size>6, 7, 8 Fr&#xD;
90cm length</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>142924</ARTG>
                <ARTG>224254</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT029</BillingCode>
            <Name>Vortek Double Loop Ureteral Stents</Name>
            <Description>Vortek Double Loop Ureteral Stents have a double layered structure which make them easy to insert over guidewire, the stiffness of each size has been adapted in order to keep the mechanical properties.</Description>
            <Size>4.8, 6, 7 &amp; 8 Fr&#xD;
with steerable or simple pusher&#xD;
with or without guidewire&#xD;
O/O or O/C</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>142924</ARTG>
                <ARTG>224254</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT030</BillingCode>
            <Name>Biosoft Minute Stent</Name>
            <Description>Biosoft minute double loop ureteral stent. Ready to use; the stent is in place over the guidewire and connected to the steerable pusher. Duration of implantation: 6 months.</Description>
            <Size>6 - 8 Fr&#xD;
24 - 30 cm length</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>142925</ARTG>
                <ARTG>224219</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT031</BillingCode>
            <Name>Vortek TUMOR STENT Double loop ureteral stent</Name>
            <Description>Vortek Tumor Stent is reinforced with stiffness of material offering excellent resistance to compression.</Description>
            <Size>7-8Fr&#xD;
26-30cm in length</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>224254</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT032</BillingCode>
            <Name>Silicone Double Loop Ureteral Stent</Name>
            <Description>Silicone Double Loop Ureteral Stent with guidewire and pusher</Description>
            <Size>6 - 8Fr&#xD;
16cm - 30cm</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>142923</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT035</BillingCode>
            <Name>Vortek Hydro-Coated Double Loop Ureteral Stents</Name>
            <Description>Vortek Hydro-Coated Double Loop Ureteral Stents with simple or steerable pusher and with or without guidewire</Description>
            <Size>4.8 - 7Fr&#xD;
22 - 30cm lengths</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>224254</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL078</BillingCode>
            <Name>Ureteral Stents </Name>
            <Description>Diversion Stent, silicone</Description>
            <Size>7 - 8.5 F x 90cm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>130442</ARTG>
                <ARTG>136671</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX003</BillingCode>
            <Name>DD Ureteric Tumor Stent Set</Name>
            <Description>Open/Closed end with introducer and guide wire, Polyurethane</Description>
            <Size>20 - 28cm</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>136657</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC273</BillingCode>
            <Name>Ureteric Stent Set</Name>
            <Description>Set includes soft Aqueous Coated (AQ) ureteric stent, positioner, with or without wire guide</Description>
            <Size>Multiple French Sizes and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5322</SubGroupID>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC226</BillingCode>
            <Name>RESONANCE Metallic Ureteral Stent Set</Name>
            <Description>Metallic Double Pigtail Stent</Description>
            <Size> 6 Fr, lengths 12-30cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5323</SubGroupID>
            <Suffix>T</Suffix>
            <ARTGs>
                <ARTG>118616</ARTG>
            </ARTGs>
            <MinimumBenefit>1634</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET055</BillingCode>
            <Name>Memokath Ureteric Stent</Name>
            <Description>Memokath Model 051CW.</Description>
            <Size>30mm - 200mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5323</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>141654</ARTG>
            </ARTGs>
            <MinimumBenefit>3273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB016</BillingCode>
            <Name>Allium Ureteral Stent</Name>
            <Description>Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. Intended to be inserted into the lower ureter to allow free flow of urine from the kidney to the bladder.</Description>
            <Size>8mm x 100mm, 8mm x 120mm, 10mm x 100mm, 10mm x 120mm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5323</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>205005</ARTG>
            </ARTGs>
            <MinimumBenefit>3273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB028</BillingCode>
            <Name>Allium URS Long Ureteral stent</Name>
            <Description>Fully covered, flexible, extra long ureteral stent</Description>
            <Size>9 mm diameter&#xD;
200 mm length</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5323</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>205005</ARTG>
            </ARTGs>
            <MinimumBenefit>3273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY030</BillingCode>
            <Name>Taewoong ePTFE covered dual nitinol ureteral/urethral stent</Name>
            <Description>Taewoong ePTFE covered dual nitinol ureteral/urethral stent</Description>
            <Size>Diameter: 6mm to 16mm&#xD;
Length: 4cm to 20cm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1701</GroupID>
            <SubGroupID>5323</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>130532</ARTG>
                <ARTG>220258</ARTG>
            </ARTGs>
            <MinimumBenefit>3273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC218</BillingCode>
            <Name>C-Flex Multilength Ureteric Stent Set</Name>
            <Description>Set includes: Paediatric Stent, Wire, Positioner</Description>
            <Size>3.7 Fr, Multiple Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5324</SubGroupID>
            <Suffix>P</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC219</BillingCode>
            <Name>C-Flex Double Pigtail Ureteric Stent Set</Name>
            <Description>Set includes: Paediatric Stent, Wire and Positioner</Description>
            <Size>3.7 Fr, Multilple Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5324</SubGroupID>
            <Suffix>P</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA044</BillingCode>
            <Name>Ureteral Stent</Name>
            <Description>Hydrophilic coated ureteral stent</Description>
            <Size>Fr 4.7 – 8.0, Length 22-32cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5324</SubGroupID>
            <ARTGs>
                <ARTG>235658</ARTG>
            </ARTGs>
            <MinimumBenefit>189</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC282</BillingCode>
            <Name>Universa Soft Ureteral Stent Set</Name>
            <Description>Universa Soft Ureteral Stent Set, with or without the TFE WireGuide, multi-length</Description>
            <Size>5, 6, 7 and 8FR in multi-length (21-31CM)</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5324</SubGroupID>
            <ARTGs>
                <ARTG>174924</ARTG>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>189</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC217</BillingCode>
            <Name>Sof-Flex Multilength Ureteric Stent Set</Name>
            <Description>Set includes: Paediatric Stent, Wire, Positioner</Description>
            <Size>3 Fr, Multiple Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>P</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC220</BillingCode>
            <Name>Sof-Flex Double Pigtail Ureteric Stent Set</Name>
            <Description>Set includes: Paediatric Stent, Wire, Positioner</Description>
            <Size>3 Fr, Multiple Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>P</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC023</BillingCode>
            <Name>Greene Renal Transplant Stent Set</Name>
            <Description>Transplant stent set</Description>
            <Size>Multiple French Sizes, Multi-length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>SP</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>231</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC138</BillingCode>
            <Name>Filiform Double Pugtail Silicone Stent Set</Name>
            <Description>Stent, Wire, Positioner</Description>
            <Size>Multiple French Sizes and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>T</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>252</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS094</BillingCode>
            <Name>Contour VL; Stretch VL Flexima; Ureteral Stents</Name>
            <Description>Ureteral stent with attached suture</Description>
            <Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>129376</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC035</BillingCode>
            <Name>Ureteric Stent Set</Name>
            <Description>Set includes Aqueous Coated (AQ) firm multilength ureteric stent, positioner, with or without wire guide</Description>
            <Size>Multiple French Sizes, Multi-Length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC171</BillingCode>
            <Name>Universa Firm</Name>
            <Description>Universa Firm Multi-length Stent and Positioner only</Description>
            <Size>Multiple French Sizes and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>174924</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WJ001</BillingCode>
            <Name>Roca Multi-Length</Name>
            <Description>Soft / Firm Ureteral Stent &amp; Simple / Connectable Pusher &amp; Without / With GuideWire</Description>
            <Size>4.8Fr / 6Fr / 7Fr ( 22cm-32cm )</Size>
            <SupplierCode>WJ</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <Suffix>Therm</Suffix>
            <ARTGs>
                <ARTG>381055</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT023</BillingCode>
            <Name>Biosoft Duo Multi Length Hydro-Coated Ureteral Stents</Name>
            <Description>Biosoft Duo Multi Length Hydro-Coated Stents for drainage of upper urinary tract.</Description>
            <Size>4.8, 6. 7 Fr</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>142925</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL076</BillingCode>
            <Name>Ureteral Stents </Name>
            <Description>Single J Ureteric Stent, silicone</Description>
            <Size>7 - 8.5 F x 90cm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>130442</ARTG>
                <ARTG>136671</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL077</BillingCode>
            <Name>Ureteral Stents</Name>
            <Description>Double J Ureteric stent, silicone</Description>
            <Size>6-8.5 F, 12 - 30 cm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>130442</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL080</BillingCode>
            <Name>Ureteral Stents</Name>
            <Description>Tecoflex polymer, hydrophilic coating/PTFE coating</Description>
            <Size>4.5F-8.5F x length 8 - 32cm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>130442</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC002</BillingCode>
            <Name>Sof-Flex Multi-length Ureteric Stent Set</Name>
            <Description>Set includes Stent, Wire, Positioner</Description>
            <Size>Multiple French Sizes, Multi-length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC003</BillingCode>
            <Name>Sof-Flex Multi-length Ureteric Stent Set</Name>
            <Description>Stent and Positioner only</Description>
            <Size>Multiple French Sizes, Multi-length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC104</BillingCode>
            <Name>Cook Ureteral Stent - Sof-Flex Double Pigtail Stent Set - Special</Name>
            <Description>Radiopaque Sof-Flex Stent, Stainless Steel Wire Guide, Radiopaque Polyurethane Catheter and Radiolucent Vinyl Positioner</Description>
            <Size>Multiple French Sizes and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC150</BillingCode>
            <Name>Sof-Flex Double Pigtail Ureteric Stent Set</Name>
            <Description>Set includes: Stent, Wire, Positioner</Description>
            <Size>Multiple French Sizes and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC272</BillingCode>
            <Name>Ureteric Stent Set</Name>
            <Description>Set includes soft Aqueous Coated (AQ) ureteric stent, positioner, with or without wire guide</Description>
            <Size>Multiple French Sizes, multi-length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1702</GroupID>
            <SubGroupID>5325</SubGroupID>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC128</BillingCode>
            <Name>Bander Ureteral Diversion Stent Set</Name>
            <Description>Left and Right Stents</Description>
            <Size>Multiple French Sizes and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1703</GroupID>
            <Suffix>D</Suffix>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>201</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS095</BillingCode>
            <Name>Urinary Diversion Stents</Name>
            <Description>Percuflex urinary diversion stent</Description>
            <Size>Diameters up to 14Fr &amp; lengths up to 95cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1703</GroupID>
            <ARTGs>
                <ARTG>104324</ARTG>
                <ARTG>129379</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC031</BillingCode>
            <Name>Bander Ureteral Diversion Stent Set</Name>
            <Description>Left or right stent</Description>
            <Size>Multiple French Sizes and Lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>227</SubCategoryID>
            <GroupID>1703</GroupID>
            <ARTGs>
                <ARTG>216072</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET054</BillingCode>
            <Name>Memokath Prostatic - Urethral Stents</Name>
            <Description>Memokath Models: 028S, 028SW, 028T, 028TW, 044T, 044TW, 045T, 045TW, 045TTW</Description>
            <Size> 5mm - 90mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>1800</GroupID>
            <SubGroupID>5501</SubGroupID>
            <ARTGs>
                <ARTG>141653</ARTG>
            </ARTGs>
            <MinimumBenefit>2351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB013</BillingCode>
            <Name>Allium Bulbar Urethral Stent</Name>
            <Description>Round Nitinol stent with co-polymer covering and supplied premounted on a delivery tool.</Description>
            <Size>50, 55, 60, 80 mm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>1800</GroupID>
            <SubGroupID>5501</SubGroupID>
            <ARTGs>
                <ARTG>205004</ARTG>
            </ARTGs>
            <MinimumBenefit>2351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB014</BillingCode>
            <Name>Allium Round Posterior Urethral Stent</Name>
            <Description>Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. For longer term temporary treatment of bladder outlet obstruction caused by  male stenotic posterior urethra or  stenotic bladder-neck.</Description>
            <Size>The RPS has a body length of 40mm and a main body calibre of 45Fr</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>1800</GroupID>
            <SubGroupID>5501</SubGroupID>
            <ARTGs>
                <ARTG>205004</ARTG>
            </ARTGs>
            <MinimumBenefit>2351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB015</BillingCode>
            <Name>Allium Triangle Prostatic Urethral Stent</Name>
            <Description>Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. For longer term temporary treatment of bladder outlet obstruction caused by enlarged prostate.</Description>
            <Size>Body lengths 30, 40, 50, 60, 65mm&#xD;
main body calibre 45Fr</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>1800</GroupID>
            <SubGroupID>5501</SubGroupID>
            <ARTGs>
                <ARTG>205004</ARTG>
            </ARTGs>
            <MinimumBenefit>2351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC126</BillingCode>
            <Name>Firlit-Kluge Urethral Stent</Name>
            <Description>Firlit-Kluge urethral stent</Description>
            <Size>Multiple French Sizes, Length 30cm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>1800</GroupID>
            <SubGroupID>5502</SubGroupID>
            <ARTGs>
                <ARTG>214821</ARTG>
            </ARTGs>
            <MinimumBenefit>55</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC136</BillingCode>
            <Name>Zaontz Urethral Stent</Name>
            <Description>Zaontz Urethral Stent</Description>
            <Size>Multiple French Sizes, Length 12cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>1800</GroupID>
            <SubGroupID>5502</SubGroupID>
            <ARTGs>
                <ARTG>214821</ARTG>
            </ARTGs>
            <MinimumBenefit>55</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX055</BillingCode>
            <Name>UroLift® System</Name>
            <Description>Prostatic urethral tissue-retaining retractor with adjustable retraction.</Description>
            <Size>One system</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>1801</GroupID>
            <ARTGs>
                <ARTG>200361</ARTG>
            </ARTGs>
            <MinimumBenefit>712</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL096</BillingCode>
            <Name>iTind Device</Name>
            <Description>Temporary Nitinol Urethral Stent for the treatment of BPH</Description>
            <Size>One size</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>256</SubCategoryID>
            <GroupID>2958</GroupID>
            <ARTGs>
                <ARTG>318768</ARTG>
            </ARTGs>
            <MinimumBenefit>2205</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT007</BillingCode>
            <Name>Genesis Penile Prosthesis (Resist Coated)</Name>
            <Description>Malleable Penile Prosthesis (Resist Coated)</Description>
            <Size>Dia: 9.5 mm (14 - 23cm lengths), Dia: 11mm (16 - 25cm lengths), Dia: 13mm (18 - 27cm lengths)</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1721</GroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>140302</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO004</BillingCode>
            <Name>Rigi10 - Hydrophilic Malleable Penile Prosthesis  </Name>
            <Description>Hydrophilic Malleable Penile Prosthesis</Description>
            <Size>9mm x 23cm, 10mm x 23cm, 11mm x 25cm, 12mm x 25cm, 13mm x 25cm, 14mm x 25cm.</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1721</GroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>337610</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS367</BillingCode>
            <Name>Tactra</Name>
            <Description>Malleable Penile Prosthesis</Description>
            <Size>9.5mm - 13mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1721</GroupID>
            <ARTGs>
                <ARTG>165751</ARTG>
            </ARTGs>
            <MinimumBenefit>776</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB022</BillingCode>
            <Name>Zephyr Hydraulic  Penile Implant</Name>
            <Description>This hydraulic  penile implant is made from silicone elastomer and comprises of two inflatable cylinders. a reservoir and a pump.</Description>
            <Size>All sizes contained in one system pack. (13, 16, 19 cm)</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1709</GroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>216415</ARTG>
            </ARTGs>
            <MinimumBenefit>9893</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MB027</BillingCode>
            <Name>Zephyr Hydraulic Phalloplasty Penile Implant</Name>
            <Description>Hydraulic phalloplasty penile implant</Description>
            <Size>120-210 mm</Size>
            <SupplierCode>MB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1709</GroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>320689</ARTG>
            </ARTGs>
            <MinimumBenefit>9893</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM004</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses with Inhibizone Cylinders</Name>
            <Description>700 Series with InhibiZone</Description>
            <Size>12, 14, 15, 16, 18, 21cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5330</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>125444</ARTG>
            </ARTGs>
            <MinimumBenefit>3638</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT008</BillingCode>
            <Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Cylinders</Name>
            <Description>Cylinders for three component penile prosthesis (Resist Coated)</Description>
            <Size>10, 12, 14,  16, 18, 20, 22cm</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5330</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>140111</ARTG>
            </ARTGs>
            <MinimumBenefit>3638</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM022</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses Cylinders</Name>
            <Description>700 Series (Non InhibiZone)</Description>
            <Size>12, 14, 15, 16, 18, 21cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5330</SubGroupID>
            <ARTGs>
                <ARTG>106606</ARTG>
            </ARTGs>
            <MinimumBenefit>3344</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM038</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses InhibiZone Reservoir</Name>
            <Description>700 Series InhibiZone</Description>
            <Size>50, 65, 100ml</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5331</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>125444</ARTG>
            </ARTGs>
            <MinimumBenefit>1881</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT010</BillingCode>
            <Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Lock-out Valve Reservoir</Name>
            <Description>Reservoir for three component penile prosthesis (Resist Coated)</Description>
            <Size>60, 75, 100ml</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5331</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>140111</ARTG>
            </ARTGs>
            <MinimumBenefit>1881</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO005</BillingCode>
            <Name>Infla10 Inflatable Penile Prosthesis - Reservoir (HydroShield coated)</Name>
            <Description>Reservoir for Infla10 Inflatable Penile Prosthesis (HydroShield Coated)</Description>
            <Size>65ml, 70ml, 110ml</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5331</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>337611</ARTG>
            </ARTGs>
            <MinimumBenefit>1881</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM044</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses Reservoir non Inhibizone</Name>
            <Description>700 Series (Non InhibiZone)</Description>
            <Size> 50, 65, 100ml</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5331</SubGroupID>
            <ARTGs>
                <ARTG>106606</ARTG>
            </ARTGs>
            <MinimumBenefit>1705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM036</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses with InhibiZone Pump</Name>
            <Description>700 Series with InhibiZone</Description>
            <Size>One Size</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5332</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>125444</ARTG>
            </ARTGs>
            <MinimumBenefit>4432</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT011</BillingCode>
            <Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Pump</Name>
            <Description>Pump for three component penile prosthesis (Resist Coated)</Description>
            <Size>One Size</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5332</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>140111</ARTG>
            </ARTGs>
            <MinimumBenefit>4432</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM042</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses Pump</Name>
            <Description>700 Series (Non InhibiZone)</Description>
            <Size>One Size</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5332</SubGroupID>
            <ARTGs>
                <ARTG>106606</ARTG>
            </ARTGs>
            <MinimumBenefit>4076</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM040</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses with InhibiZone Deactivation Package</Name>
            <Description>700 Series with InhibiZone</Description>
            <Size>One Size</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5333</SubGroupID>
            <ARTGs>
                <ARTG>125444</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM046</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses Deactivation Package</Name>
            <Description>700 Series (Non InhibiZone)</Description>
            <Size>One Size</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5333</SubGroupID>
            <ARTGs>
                <ARTG>106606</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT012</BillingCode>
            <Name>Titan Inflatable Penile Prosthesis (Resist Coated) - True-lock Plug</Name>
            <Description>True Lock Plug for deactivation of three component penile prosthesis (Resist Coated)</Description>
            <Size>One Size</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5333</SubGroupID>
            <ARTGs>
                <ARTG>140111</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT005</BillingCode>
            <Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Assembly Kit</Name>
            <Description>Assembly kit for three component penile prosthesis (Resist Coated)</Description>
            <Size>Standard &amp; Narrow -base</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5334</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>140111</ARTG>
            </ARTGs>
            <MinimumBenefit>655</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO006</BillingCode>
            <Name>Infla10 Inflatable Penile Prosthesis - Accessory Kit</Name>
            <Description>Accessory Kit for Infla10 Inflatable Penile Prosthesis (HydroShield Coated). Accessory kit includes Easy-Click Connectors and ConnectSecure Extenders.</Description>
            <Size>Standard &amp; Narrow </Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5334</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>337611</ARTG>
            </ARTGs>
            <MinimumBenefit>655</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM045</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses Accessory Kit</Name>
            <Description>700 Series (Non InhibiZone)</Description>
            <Size>One Size</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5334</SubGroupID>
            <ARTGs>
                <ARTG>106606</ARTG>
            </ARTGs>
            <MinimumBenefit>655</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM037</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses with InhibiZone Pump &amp; Cylinders Preconnected</Name>
            <Description>700 Series with InhibiZone</Description>
            <Size>12-24cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5335</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>352831</ARTG>
                <ARTG>125444</ARTG>
            </ARTGs>
            <MinimumBenefit>8070</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT009</BillingCode>
            <Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Cylinders &amp; Pump Preconnected</Name>
            <Description>Preconnected Cylinders &amp; pump for three component penile prosthesis (Resist Coated)</Description>
            <Size>10, 12, 14, 16, 18, 20, 22cm (in both infrapubic &amp; scrotal models)</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5335</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>140111</ARTG>
            </ARTGs>
            <MinimumBenefit>8070</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO007</BillingCode>
            <Name>Infla10 Inflatable Penile Prosthesis - Pump &amp; Cylinder (HydroShield coated)</Name>
            <Description>Preconnected Cylinders &amp; Pump for three piece penile prosthesis (Hydrophilic Coated).</Description>
            <Size>10, 12, 14, 15, 16, 18, 22, 24cm (in both infrapubic &amp; scrotal models)</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5335</SubGroupID>
            <Suffix>A</Suffix>
            <ARTGs>
                <ARTG>337611</ARTG>
            </ARTGs>
            <MinimumBenefit>8070</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AM043</BillingCode>
            <Name>AMS 700 Series Inflatable Penile Prostheses Pump &amp; Cylinders Preconnected</Name>
            <Description>700 Series (Non InhibiZone)</Description>
            <Size>12, 14, 15, 16, 18, 21cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>230</SubCategoryID>
            <GroupID>1710</GroupID>
            <SubGroupID>5335</SubGroupID>
            <ARTGs>
                <ARTG>106606</ARTG>
            </ARTGs>
            <MinimumBenefit>7419</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CT003</BillingCode>
            <Name>Saline Filled Testicular Prosthesis</Name>
            <Description> Testicular Prosthesis</Description>
            <Size>Extra Small, Small, Medium, Large</Size>
            <SupplierCode>CT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>231</SubCategoryID>
            <GroupID>1711</GroupID>
            <ARTGs>
                <ARTG>140205</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG026</BillingCode>
            <Name>Testicular Implant</Name>
            <Description>Gel Filled Testicular Implant</Description>
            <Size>Height : 25 , 34, 40, 50, 53mm</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>231</SubCategoryID>
            <GroupID>1711</GroupID>
            <ARTGs>
                <ARTG>343218</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET028</BillingCode>
            <Name>Promedon Testicular Prosthesis</Name>
            <Description>Silicone Elastomer</Description>
            <Size>Small - 31 x 23 mm,  Medium - 37 x 28 mm,  Large - 42 x 32 mm,  Xlarge</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>231</SubCategoryID>
            <GroupID>1711</GroupID>
            <ARTGs>
                <ARTG>136709</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Testicular Implant</Name>
            <Description>Silicone Elastomer</Description>
            <Size>Small / Medium / Large</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>231</SubCategoryID>
            <GroupID>1711</GroupID>
            <ARTGs>
                <ARTG>137352</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JT008</BillingCode>
            <Name>Testicular Implants</Name>
            <Description>Testicular Implants with needle guide or reinforced cap for fixation</Description>
            <Size>The Testicular Implants with needle guide or reinforced cap are available in 5 different sizes ranging from 5, 12, 21, 27 and 36 grams.</Size>
            <SupplierCode>JT</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>231</SubCategoryID>
            <GroupID>1711</GroupID>
            <ARTGs>
                <ARTG>168141</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO001</BillingCode>
            <Name>Testi10 Firm Testicular Prosthesis</Name>
            <Description>Firm Silicon Testicular Prosthesis.</Description>
            <Size>XS, S, M, L, XL</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>231</SubCategoryID>
            <GroupID>1711</GroupID>
            <ARTGs>
                <ARTG>345571</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VO002</BillingCode>
            <Name>Testi10 Saline Filled Testicular Prosthesis</Name>
            <Description>Saline filled testicular prosthesis</Description>
            <Size>XS, S, M, L, XL</Size>
            <SupplierCode>VO</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>231</SubCategoryID>
            <GroupID>1711</GroupID>
            <ARTGs>
                <ARTG>345571</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC755</BillingCode>
            <Name>InterStim II Neurostimulator</Name>
            <Description>Titanium</Description>
            <Size>Weight 22g</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1712</GroupID>
            <ARTGs>
                <ARTG>136721</ARTG>
            </ARTGs>
            <MinimumBenefit>9073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC756</BillingCode>
            <Name>InterStim iCON Patient Programmer</Name>
            <Description>Hand held device Model 3037 to be used with implantable neurostimulation devices</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1713</GroupID>
            <SubGroupID>5337</SubGroupID>
            <ARTGs>
                <ARTG>137808</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI443</BillingCode>
            <Name>InterStim neurostimulator- Programmer</Name>
            <Description>Programmer</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1713</GroupID>
            <SubGroupID>5337</SubGroupID>
            <ARTGs>
                <ARTG>355036</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW004</BillingCode>
            <Name>Axonics Patient Remote Control</Name>
            <Description>Remote patient controller for Axonics Sacral Neurmodulation System</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1713</GroupID>
            <SubGroupID>5337</SubGroupID>
            <ARTGs>
                <ARTG>325941</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI126</BillingCode>
            <Name>Verify External Neurostimulator</Name>
            <Description>External Neurostimulator</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1713</GroupID>
            <SubGroupID>5518</SubGroupID>
            <ARTGs>
                <ARTG>215635</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW006</BillingCode>
            <Name>Axonics Trial Stimulator</Name>
            <Description>External neurostimulator with belt</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1713</GroupID>
            <SubGroupID>5518</SubGroupID>
            <ARTGs>
                <ARTG>313220</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI451</BillingCode>
            <Name>InterStim MRI rechargeable neurostimulator- Recharger</Name>
            <Description>Recharger kit</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1713</GroupID>
            <SubGroupID>7367</SubGroupID>
            <ARTGs>
                <ARTG>121279</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW005</BillingCode>
            <Name>Axonics Charging System</Name>
            <Description>Charger and dock with belt and adhesive carriers for Axonics Sacral Neuromodulation System</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1713</GroupID>
            <SubGroupID>7367</SubGroupID>
            <ARTGs>
                <ARTG>297956</ARTG>
            </ARTGs>
            <MinimumBenefit>1215</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI074</BillingCode>
            <Name>Sacral Nerve Stimulation Lead</Name>
            <Description>4 Electrode tined lead (Non-MRI and MRI Leads)</Description>
            <Size>28 - 41cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1714</GroupID>
            <SubGroupID>5339</SubGroupID>
            <Suffix>tined</Suffix>
            <ARTGs>
                <ARTG>355030</ARTG>
                <ARTG>355041</ARTG>
            </ARTGs>
            <MinimumBenefit>4199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW007</BillingCode>
            <Name>Axonics Tined Lead</Name>
            <Description>Tined lead for sacral neuromodulation</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1714</GroupID>
            <SubGroupID>5339</SubGroupID>
            <Suffix>tined</Suffix>
            <ARTGs>
                <ARTG>297953</ARTG>
            </ARTGs>
            <MinimumBenefit>4199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC185</BillingCode>
            <Name>Sacral Nerve Stimulation Unilateral</Name>
            <Description>Interstim Temporary test stimulation lead</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1714</GroupID>
            <SubGroupID>5340</SubGroupID>
            <ARTGs>
                <ARTG>137440</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW011</BillingCode>
            <Name>Axonics PNE Lead</Name>
            <Description>Trial Lead</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1714</GroupID>
            <SubGroupID>5340</SubGroupID>
            <ARTGs>
                <ARTG>312912</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW001</BillingCode>
            <Name>Axonics Tined Lead Extension</Name>
            <Description>Percutaneous extension</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1714</GroupID>
            <SubGroupID>5341</SubGroupID>
            <ARTGs>
                <ARTG>325940</ARTG>
                <ARTG>312913</ARTG>
            </ARTGs>
            <MinimumBenefit>1434</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI169</BillingCode>
            <Name>Interstim Trial Lead and Screener Kit </Name>
            <Description>Trial lead and screener cables kit</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1714</GroupID>
            <SubGroupID>6036</SubGroupID>
            <ARTGs>
                <ARTG>137440</ARTG>
            </ARTGs>
            <MinimumBenefit>753</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW002</BillingCode>
            <Name>Axonics PNE Lead Implant Kit</Name>
            <Description>Peripheral Nerve Evaluation Kit including lead, cables and implant tools</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1714</GroupID>
            <SubGroupID>6036</SubGroupID>
            <ARTGs>
                <ARTG>312912</ARTG>
                <ARTG>298140</ARTG>
            </ARTGs>
            <MinimumBenefit>753</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC775</BillingCode>
            <Name>Interstim Lead Introducer Kit</Name>
            <Description>Lead Introducer Kit for Sacral Nerve Stimulation</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5342</SubGroupID>
            <ARTGs>
                <ARTG>355030</ARTG>
                <ARTG>355041</ARTG>
            </ARTGs>
            <MinimumBenefit>514</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI387</BillingCode>
            <Name>InterStim neurostimulator- Lead Introducer Kit</Name>
            <Description>Sacral Nerve Stimulation Lead Introducer Kit</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5342</SubGroupID>
            <ARTGs>
                <ARTG>240576</ARTG>
            </ARTGs>
            <MinimumBenefit>514</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI444</BillingCode>
            <Name>InterStim neurostimulator- Extension Lead</Name>
            <Description>Sacral Nerve Stimulation Extension Lead</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5342</SubGroupID>
            <ARTGs>
                <ARTG>239412</ARTG>
            </ARTGs>
            <MinimumBenefit>514</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW008</BillingCode>
            <Name>Axonics Lead Implant Kit</Name>
            <Description>Lead introducer kit including needles, sheath and tools</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5342</SubGroupID>
            <ARTGs>
                <ARTG>298140</ARTG>
            </ARTGs>
            <MinimumBenefit>514</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI333</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MC186</PriorBillingCode>
                <PriorBillingCode>MI318</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Sacral Nerve Stimulation Accessories</Name>
            <Description>Foramen Needle. Sterile individual units.Stainless steel.</Description>
            <Size>8.9 to 12.7 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5343</SubGroupID>
            <ARTGs>
                <ARTG>121280</ARTG>
            </ARTGs>
            <MinimumBenefit>21</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW009</BillingCode>
            <Name>Axonics Foramen Needles</Name>
            <Description>6 Foramen needles</Description>
            <Size>Short and Long</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5343</SubGroupID>
            <ARTGs>
                <ARTG>298140</ARTG>
            </ARTGs>
            <MinimumBenefit>21</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI127</BillingCode>
            <Name>Medtronic Cables</Name>
            <Description>Stimulation Cables for Intraoperative testing</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5517</SubGroupID>
            <ARTGs>
                <ARTG>355030</ARTG>
                <ARTG>355041</ARTG>
            </ARTGs>
            <MinimumBenefit>190</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW010</BillingCode>
            <Name>Axonics Stimulation Cable</Name>
            <Description>Cable for trial and implant</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>1715</GroupID>
            <SubGroupID>5517</SubGroupID>
            <ARTGs>
                <ARTG>314969</ARTG>
            </ARTGs>
            <MinimumBenefit>190</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UW003</BillingCode>
            <Name>Axonics Neurostimulator</Name>
            <Description>Rechargeable neurostimulator for sacral nerve stimulation</Description>
            <Size>One size only</Size>
            <SupplierCode>UW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>232</SubCategoryID>
            <GroupID>2950</GroupID>
            <ARTGs>
                <ARTG>390437</ARTG>
            </ARTGs>
            <MinimumBenefit>9606</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FE003</BillingCode>
            <Name>Filshie Clips - Sterishot</Name>
            <Description>With Disposable Applicator</Description>
            <Size>One Size</Size>
            <SupplierCode>FE</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>233</SubCategoryID>
            <GroupID>1716</GroupID>
            <SubGroupID>5344</SubGroupID>
            <Suffix>With applicator</Suffix>
            <ARTGs>
                <ARTG>157661</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FE001</BillingCode>
            <Name>Filshie Clip</Name>
            <Description>Titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>FE</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>233</SubCategoryID>
            <GroupID>1716</GroupID>
            <SubGroupID>5344</SubGroupID>
            <ARTGs>
                <ARTG>153023</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OL079</BillingCode>
            <Name>Falope-Ring Bands</Name>
            <Description>Fallopian Tube Clip (each)</Description>
            <Size>5mm - 12mm</Size>
            <SupplierCode>OL</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>233</SubCategoryID>
            <GroupID>1716</GroupID>
            <SubGroupID>5345</SubGroupID>
            <ARTGs>
                <ARTG>130442</ARTG>
                <ARTG>136671</ARTG>
            </ARTGs>
            <MinimumBenefit>37</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA250</BillingCode>
            <Name>Navarre Drainage Catheter</Name>
            <Description>A drainage catheter intended for use for Nephrostomy applications either by direct stick or modified seldinger technique.</Description>
            <Size>6-12 French, Length: 15-40cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>234</SubCategoryID>
            <GroupID>1718</GroupID>
            <ARTGs>
                <ARTG>180316</ARTG>
                <ARTG>180317</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS228</BillingCode>
            <Name>Flexima Nephrostomy Catheter</Name>
            <Description>Urinary drainage catheters for internal and external drainage of the urinary tract.</Description>
            <Size>Length up to 25cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>234</SubCategoryID>
            <GroupID>1718</GroupID>
            <ARTGs>
                <ARTG>132027</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB018</BillingCode>
            <Name>Skater Nephrostomy Drainage Catheter</Name>
            <Description>A drainage catheter intended for use for Nephrostomy applications either by direct stick or modified seldinger technique.</Description>
            <Size>6 - 14 Fr</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>234</SubCategoryID>
            <GroupID>1718</GroupID>
            <ARTGs>
                <ARTG>223260</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME216</BillingCode>
            <Name>NEPHRO-CATH Nephrostomy Drainage Catheter</Name>
            <Description>Nephrostomy Drainage Catheter</Description>
            <Size>Diameters: 8fr to 14fr sizes; Lengths 27cm through to 29cm</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>234</SubCategoryID>
            <GroupID>1718</GroupID>
            <ARTGs>
                <ARTG>98030</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC291</BillingCode>
            <Name>Dawson-Mueller Drainage Catheter</Name>
            <Description>A drainage catheter intended for use for Nephrostomy applications either by direct stick or modified seldinger technique.</Description>
            <Size>5-14 Fr, Length: 15-25cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>234</SubCategoryID>
            <GroupID>1718</GroupID>
            <ARTGs>
                <ARTG>139357</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GN003</BillingCode>
            <Name>Vantris</Name>
            <Description>Bulking agent for the treatment of Vesicoureteric Reflux</Description>
            <Size>1ml Syringe</Size>
            <SupplierCode>GN</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>235</SubCategoryID>
            <GroupID>1719</GroupID>
            <ARTGs>
                <ARTG>169958</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RW001</BillingCode>
            <Name>Deflux</Name>
            <Description>Deflux is a sterile, highly viscous gel of dextranomer microspheres and non-animal stabilised hyaluronic acid constituting a biocompatible and biodegradable implant for the treatment of vesicoureteral reflux.  The stabilised hyaluronic acid acts mainly as</Description>
            <Size>1ml in syringe</Size>
            <SupplierCode>RW</SupplierCode>
            <CategoryID>26</CategoryID>
            <SubCategoryID>235</SubCategoryID>
            <GroupID>1719</GroupID>
            <ARTGs>
                <ARTG>345790</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW894</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR367</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Salto Talaris Ankle Prosthesis - Tibial insert</Name>
            <Description>Tibial insert, fixed, UHMWPE</Description>
            <Size>Sizes 0,1,2,3, Left and Right, each size available in the following thicknesses, 8mm, 9mm,10mm,11mm, 13mm,15mm, 17mm, 19mm, 21mm.  Sizes 00, Left and Right, available in the following thicknesses, 8mm,9mm,10mm,11mm.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3645</SubGroupID>
            <ARTGs>
                <ARTG>134055</ARTG>
                <ARTG>198095</ARTG>
            </ARTGs>
            <MinimumBenefit>627</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW995</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR322</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INFINITY Total Ankle System: Poly Insert</Name>
            <Description>UHMWPE poly insert, Standard or Plus</Description>
            <Size>Sizes 1-5; 6-13mm thick</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3645</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>627</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW996</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR272</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INBONE® Total Ankle System: Poly Insert</Name>
            <Description>Poly Insert, Standard or Plus</Description>
            <Size>Sizes 1-6, 6-20mm thick</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3645</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>627</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA022</BillingCode>
            <Name>TM Ankle</Name>
            <Description>Tibial Polyethylene Insert</Description>
            <Size>6 sizes of the polyethylene insert with standard, +2 mm and +4 mm offsets</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3645</SubGroupID>
            <ARTGs>
                <ARTG>202429</ARTG>
            </ARTGs>
            <MinimumBenefit>627</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR219</BillingCode>
            <Name>Zenith Total Ankle Replacement System – Meniscal Component</Name>
            <Description>The Meniscal component the mobile bearing component of the Zenith total ankle&#xD;
replacement system.</Description>
            <Size>size x thickness:&#xD;
Sizes 1-4,&#xD;
Thickness 5mm,6mm,7mm,8mm,10mm,12mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3646</SubGroupID>
            <ARTGs>
                <ARTG>115739</ARTG>
            </ARTGs>
            <MinimumBenefit>591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD077</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK626</PriorBillingCode>
            </PriorBillingCodes>
            <Name> STAR Ankle Prosthesis</Name>
            <Description>UHMWPE Sliding Core</Description>
            <Size>6- 14mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3646</SubGroupID>
            <ARTGs>
                <ARTG>237795</ARTG>
            </ARTGs>
            <MinimumBenefit>591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER385</BillingCode>
            <Name>Hintermann Series H3™ Total Ankle Prosthesis-Inlay</Name>
            <Description>Hintermann Series H3™ Total Ankle Prosthesis-Inlay, UHMW Polyethylene</Description>
            <Size>0-6, thickness 5-9 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3646</SubGroupID>
            <ARTGs>
                <ARTG>289319</ARTG>
            </ARTGs>
            <MinimumBenefit>591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA031</BillingCode>
            <Name>Vantage Total Ankle System - Tibial Insert</Name>
            <Description>Inlay, Mobile Bearing, UHMWPE</Description>
            <Size>Left and Right, size 1-5, thickness 6mm - 12mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3646</SubGroupID>
            <ARTGs>
                <ARTG>308700</ARTG>
            </ARTGs>
            <MinimumBenefit>591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW884</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR356</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cheville Salto Ankle Prostheses</Name>
            <Description>Mobile insert UHMWPE</Description>
            <Size>Sizes 0,1,2,3. Each size has thickness 4,5,6 &amp; 7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1269</GroupID>
            <SubGroupID>3646</SubGroupID>
            <ARTGs>
                <ARTG>198095</ARTG>
            </ARTGs>
            <MinimumBenefit>591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU103</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE293</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Prostop</Name>
            <Description>Arthroereisis Subtalar implant</Description>
            <Size>7x12mm 8x12mm 9x14mm 10x14mm 11x16mm 12x16mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW681</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioArch Subtalar Arthroereisis Implant</Name>
            <Description>Conical, tapered, titanium implant with blunt thread design.</Description>
            <Size>8, 9, 10, 11, 12mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>164928</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW912</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR389</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Futura Conical Subtalar Implant</Name>
            <Description>The Conical Subtalar Implant (CSI) is designed to treat hyperpronated foot and to stabilize the subtalar joint. It is intended to block forward, downward and medial displacement of the talus, allowing for normal subtalar joint motion while simultaneously </Description>
            <Size>7 - 12</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>130055</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT017</BillingCode>
            <Name>Arch It</Name>
            <Description>Subtalar Arthroereisis Implant</Description>
            <Size>8mm, 9mm, 10mm, 11mm &amp; 12mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>266192</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT035</BillingCode>
            <Name>Fuse It Healing Screw</Name>
            <Description>Fenestrated conical fusion cage - intended to be used in situations where an aid is required to help facilitate bone fusion and alignment generally following an osteotomy but also in the instance of large bone deformities and complex fusion procedures.</Description>
            <Size>Diameters from 6mm-16mm, lengths from 10mm-30mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>308601</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM100</BillingCode>
            <Name>Hyprocure</Name>
            <Description>Sinus Tarsi Implant</Description>
            <Size>5-9mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>291288</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM373</BillingCode>
            <Name>Subtalar Implants</Name>
            <Description>Subtalar Implants</Description>
            <Size>All sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>308018</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB045</BillingCode>
            <Name>Subtalar Implant</Name>
            <Description>Conical tapered titanium implant to treat flat foot and stabilise subtalar joint</Description>
            <Size>7 – 12mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF090</BillingCode>
            <Name>R2 Subtalar Implant</Name>
            <Description>R2 Subtalar Implant</Description>
            <Size>Size 7/13mm to 12/18mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL189</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG053</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MBA Titanium Subtalar Implant</Name>
            <Description>Implant for subtalar joint arthroereisis</Description>
            <Size>6, 8, 9, 10, 12mm and guide pin 2mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1219</GroupID>
            <SubGroupID>3261</SubGroupID>
            <ARTGs>
                <ARTG>177631</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR217</BillingCode>
            <Name>Zenith Total Ankle Replacement System - Talar Component</Name>
            <Description>Talar Component is a components of the Zenith total ankle replacement system.</Description>
            <Size>Sizes 1 - 4</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <Suffix>CS</Suffix>
            <ARTGs>
                <ARTG>115739</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD075</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK624</PriorBillingCode>
            </PriorBillingCodes>
            <Name> STAR Ankle Prosthesis</Name>
            <Description>Talar Component, cemented</Description>
            <Size>xx-Small - x- large</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>237795</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD078</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK627</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STAR Ankle Prosthesis</Name>
            <Description>Talar Component, cementless</Description>
            <Size>xx- small - x-large</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>237795</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER383</BillingCode>
            <Name>Hintermann Series H3™ Total Ankle Prosthesis-Talar Component</Name>
            <Description>Hintermann Series H3™ Total Ankle Prosthesis-Talar component, left or right, primary or revision, CoCr, plasma sprayed titanium coating and a hydroxyapatite coating</Description>
            <Size>0-6</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>289321</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA030</BillingCode>
            <Name>Vantage Total Ankle System - Talar component</Name>
            <Description>Talar component, left and right, uncemented, plasma sprayed titanium coating</Description>
            <Size>Left and Right, size 1-5</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>308700</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW827</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR273</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INBONE® II Total Ankle System: Talar Component</Name>
            <Description>Modular Talar Dome and Talar Stem</Description>
            <Size>Sizes 1-6</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW860</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR328</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INVISION Talar Component</Name>
            <Description>Talar Dome</Description>
            <Size>Size 1, 2, 3, 4, 5</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW883</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR355</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Salto Ankle Prostheses</Name>
            <Description>Talar component mobile bearing CoCr, Ti, HA</Description>
            <Size>Sizes 0,1,2,3 left and right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>198095</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW892</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR365</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Salto Talaris Ankle Prosthesis - Talar component</Name>
            <Description>Talar compoment, CrCo + Ti</Description>
            <Size>Sizes 0, 1, 2, 3, Left and Right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>198095</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW965</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR456</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INVISION Talar Component</Name>
            <Description>Talar Dome</Description>
            <Size>Size 1, 2, 3, 4, 5  - Standard and Thick (+3mm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW984</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR321</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INFINITY Total Ankle System: Talar Component</Name>
            <Description>Talar dome</Description>
            <Size>Sizes 1-5</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA027</BillingCode>
            <Name>TM Ankle</Name>
            <Description>Talar Component</Description>
            <Size>6 sizes of left and right</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4040</SubGroupID>
            <ARTGs>
                <ARTG>202429</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR218</BillingCode>
            <Name>Zenith Total Ankle Replacement System - Tibial Component</Name>
            <Description>The Tibial Component a component of the Zenith total ankle replacement system.</Description>
            <Size>Sizes 1 - 4</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4041</SubGroupID>
            <ARTGs>
                <ARTG>115739</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD076</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK625</PriorBillingCode>
            </PriorBillingCodes>
            <Name> STAR Ankle Prosthesis</Name>
            <Description>Tibial Component, cemented</Description>
            <Size>xx-small - x-large</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4041</SubGroupID>
            <ARTGs>
                <ARTG>237795</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD079</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK628</PriorBillingCode>
            </PriorBillingCodes>
            <Name> STAR Ankle Prosthesis</Name>
            <Description>Tibial Component, cementless</Description>
            <Size>xx-small - x-large</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4041</SubGroupID>
            <ARTGs>
                <ARTG>237795</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER384</BillingCode>
            <Name>Hintermann Series H3™ Total Ankle Prosthesis-Tibial Component</Name>
            <Description>Hintermann Series H3™ Total Ankle Prosthesis-Tibial Component, left or right, primary or revision, CoCr, plasma sprayed titanium coating and a hydroxyapatite coating</Description>
            <Size>0-6, 8 or 12mm thickness (revision)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4041</SubGroupID>
            <ARTGs>
                <ARTG>289424</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA032</BillingCode>
            <Name>Vantage Total Ankle System - Tibial Component</Name>
            <Description>Tibial component, mobile bearing, CoCr, plasma sprayed titanium coating</Description>
            <Size>Left and right, size 1-4</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4041</SubGroupID>
            <ARTGs>
                <ARTG>308700</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW882</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR354</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cheville Salto Ankle Prostheses</Name>
            <Description>Tibial component mobile bearing CoCr, Ti, HA</Description>
            <Size>Sizes 0,1,2,3 left and right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4041</SubGroupID>
            <ARTGs>
                <ARTG>134055</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK629</BillingCode>
            <Name>STAR Ankle Prosthesis</Name>
            <Description>Revision Tibial Component, Cemented</Description>
            <Size>Extra small - Extra large</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4041</SubGroupID>
            <ARTGs>
                <ARTG>167057</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW828</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR274</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INBONE® II Total Ankle System: Tibial Component</Name>
            <Description>Modular Tibial Tray, Tibial Base Stem, Tibial Top Stem</Description>
            <Size>Sizes 2-5</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4042</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>1638</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW859</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR327</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INVISION Tibial Component</Name>
            <Description>Tibial Tray, Standard or Long</Description>
            <Size>Sizes 2, 3, 4, 5; Standard or Long; +4mm; +8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4042</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>1638</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW893</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR366</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Salto Talaris Ankle Prosthesis - Tibial component</Name>
            <Description>Tibial component, fixed bearing, CrCo + Ti</Description>
            <Size>Sizes 0, 1,2,3</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4042</SubGroupID>
            <ARTGs>
                <ARTG>134055</ARTG>
            </ARTGs>
            <MinimumBenefit>1638</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW983</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR320</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INFINITY Total Ankle System: Tibial Component</Name>
            <Description>Tibial tray</Description>
            <Size>Sizes 1-5 and 3 Long, 4 Long, 5 Long</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4042</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>1638</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA024</BillingCode>
            <Name>TM Ankle</Name>
            <Description>tibial base component</Description>
            <Size>6 sizes</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>4042</SubGroupID>
            <ARTGs>
                <ARTG>202429</ARTG>
            </ARTGs>
            <MinimumBenefit>1638</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW861</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR329</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INVISION Talar Augment</Name>
            <Description>Talar Augment</Description>
            <Size>15, 20, 25, 30, 35mm Diameter; 6mm and 10mm Depth</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>6021</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>707</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW862</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR330</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INVISION Talar Plate</Name>
            <Description>Talar Plate</Description>
            <Size>Sizes 1 – 5, Left or right, standard or long, 3mm, 6mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>6021</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>707</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW980</BillingCode>
            <Name>INBONE II Total Ankle System: Tibial Stem Extender</Name>
            <Description>Modular Tibial Segments</Description>
            <Size>12mm, 14mm, 16mm, 18mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1460</GroupID>
            <SubGroupID>6021</SubGroupID>
            <ARTGs>
                <ARTG>168052</ARTG>
            </ARTGs>
            <MinimumBenefit>707</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE138</BillingCode>
            <Name>Hemi CAP Articular Resurfacing Great Toe System</Name>
            <Description>Articular Component</Description>
            <Size>12mm (1-2mm x 1.5-3mm offset), 15mm (1.5-2.5mm x 2.5-4.5mm offset)</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1461</GroupID>
            <SubGroupID>4047</SubGroupID>
            <ARTGs>
                <ARTG>123538</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE139</BillingCode>
            <Name>Hemi CAP Articular Resurfacing Great Toe System</Name>
            <Description>Fixation Component</Description>
            <Size>8mm x 16mm, 9.5mm x 18mm</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1461</GroupID>
            <SubGroupID>4047</SubGroupID>
            <ARTGs>
                <ARTG>123538</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM363</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH232</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Toe Joint</Name>
            <Description>Metallic Hemiarthroplasty resurfacing prosthesis for the Metatarsophalangeal Joint</Description>
            <Size>8mm - 23 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1461</GroupID>
            <SubGroupID>4048</SubGroupID>
            <ARTGs>
                <ARTG>141544</ARTG>
            </ARTGs>
            <MinimumBenefit>1145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW705</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>WMT Orthopaedics Implants Hinge Toe and Hammertoe Implant</Name>
            <Description>Silastic flexible hinge toe with/without grommets</Description>
            <Size>0, 1, 2, 3, 4, 5, 6, 7</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>124</SubCategoryID>
            <GroupID>1461</GroupID>
            <SubGroupID>4049</SubGroupID>
            <ARTGs>
                <ARTG>131003</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO416</BillingCode>
            <Name>Motec Wrist Joint Prosthesis</Name>
            <Description>Metacarpal Threaded Implant</Description>
            <Size>45-70mm lengths in 5mm increments, both in Small and Large sizes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3664</SubGroupID>
            <ARTGs>
                <ARTG>194619</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK596</BillingCode>
            <Name>Total Wrist Implant System</Name>
            <Description>Carpal Component</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3664</SubGroupID>
            <ARTGs>
                <ARTG>237794</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL211</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG110</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Universal2 Carpal Component</Name>
            <Description>Carpal plate (titanium) with fixed central peg and porous coating</Description>
            <Size>xs, small, med, large</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3664</SubGroupID>
            <ARTGs>
                <ARTG>177632</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM347</BillingCode>
            <Name>KinematX Wrist Arthroplasty System</Name>
            <Description>Modular Wrist Arthroplasty</Description>
            <Size>1, 2, 3</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3665</SubGroupID>
            <ARTGs>
                <ARTG>242002</ARTG>
            </ARTGs>
            <MinimumBenefit>3111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO417</BillingCode>
            <Name>Motec Wrist Joint Prosthesis</Name>
            <Description>Radius Threaded Implant</Description>
            <Size>Radius threaded Implant, lengths 32-70mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3665</SubGroupID>
            <ARTGs>
                <ARTG>194619</ARTG>
            </ARTGs>
            <MinimumBenefit>3111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK592</BillingCode>
            <Name>Total Wrist Implant System</Name>
            <Description>Left and Right Radial Components</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3665</SubGroupID>
            <ARTGs>
                <ARTG>237794</ARTG>
            </ARTGs>
            <MinimumBenefit>3111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL213</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG112</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Universal2 Radial Component</Name>
            <Description>Radial Implant (cobalt chrome) with integral stem and porous coating</Description>
            <Size>x-small - left &amp; right, small - left &amp; right, medium - left &amp; right, large - left &amp; right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3665</SubGroupID>
            <ARTGs>
                <ARTG>177632</ARTG>
            </ARTGs>
            <MinimumBenefit>3111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW702</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR041</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthosphere</Name>
            <Description>The Orthosphere is a spherical interpositional implant that may be used in both the carpometacarpal joint and tarsometatarsal joint as a spherical interpositional device.  It is used to replace the sympotmatic joint - either between the trapezium and firs</Description>
            <Size>9mm - 14mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3666</SubGroupID>
            <ARTGs>
                <ARTG>130998</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW923</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR403</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioProfile Pyrocarbon Total Wrist Replacement (Capitate Resurfacing)</Name>
            <Description>Low Temperature Isotropic Pyrolytic Carbon Implants for capitate resurfacing (reverse total wrist arthroplasty)</Description>
            <Size>Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3666</SubGroupID>
            <ARTGs>
                <ARTG>94262</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW924</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR404</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioProfile Pyrocarbon Carpal Implants</Name>
            <Description>Low temperature Isotropic Pyrolytic Carbon Implants for carpal replacement/interposition, includes Proximal Scaphoid, Scapho/Trapezio/Trapezoid &amp; Trapezium</Description>
            <Size>Small, Medium, Large &amp; Extra Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3666</SubGroupID>
            <ARTGs>
                <ARTG>94262</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM297</BillingCode>
            <Name>Pyrocarbon Lunate</Name>
            <Description>Pyrocarbon Lunate replacement</Description>
            <Size>Mulitple</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3666</SubGroupID>
            <ARTGs>
                <ARTG>92524</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO418</BillingCode>
            <Name>Motec Wrist Joint Prosthesis</Name>
            <Description>Modular Radius Cups available with 15mm PEEK insert bearing and Cobalt Chromium Molybdenum coated with Ceramic Chromium Nitride 15mm &amp; 18mm. Modular Metacarpal Heads available with 4 neck lengths</Description>
            <Size>Modular Radius Cup PEEK 15mm Ceramitised 15mm &amp; 17mm.  Modular Metacarpal Head 15mm short, med, long &amp; Extra long Neck - 18mm short medium &amp; long Neck</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3666</SubGroupID>
            <ARTGs>
                <ARTG>194619</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK594</BillingCode>
            <Name>Total Wrist Implant System</Name>
            <Description>Carpal Ball</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3666</SubGroupID>
            <ARTGs>
                <ARTG>237794</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL212</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG111</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Universal2 Carpal Poly Component</Name>
            <Description>Polyethylene carpal component to restore proper carpal height in Universal2 total wrist implant</Description>
            <Size>xs-standard, xs +1, xs+2, small - standard, small +1, small +2, Med-standard, med+1, med+2; large-standard, large+1, large+2</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3666</SubGroupID>
            <ARTGs>
                <ARTG>177632</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW926</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR406</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Eclypse Modular Pyrocarbon Ulnar Head</Name>
            <Description>A modular titanium stem for ulnar head prostheses</Description>
            <Size>6, 7.5, 9mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3667</SubGroupID>
            <ARTGs>
                <ARTG>121874</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT076</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH502</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Martin Ulna Head prosthesis</Name>
            <Description>Ulnar Stem Titanium</Description>
            <Size>Small, medium and large,2mm,4mm and 17mm collar</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3667</SubGroupID>
            <ARTGs>
                <ARTG>225176</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM148</BillingCode>
            <Name>Ascension DRUJ Ulna Head, Implant System</Name>
            <Description>Cobalt chromium stem with PyroCarbon or Cobalt Chromium Articular Surface</Description>
            <Size>0, 1, 2, 3, 4</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3667</SubGroupID>
            <ARTGs>
                <ARTG>118638</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM356</BillingCode>
            <Name>Radio-Ulnar Joint Stem</Name>
            <Description>Radio-Ulnar Joint Stem</Description>
            <Size>Multiple Sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3667</SubGroupID>
            <ARTGs>
                <ARTG>178232</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW925</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR405</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Eclypse Modular Pyrocarbon Ulnar Head</Name>
            <Description>A modular pyrocarbon ulnar head prosthesis</Description>
            <Size>14, 16, 18mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3668</SubGroupID>
            <ARTGs>
                <ARTG>121874</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT075</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH500</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Martin Ulna Head prosthesis</Name>
            <Description>UHP Ceramic Head</Description>
            <Size>Small, medium and large</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3668</SubGroupID>
            <ARTGs>
                <ARTG>225176</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT077</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH501</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Martin Ulna Head prosthesis</Name>
            <Description>UHP Cobalt Chrome Head</Description>
            <Size>Small, medium and large</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3668</SubGroupID>
            <ARTGs>
                <ARTG>225176</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM149</BillingCode>
            <Name>Ascension DRUJ Ulna Head, Implant System</Name>
            <Description>Cobalt chromium stem with PyroCarbon or Cobalt Chromium Articular Surface</Description>
            <Size>0, 1, 2, 3, 4</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3668</SubGroupID>
            <ARTGs>
                <ARTG>118638</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM357</BillingCode>
            <Name>UHMWP Ball</Name>
            <Description>UHMWP Ball</Description>
            <Size>Multiple</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>3668</SubGroupID>
            <ARTGs>
                <ARTG>178232</ARTG>
            </ARTGs>
            <MinimumBenefit>1064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW710</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR053</PriorBillingCode>
            </PriorBillingCodes>
            <Name>WMT Orthopaedic Implants Hand</Name>
            <Description>Silastic tendon spacer</Description>
            <Size>24in long, 3, 4, 5, 6mm wide</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>4050</SubGroupID>
            <ARTGs>
                <ARTG>141772</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM245</BillingCode>
            <Name>Universal Tendon Spacer</Name>
            <Description>Tendon Spacer</Description>
            <Size>1 size only</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>4050</SubGroupID>
            <ARTGs>
                <ARTG>235820</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM366</BillingCode>
            <Name>Distal Radio-Ulnar Joint Prosthesis</Name>
            <Description>Distal Radio-Ulnar Joint Prosthesis</Description>
            <Size>Multiple sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1273</GroupID>
            <SubGroupID>7061</SubGroupID>
            <ARTGs>
                <ARTG>178232</ARTG>
            </ARTGs>
            <MinimumBenefit>2333</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK601</BillingCode>
            <Name>Elektra Neck</Name>
            <Description>Cobalt Chromium</Description>
            <Size>Extra Short, Short, Medium, Long</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>5530</SubGroupID>
            <ARTGs>
                <ARTG>167056</ARTG>
            </ARTGs>
            <MinimumBenefit>420</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK602</BillingCode>
            <Name>Trapezio Metacarpal Prosthesis DLC</Name>
            <Description>Cup, Polyethylene</Description>
            <Size>One size only</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>5530</SubGroupID>
            <ARTGs>
                <ARTG>252453</ARTG>
            </ARTGs>
            <MinimumBenefit>420</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK604</BillingCode>
            <Name>Elektra Cup</Name>
            <Description>Cobalt Chromium and Hydroxyapatite coating</Description>
            <Size>One size only</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>5530</SubGroupID>
            <ARTGs>
                <ARTG>167056</ARTG>
            </ARTGs>
            <MinimumBenefit>420</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW704</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR043</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Wright Swanson Titanium Carpal Scaphoid, Carpal Lunate, Basal Thumb Implant</Name>
            <Description>The Swanson Basal Thumb implant is a one-piece intramedullary-stemmed implant designed to be used as an adjunct to resection arthroplasty of the trapeziometacarpal joint.  It acts as a spacer to preserve joint relationship and allow appropriate capsulolig</Description>
            <Size>1 to 5 - length 19.3 to 26.3mm, width 9.5 to 13.6mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6041</SubGroupID>
            <ARTGs>
                <ARTG>131003</ARTG>
            </ARTGs>
            <MinimumBenefit>420</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM389</BillingCode>
            <Name>Modular Thumb Head and Stem </Name>
            <Description>Modular Thumb Head and Stem</Description>
            <Size>Suitable for patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6041</SubGroupID>
            <ARTGs>
                <ARTG>329234</ARTG>
            </ARTGs>
            <MinimumBenefit>420</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK600</BillingCode>
            <Name>Elektra Stem</Name>
            <Description>Cobalt Chromium/Hydroxyapatite coated</Description>
            <Size>6-8mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6041</SubGroupID>
            <ARTGs>
                <ARTG>167056</ARTG>
            </ARTGs>
            <MinimumBenefit>420</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD067</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>HW565</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SR Hand Implant System</Name>
            <Description>SR Hand MCP Proximal, CoCr - Titanium Alloy, UHMWPE</Description>
            <Size>XS/S/M/L/XL</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6044</SubGroupID>
            <ARTGs>
                <ARTG>237799</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM294</BillingCode>
            <Name>Ascension MCP Finger Joint Replacement</Name>
            <Description>PyroCarbon MCP Proximal Component</Description>
            <Size>05P, 10P, 20P, 30P, 40P, 50P</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6044</SubGroupID>
            <ARTGs>
                <ARTG>94980</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK598</BillingCode>
            <Name>MCP Finger Prosthesis "Ariadna"</Name>
            <Description>Proximal part, Stainless Steel</Description>
            <Size>1,2,or 3</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6044</SubGroupID>
            <ARTGs>
                <ARTG>167056</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD068</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>HW566</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SR Hand Implant System</Name>
            <Description>SR Hand MCP Distal CoCr - Titanium Alloy, UHMWPE</Description>
            <Size>XS/S/M/L/XL</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6143</SubGroupID>
            <ARTGs>
                <ARTG>237799</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM293</BillingCode>
            <Name>Ascension MCP Finger Joint Replacement</Name>
            <Description>PyroCarbon MCP Distal Component</Description>
            <Size>05D, 10D, 20D, 30D, 40D, 50D</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6143</SubGroupID>
            <ARTGs>
                <ARTG>94980</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD071</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK597</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PIP Finger Prosthesis</Name>
            <Description>Proximal part PIP joint</Description>
            <Size>0-5</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6144</SubGroupID>
            <ARTGs>
                <ARTG>237793</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD073</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>HW675</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tactys PIP - Proximal System</Name>
            <Description>Proximal Surface and Stem</Description>
            <Size>XS, S, M &amp; L</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6144</SubGroupID>
            <ARTGs>
                <ARTG>237793</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT092</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH655</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Martin Endoprosthesis System CapFlex PIP</Name>
            <Description>CapFlex PIP Proximal</Description>
            <Size>S,M,L</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6144</SubGroupID>
            <ARTGs>
                <ARTG>266373</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM296</BillingCode>
            <Name>Ascension PIP Finger Joint Replacement</Name>
            <Description>PyroCarbon PIP Proximal Component.</Description>
            <Size>10P, 20P, 30P, 40P</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6144</SubGroupID>
            <ARTGs>
                <ARTG>94980</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ022</BillingCode>
            <Name>PIPR Finger Joint</Name>
            <Description>Proximal Interphalangeal Replacement Joint:&#xD;
Proximal Component&#xD;
CoCr, HA</Description>
            <Size>Sizes 7 through to 11</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6144</SubGroupID>
            <ARTGs>
                <ARTG>138339</ARTG>
                <ARTG>192787</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD072</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK603</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PIP Finger Prosthesis</Name>
            <Description>Distal part PIP joint</Description>
            <Size>0-5</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6145</SubGroupID>
            <ARTGs>
                <ARTG>237793</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD074</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>HW676</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tactys PIP - Distal System </Name>
            <Description>Distal Surface and Stem</Description>
            <Size>XS, S, M &amp; L</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6145</SubGroupID>
            <ARTGs>
                <ARTG>237793</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT093</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH656</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Martin Endoprosthesis System CapFlex PIP</Name>
            <Description>CapFlex PIP Distal</Description>
            <Size>S,M,L, Height: 2.1, 3.0 &amp; 4.4mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6145</SubGroupID>
            <ARTGs>
                <ARTG>266373</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM295</BillingCode>
            <Name>Ascension PIP Finger Joint Replacement</Name>
            <Description>PyroCarbon PIP Distal Component</Description>
            <Size>10D, 20D, 30D, 40D</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6145</SubGroupID>
            <ARTGs>
                <ARTG>94980</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ023</BillingCode>
            <Name>PIPR Finger Joint</Name>
            <Description>Proximal Interphalangeal Replacement Joint:&#xD;
Middle Component and Insert&#xD;
CoCr, HA, UHMWPE</Description>
            <Size>Sizes 7 through to 11</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6145</SubGroupID>
            <ARTGs>
                <ARTG>138339</ARTG>
                <ARTG>192787</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK595</BillingCode>
            <Name>MCP Finger Prosthesis "Ariadna"</Name>
            <Description>Distal part, Stainless Steel</Description>
            <Size>1,2 or3</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6145</SubGroupID>
            <ARTGs>
                <ARTG>167056</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD069</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK588</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Sbi PIP Silicone Implant System</Name>
            <Description>Silicone finger joint</Description>
            <Size>Various</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <Suffix>Total</Suffix>
            <ARTGs>
                <ARTG>237800</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD070</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SK589</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Sbi Silicone MCP Implant System</Name>
            <Description>Silicon finger joint</Description>
            <Size>Various</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <Suffix>Total</Suffix>
            <ARTGs>
                <ARTG>237799</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW706</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>WMT Orthopaedic Implants Finger/Thumb</Name>
            <Description>Silastic finger joint with/without Ti grommets 470 series</Description>
            <Size>00, 0, 1, 2, 3, 4, 5, 6, 7, 8, 9</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <Suffix>Total</Suffix>
            <ARTGs>
                <ARTG>131003</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM053</BillingCode>
            <Name>Osteotec Silicone PIP Joint Replacement</Name>
            <Description>2 component hinged joint replacement for the proximal interphalangeal joint</Description>
            <Size>5 - 50</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <Suffix>Total</Suffix>
            <ARTGs>
                <ARTG>118424</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM102</BillingCode>
            <Name>Ascension Silicone Finger joint replacement</Name>
            <Description>MCP moulded silicone finger joint</Description>
            <Size>Various</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <Suffix>Total</Suffix>
            <ARTGs>
                <ARTG>92524</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM103</BillingCode>
            <Name>Ascension Silicone Finger joint replacement</Name>
            <Description>PIP moulded silicone finger joint</Description>
            <Size>00-05</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <Suffix>Total</Suffix>
            <ARTGs>
                <ARTG>92524</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN187</BillingCode>
            <Name>Neuflex Finger</Name>
            <Description>Silicon Interpositional device</Description>
            <Size>0-60</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <Suffix>Total</Suffix>
            <ARTGs>
                <ARTG>97976</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW703</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR042</PriorBillingCode>
            </PriorBillingCodes>
            <Name>WMT Orthopaedic Implants Hand</Name>
            <Description>The Swanson Trapezium Implant is a flexible, one-piece intramedullary-stemmed implant developed to restore function to thumbs disabled by degenerative arthritis or post-traumatic arthritis.</Description>
            <Size>1, 2, 3, 4, 5</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <ARTGs>
                <ARTG>130998</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW933</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR418</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BIOProfile Pyrocarbon Carpometacarpal Implants</Name>
            <Description>Low Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty)</Description>
            <Size>Small, Medium, Large &amp; Extra Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <ARTGs>
                <ARTG>94262</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM298</BillingCode>
            <Name>Pyrocarbon carpal implants</Name>
            <Description>Pyrocarbon carpal replacement implants</Description>
            <Size>Multiple sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1274</GroupID>
            <SubGroupID>6146</SubGroupID>
            <ARTGs>
                <ARTG>92524</ARTG>
            </ARTGs>
            <MinimumBenefit>665</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH338</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Distal Humeral Body</Description>
            <Size>50mm to 70mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW377</BillingCode>
            <Name>Souter Strathclyde Elbow</Name>
            <Description>Humeral - Long stem, left and right</Description>
            <Size>Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>16236</ARTG>
                <ARTG>166620</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW379</BillingCode>
            <Name>Souter Strathclyde Elbow</Name>
            <Description>Revision Humeral  - Custom, Long Stem</Description>
            <Size>A, B, C, D</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>16236</ARTG>
                <ARTG>166620</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW985</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR432</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Latitude EV Humeral Stem</Name>
            <Description>Cobalt-chromium humeral stem with Ti Plasma spray</Description>
            <Size>Stem length: Standard, 150mm, 200mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>200974</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH663</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO123</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Distal Humerus</Name>
            <Description>MUTARS Distal Humerus</Description>
            <Size>50mm, 30mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>221739</ARTG>
                <ARTG>284227</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST818</BillingCode>
            <Name>Osteonics Solar Elbow System - humeral assembly</Name>
            <Description>Titanium alloy with polyethylene bushing</Description>
            <Size>Standard, large</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>12875</ARTG>
                <ARTG>166619</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST819</BillingCode>
            <Name>Osteonics Solar Elbow System - long humeral assembly</Name>
            <Description>Titanium alloy with polyethylene bushing</Description>
            <Size>Standard, large</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>12875</ARTG>
                <ARTG>166620</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA026</BillingCode>
            <Name>Nexel Elbow</Name>
            <Description>Humeral Component</Description>
            <Size>Sizes 4-6 with multiple stem lengths</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>213309</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI004</BillingCode>
            <Name>Coonrad-Morrey Elbow</Name>
            <Description>Humerus - Titanium</Description>
            <Size>4, 6, 8 inch, Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3673</SubGroupID>
            <ARTGs>
                <ARTG>95733</ARTG>
            </ARTGs>
            <MinimumBenefit>4387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW694</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Modular Radial Head</Name>
            <Description>Cobalt chromium alloy, standard and plus stems</Description>
            <Size>Stem 4.5 - 9.5mm Standard, +2 &amp; +4mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>118455</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW885</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR357</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RHS Radial Head System, Radial Stem</Name>
            <Description>RHS Elbow prosthesis, Proximal Radial Stem, Press-fit Short Stems or Long Cemented Stems, Ti Co</Description>
            <Size>Press-Fit Short Stems: 6 to 10mm , neck 13mm or 16mm. Cementeed Long Stems: 6.5 or 8mm, neck 19 or 22mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>94231</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW888</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR360</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Latitude Elbow Prosthesis</Name>
            <Description>Latitude Radial Stem component</Description>
            <Size>Diam 6.5mm or 5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>200973</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW928</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR408</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MoPyC-Modular Pyrocarbon Radial head Prosthesis</Name>
            <Description>A modular titanium stem for radial head prosthesis</Description>
            <Size>7mm, 8mm, 9mm, 10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>94231</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG145</BillingCode>
            <Name>Katalyst Bipolar Radial Head System - Stem</Name>
            <Description>Katalyst Bipolar Radial Head System (head and stem) to restore the support and bearing surface of the radial head in fracture, arthritis or failed prior radial head implantation.</Description>
            <Size>6.5mm and 7.5mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>177627</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM104</BillingCode>
            <Name>Ascension Radial Head</Name>
            <Description>Proximal Radial Stem</Description>
            <Size>01/02/03/04, standard &amp; long</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>112685</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM532</BillingCode>
            <Name>Align Radial Head System</Name>
            <Description>Titanium alloy stems with titanium plasma spray coating   </Description>
            <Size>7 - 11mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>279801</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO271</BillingCode>
            <Name>Acumed Total Radial Head</Name>
            <Description>Stem</Description>
            <Size>Standard Stems 6-10mm diameter 0-8mm neck height, Long Stems 6-12mm diameter</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3674</SubGroupID>
            <ARTGs>
                <ARTG>126428</ARTG>
            </ARTGs>
            <MinimumBenefit>1259</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW381</BillingCode>
            <Name>Radial Head Prostheses</Name>
            <Description>Radial Head - Small, Medium, Large</Description>
            <Size>8 - 15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>166613</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW695</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>WMT Orthopaedic Implants Radial/Ulna Head</Name>
            <Description>Radial head implant HP silastic</Description>
            <Size>1, 1.5, 2, 2.5, 3</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>118455</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW696</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Modular Radial Head</Name>
            <Description>Cobalt chromium alloy head</Description>
            <Size>Head 18-28mm Std, +2 and +4mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>118455</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW886</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR358</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RHS Radial Head System, Radial Head</Name>
            <Description>RHS Elbow prosthesis, Radial Head, Ti Co</Description>
            <Size>18mm to 24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>94231</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW887</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR359</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Latitude Elbow Prosthesis</Name>
            <Description>Latitude Radial Head component</Description>
            <Size>Small, Medium, Large, Large +</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>200973</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW927</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR407</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MoPyC-Modular Pyrocarbon Radial head Prosthesis</Name>
            <Description>A modular pyrocarbon radial head / neck prosthesis</Description>
            <Size>18mm, 20mm, 22mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>94231</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG144</BillingCode>
            <Name>Katalyst Bipolar Radial Head System - Head</Name>
            <Description>Katalyst Bipolar Radial Head System (head and stem) to restore the support and bearing surface of the radial head in fracture, arthritis or failed prior radial head implantation</Description>
            <Size>18mm, 21mm and 24mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>177627</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM105</BillingCode>
            <Name>Ascension Radial head</Name>
            <Description>Proximal Radial Head</Description>
            <Size>20/22/24mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>112685</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM531</BillingCode>
            <Name>Align Radial Head </Name>
            <Description>CoCr Radial Head with Lock Screw</Description>
            <Size>18 - 26mm </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>279801</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO270</BillingCode>
            <Name>Acumed Total Radial Head</Name>
            <Description>Head</Description>
            <Size>20-28mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3675</SubGroupID>
            <ARTGs>
                <ARTG>126428</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW378</BillingCode>
            <Name>Souter Strathclyde Elbow</Name>
            <Description>Ulnar - Retentive, non retentive</Description>
            <Size>50 - 90mm (Non), 70 - 90mm (Retentive)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>16236</ARTG>
                <ARTG>166619</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW380</BillingCode>
            <Name>Souter Strathclyde Elbow</Name>
            <Description>Revision Ulnar - Custom, Long stem</Description>
            <Size>Small, Medium</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>16236</ARTG>
                <ARTG>166619</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW866</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR335</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tornier Latitude Total Elbow Prosthesis</Name>
            <Description>Ulnar component, CoCr + UHMWPE</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>201352</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW944</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR433</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Latitude EV Ulnar Stem</Name>
            <Description>Chromium cobalt ulnar stem with Ti Plasma spray</Description>
            <Size>Stem length: Short, Standard, 70mm, 125mm, 150mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>201352</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH671</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO132</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Proximal ulna</Name>
            <Description>MUTARS Proximal ulna</Description>
            <Size>60mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>221739</ARTG>
                <ARTG>284268</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH673</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO134</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS ulna anchorage</Name>
            <Description>MUTARS ulna anchorage</Description>
            <Size>left/right 70mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>221739</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH685</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO177</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Ulna Anchorage</Name>
            <Description>MUTARS Ulna Anchorage Component</Description>
            <Size>Left/Right 70-100mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>221739</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA028</BillingCode>
            <Name>Nexel Elbow</Name>
            <Description>Ulnar Component</Description>
            <Size>75mm-115mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>213309</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI003</BillingCode>
            <Name>Coonrad-Morrey Elbow</Name>
            <Description>Ulna - Titanium</Description>
            <Size>Petite, Left, Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3676</SubGroupID>
            <ARTGs>
                <ARTG>95731</ARTG>
            </ARTGs>
            <MinimumBenefit>3398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW224</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humeral Axis -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3678</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
            </ARTGs>
            <MinimumBenefit>788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW938</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR425</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Latitude Elbow Prosthesis – Humeral Screw</Name>
            <Description>Humeral Screw for revision surgery</Description>
            <Size>Small, Medium and Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>3678</SubGroupID>
            <ARTGs>
                <ARTG>200974</ARTG>
            </ARTGs>
            <MinimumBenefit>788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH062</BillingCode>
            <Name>Discovery Elbow System</Name>
            <Description>2 x Condyle Bearings, 2 x screws, Poly articulation bearings</Description>
            <Size>Std, Revision</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>4052</SubGroupID>
            <ARTGs>
                <ARTG>126999</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW881</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR352</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Latitude Elbow Prosthesis</Name>
            <Description>Latitude Humeral Spool component, standard or anatomic, CoCr + PEEK</Description>
            <Size>Standard spool: Small, Medium, Large, Large +, anterior, posterior or centered,   Anatomic Spool: Small, Medium, Large, Large +, Left and Right, Anterior Centred and Posterior Offset</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>4052</SubGroupID>
            <ARTGs>
                <ARTG>200974</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW937</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR424</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Latitude Total Elbow Prosthesis – Ulnar Bushing</Name>
            <Description>Ultra-high molecular weight polyethylene ulnar bushing</Description>
            <Size>Small, Medium, Large – Right and Left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>4052</SubGroupID>
            <ARTGs>
                <ARTG>201352</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA029</BillingCode>
            <Name>Nexel Elbow</Name>
            <Description>Accessories (1 Humeral Bearing, 2 Ulnar Bearings and 1 Axle Pin)</Description>
            <Size>Various</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>4052</SubGroupID>
            <ARTGs>
                <ARTG>213309</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI005</BillingCode>
            <Name>Coonrad-Morrey Elbow</Name>
            <Description>Bushing -  Polyethylene, Titanium</Description>
            <Size>1 &amp; 2</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>4052</SubGroupID>
            <ARTGs>
                <ARTG>95733</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW199</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Circlip -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>4053</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
                <ARTG>261514</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW223</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Ulna Joint -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1275</GroupID>
            <SubGroupID>4055</SubGroupID>
            <ARTGs>
                <ARTG>128026</ARTG>
            </ARTGs>
            <MinimumBenefit>3594</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD059</BillingCode>
            <Name>RSP Monoblock Humeral Stem Cemented</Name>
            <Description>RSP Monoblock Humeral Stem cemented</Description>
            <Size>6 x 101mm, 7 x 101mm, 8 x 101mm, 10 x 101mm, 12 x 101mm&#xD;
6 x 175mm, 8 x 175mm,10 x 175mm, 12 x 175mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>283578</ARTG>
                <ARTG>283579</ARTG>
            </ARTGs>
            <MinimumBenefit>6302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW874</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR344</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed fracture-standard</Name>
            <Description>Monobloc Humeral Stem CoCr cemented</Description>
            <Size>Length 130mm Dia 7 9 11 13 15</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>211015</ARTG>
            </ARTGs>
            <MinimumBenefit>6302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW875</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR345</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Fracture Shoulder - Revision</Name>
            <Description>Monobloc Humeral Stem CoCr and HA coated proximally</Description>
            <Size>Length 170, 180 or 210mm Dia 7 9 11 13mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>211015</ARTG>
            </ARTGs>
            <MinimumBenefit>6302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ971</BillingCode>
            <Name>DELTA Xtend</Name>
            <Description>Monoblock Humeral Stem</Description>
            <Size>8-14mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>126913</ARTG>
            </ARTGs>
            <MinimumBenefit>6302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA526</BillingCode>
            <Name>Affinis Inverse Stem, cemented</Name>
            <Description>Humeral component - cemented. Monoblock primary stem for reverse inlay</Description>
            <Size>6,9,12,15mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>215275</ARTG>
            </ARTGs>
            <MinimumBenefit>6302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA528</BillingCode>
            <Name>Affinis Inverse revision stem, cemented</Name>
            <Description>Monoblock Revision Humeral Stem</Description>
            <Size>6x180 to 12x230mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>224955</ARTG>
            </ARTGs>
            <MinimumBenefit>6302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI884</BillingCode>
            <Name>Comprehensive Fracture Stem</Name>
            <Description>Fracture Stem Cobalt Chrome, Titanium</Description>
            <Size>4,6,8,10,12,14mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>3771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD005</BillingCode>
            <Name>Turon Shoulder System - Humeral Stems</Name>
            <Description>Turon Humeral Stem, Primary and Revision</Description>
            <Size>6-16mm x 115mm and 6-16mm x 200mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <ARTGs>
                <ARTG>210938</ARTG>
                <ARTG>215958</ARTG>
            </ARTGs>
            <MinimumBenefit>3771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX055</BillingCode>
            <Name>Equinoxe Humeral Stem, Fracture</Name>
            <Description>The fracture stem is intended for cemented fixation only and is advised for 3 &amp; 4 part fractures of the proximal humerus</Description>
            <Size>Fracture: left: 6.5mm - 12.5mm, right 6.5mm- 12.5mm Long stem fracture: left&#xD;
6.5mmx200mm right 6.5mmx200mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <ARTGs>
                <ARTG>293561</ARTG>
                <ARTG>293562</ARTG>
            </ARTGs>
            <MinimumBenefit>3771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ969</BillingCode>
            <Name>Global Shoulder System</Name>
            <Description>Humeral Stem</Description>
            <Size>6-16mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <ARTGs>
                <ARTG>137608</ARTG>
                <ARTG>138093</ARTG>
                <ARTG>138288</ARTG>
            </ARTGs>
            <MinimumBenefit>3771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC044</BillingCode>
            <Name>SMR Large Resection Stem</Name>
            <Description>Resection Stem Large Ti6AI4V</Description>
            <Size>7-10mm Dia x 50-80 Height</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <ARTGs>
                <ARTG>211984</ARTG>
            </ARTGs>
            <MinimumBenefit>3771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA523</BillingCode>
            <Name>Affinis Shoulder System</Name>
            <Description>Stem Cemented - adjustable cone</Description>
            <Size>6, 9, 12 and 15mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4057</SubGroupID>
            <ARTGs>
                <ARTG>215496</ARTG>
                <ARTG>219396</ARTG>
            </ARTGs>
            <MinimumBenefit>3771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD060</BillingCode>
            <Name>RSP Monoblock Humeral Stem Uncemented</Name>
            <Description>RSP Monoblock Humeral Stem Uncemented</Description>
            <Size>6 x 101mm, 7 x 101mm, 8 x 101mm, 10 x 101mm,12 x 101mm&#xD;
6 x 175mm, 8 x 175mm, 10 x 175mm, 12 x 175mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>283578</ARTG>
                <ARTG>283579</ARTG>
            </ARTGs>
            <MinimumBenefit>6013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD066</BillingCode>
            <Name>Altivate Reverse Humeral Stem</Name>
            <Description>Altivate Reverse Humeral Stem</Description>
            <Size>108, 175 &amp; 220mm Length</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>297842</ARTG>
                <ARTG>297843</ARTG>
            </ARTGs>
            <MinimumBenefit>6013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA527</BillingCode>
            <Name>Affinis Inverse Stem, uncemented</Name>
            <Description>Monoblock Humeral Stem</Description>
            <Size>6 to 15 mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>215274</ARTG>
            </ARTGs>
            <MinimumBenefit>6013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA529</BillingCode>
            <Name>Affinis Inverse Revision stem, uncemented</Name>
            <Description>Monoblock Revision Humeral Stem</Description>
            <Size>6 to 12 x180 to 230mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>238292</ARTG>
            </ARTGs>
            <MinimumBenefit>6013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ119</BillingCode>
            <Name>Verso Shoulder System - Humeral Shell</Name>
            <Description>Verso Shoulder Humeral Shell</Description>
            <Size>Standard &amp; Stemmed</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>284179</ARTG>
                <ARTG>284180</ARTG>
            </ARTGs>
            <MinimumBenefit>6013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI528</BillingCode>
            <Name>Zimmer Trabecular Metal Reverse Shoulder System</Name>
            <Description>Trabecular Metal Humeral Stem Titanium Alloy and Tantalum</Description>
            <Size>8mm-18mm x 130mm-170mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>228451</ARTG>
                <ARTG>230880</ARTG>
            </ARTGs>
            <MinimumBenefit>6013</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH047</BillingCode>
            <Name>Comprehensive Shoulder System</Name>
            <Description>Humeral Stems, standard, mini, micro and revision, porous coated, Ti</Description>
            <Size>4mm to 20mm Diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD032</BillingCode>
            <Name>Reverse Shoulder System</Name>
            <Description>Humeral Stem, Ti</Description>
            <Size>6mm to 12mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>210915</ARTG>
                <ARTG>210917</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA007</BillingCode>
            <Name>Equinoxe Humeral Stem, Primary, Press-Fit</Name>
            <Description>Press-Fit Humeral Stem</Description>
            <Size>7 – 19mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>244995</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU257</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE173</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Univers Fracture Prostheses</Name>
            <Description>Shaft</Description>
            <Size>8-13mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>308823</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW867</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR337</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Fracture Shoulder HA Coated</Name>
            <Description>Fracture shoulder humeral stem Cobalt Chrome, HA coated</Description>
            <Size>Diam 6.5mm - 130mm and 170mm lengths, Diam 9mm - 130mm, 180mm and 210mm lengths. Diam 12mm - 130mm, 180mm and 210mm lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>208886</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW946</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR435</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Simpliciti - Nucleus</Name>
            <Description>Uncemented humeral component, titanium, coated with a sintered titanium CP Ti bead coating</Description>
            <Size>1,2,3</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>222657</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW948</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR437</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Ascend Flex PTC Humeral Stem</Name>
            <Description>Convertible humeral stem with proximal PTC titanium plasma spray coating</Description>
            <Size>Length: 66mm, 70mm, 74mm, 78mm, 82mm, 86mm, 88mm, 90mm, 93mm, 94mm, 98mm, 104mm, 109mm, 115mm, 120mm, 125mm, 130mm  Sizes: 1 to 9  Angulation: 127.5º, 132.5º, 137.5º</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>218732</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA522</BillingCode>
            <Name>Affinis Shoulder System</Name>
            <Description>Stem Cementless - Titanium, adjustable cone</Description>
            <Size>6, 7.5, 9, 10.5, 12, 13.5 and 15mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>219395</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA543</BillingCode>
            <Name>Affinis Shoulder System – Humeral Stem</Name>
            <Description>Humeral stem and trunion, uncemented, Ti with Ti Plasma Spray and CaP coating</Description>
            <Size>1-6</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>215479</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN354</BillingCode>
            <Name>GLOBAL ICON Stemless Shoulder System</Name>
            <Description>Anchor Plate</Description>
            <Size>40 to 56 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>395270</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST674</BillingCode>
            <Name>Osteonics Solar Shoulder Prostheses </Name>
            <Description>Humeral stem polyethylene</Description>
            <Size>3,5,7,9,11</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>128449</ARTG>
                <ARTG>12875</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA017</BillingCode>
            <Name>Comprehensive Nano Humeral Component</Name>
            <Description>stemless humeral component</Description>
            <Size>30-40mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>220712</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI326</BillingCode>
            <Name>Bigliani/Flatow Trabecular Metal Humeral Shoulder</Name>
            <Description>Porous Tantulum Humeral Stem</Description>
            <Size>6mm-19mm diameter</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>227172</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI992</BillingCode>
            <Name>Sidus Stem-Free Shoulder</Name>
            <Description>Humeral Anchor</Description>
            <Size>S,M,L</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4058</SubGroupID>
            <ARTGs>
                <ARTG>210098</ARTG>
            </ARTGs>
            <MinimumBenefit>3325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH339</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprepehnsive SRS Proximal Body</Description>
            <Size>42mm to 62mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4059</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>2314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH340</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Tumour Body</Description>
            <Size>51mm to 71mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4059</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>2314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD036</BillingCode>
            <Name>Reverse Shoulder System</Name>
            <Description>Humeral Socket Shell - Ti</Description>
            <Size>Neutral, +4mm, +8mm offset</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4059</SubGroupID>
            <ARTGs>
                <ARTG>210937</ARTG>
            </ARTGs>
            <MinimumBenefit>2314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC189</BillingCode>
            <Name>SMR Reverse Humeral Body with Locking Screw</Name>
            <Description>SMR  Humeral Body -Reverse</Description>
            <Size>Reverse Humeral body - short;  Reverse humeral body - finned;  Reverse humeral body - Standard HA Coated; 140° Reverse Humeral body - short; 140° Reverse humeral body - finned;  140°Reverse humeral body - Standard HA Coated</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <Suffix>Reverse</Suffix>
            <ARTGs>
                <ARTG>234748</ARTG>
                <ARTG>225315</ARTG>
                <ARTG>234749</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU258</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE256</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Eclipse Humeral Head Prosthesis</Name>
            <Description>Eclipse Humeral Head Prosthesis Trunnion</Description>
            <Size>41 - 53mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <ARTGs>
                <ARTG>308802</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW870</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR340</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder -Metaphysis (Cemented or Cementless)</Name>
            <Description>Cemented: CoCr and UMWHPE, Cementless: CoCr, HA Coated and UMWHPE</Description>
            <Size>D.36mm &amp; 42mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <ARTGs>
                <ARTG>208525</ARTG>
                <ARTG>208524</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ973</BillingCode>
            <Name>Delta Shoulder System</Name>
            <Description>Ephiphysis</Description>
            <Size>1 – 4 in 26-42mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <ARTGs>
                <ARTG>126913</ARTG>
                <ARTG>143529</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC188</BillingCode>
            <Name>SMR Humeral Body with Locking Screw</Name>
            <Description>Humeral Body Ti6aI4V - Finned - Trauma</Description>
            <Size>Short/Medium/Long</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <ARTGs>
                <ARTG>234232</ARTG>
                <ARTG>235005</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA481</BillingCode>
            <Name>Affinis Shoulder System</Name>
            <Description>Affinis Fracture Stem - metaphyseal, uncemented</Description>
            <Size>15.5, Part 2- 18</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <ARTGs>
                <ARTG>219732</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA536</BillingCode>
            <Name>Affinis Fracture Inverse</Name>
            <Description>Metaphyseal body with Ti plama spray plus CaPcoating- includes humeralcup with CoCr bearing surface</Description>
            <Size>39 to 42</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <ARTGs>
                <ARTG>224971</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN221</BillingCode>
            <Name>Global Unite Shoulder System</Name>
            <Description>Anatomic Proximal Body</Description>
            <Size>6 to 16</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4060</SubGroupID>
            <ARTGs>
                <ARTG>231183</ARTG>
            </ARTGs>
            <MinimumBenefit>2451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK427</BillingCode>
            <Name>Solar Reunion Humeral Fracture System</Name>
            <Description>Solar Reunion Humeral Fracture System</Description>
            <Size>Short &amp; Long</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4062</SubGroupID>
            <ARTGs>
                <ARTG>128450</ARTG>
            </ARTGs>
            <MinimumBenefit>3627</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH337</BillingCode>
            <Name>Comprehensive Segmental Revision System</Name>
            <Description>Comprehensive SRS Modular Stem</Description>
            <Size>(6 to 20) mm dia x (50 to 200)mm length</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4063</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>3755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX051</BillingCode>
            <Name>Equinoxe Humeral Long Stem</Name>
            <Description>The long/revision stem is intended for cemented fixation only. The long/revision stem is advised when the distal bone quality is insufficient to adequately anchor the primary stems (typically as a result of mid-humeral fractures)</Description>
            <Size>8x175mm, 8x215mm, 10x200mm, 12x200mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4063</SubGroupID>
            <ARTGs>
                <ARTG>264382</ARTG>
            </ARTGs>
            <MinimumBenefit>3755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW889</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR361</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder, Cemented Stem</Name>
            <Description>Aequalis Reversed Shoulder prosthesis, Cemented Stem, CoCr</Description>
            <Size>Diam 6.5mm to 15mm, Length 100 to 210mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4063</SubGroupID>
            <ARTGs>
                <ARTG>208476</ARTG>
            </ARTGs>
            <MinimumBenefit>3755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW967</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR458</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Ascend Flex Cemented Humeral Stem</Name>
            <Description>Convertible humeral stem for cemented used</Description>
            <Size>Length: 66mm, 74mm, 82mm, 88mm, 90mm, 98mm, 109mm, 120mm.    Size: 2 to 8.     Angulation: 127.5º, 132.5º, 137.5º</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4063</SubGroupID>
            <ARTGs>
                <ARTG>218731</ARTG>
            </ARTGs>
            <MinimumBenefit>3755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ972</BillingCode>
            <Name>Delta/Global Shoulder System</Name>
            <Description>Distal humeral stem</Description>
            <Size>6-16mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4063</SubGroupID>
            <ARTGs>
                <ARTG>143529</ARTG>
                <ARTG>220179</ARTG>
            </ARTGs>
            <MinimumBenefit>3755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC042</BillingCode>
            <Name>SMR Shoulder System</Name>
            <Description>Short and Revision Cemented Stem</Description>
            <Size>Dia 12-20mm x length 80-210mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4063</SubGroupID>
            <ARTGs>
                <ARTG>218715</ARTG>
                <ARTG>218783</ARTG>
            </ARTGs>
            <MinimumBenefit>3755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA479</BillingCode>
            <Name>Affinis Shoulder System</Name>
            <Description>Affinis Fracture Stem - diaphyseal, cemented, short</Description>
            <Size>6/125, 9/125, 12/125, 12/125, 9/200, 12/200</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4063</SubGroupID>
            <ARTGs>
                <ARTG>219731</ARTG>
            </ARTGs>
            <MinimumBenefit>3755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU259</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE258</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Eclipse Humeral Head Prosthesis</Name>
            <Description>Eclipse Humeral Head Prosthesis Cage Screw</Description>
            <Size>Small - X-Large</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4064</SubGroupID>
            <ARTGs>
                <ARTG>308799</ARTG>
            </ARTGs>
            <MinimumBenefit>2660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW890</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR362</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder, Cementless Stem</Name>
            <Description>Aequalis Reversed Shoulder prosthetis, Cementless stem Ti, HA Coated</Description>
            <Size>Diam 6.5mm to 154mm, Length 100mm to 210mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4064</SubGroupID>
            <ARTGs>
                <ARTG>208459</ARTG>
            </ARTGs>
            <MinimumBenefit>2660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC178</BillingCode>
            <Name>SMR Mini - Finned &amp; Revision Humeral Stem</Name>
            <Description>Mini - Finned Humeral Stem Ti6AI4V</Description>
            <Size>Dia 11-24mm x Length 60 - 80mm&#xD;
Dia 13-16mm x H 150 - 180mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4064</SubGroupID>
            <ARTGs>
                <ARTG>218726</ARTG>
                <ARTG>274360</ARTG>
            </ARTGs>
            <MinimumBenefit>2660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC179</BillingCode>
            <Name>SMR Resurfacing Humeral Stem</Name>
            <Description>Resurfacing Humeral Stem Ti6AI4V - Uncemented</Description>
            <Size>Dia 11-13mm x length 32-36mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4064</SubGroupID>
            <ARTGs>
                <ARTG>211983</ARTG>
            </ARTGs>
            <MinimumBenefit>2660</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA480</BillingCode>
            <Name>Affinis Humeral Head</Name>
            <Description>Affinis Humeral Head - Ceramic</Description>
            <Size>39 to 53</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <Suffix>Cer</Suffix>
            <ARTGs>
                <ARTG>215480</ARTG>
                <ARTG>215501</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ554</BillingCode>
            <Name>DELTA Xtend</Name>
            <Description>Delta Xtend CTA Head Extended Lip</Description>
            <Size>48 + 52; 21, 26mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <Suffix>EL</Suffix>
            <ARTGs>
                <ARTG>126913</ARTG>
            </ARTGs>
            <MinimumBenefit>4563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ970</BillingCode>
            <Name>Global Shoulder System</Name>
            <Description>CTA humeral head</Description>
            <Size>Sizes 44-56mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <Suffix>EL</Suffix>
            <ARTGs>
                <ARTG>138288</ARTG>
            </ARTGs>
            <MinimumBenefit>4563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC181</BillingCode>
            <Name>SMR CTA Humeral Head</Name>
            <Description>CTA Humeral Head CoCRMo</Description>
            <Size>42 - 54mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <Suffix>EL</Suffix>
            <ARTGs>
                <ARTG>211950</ARTG>
            </ARTGs>
            <MinimumBenefit>4563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH126</BillingCode>
            <Name>Versadial Humeral Head</Name>
            <Description>Humeral Head</Description>
            <Size>(38 -58)mm x (19 -37)mm x (39-61)mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH349</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Super EAS Head</Description>
            <Size>Short, Long</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD003</BillingCode>
            <Name>Turon Shoulder System - Humeral Head</Name>
            <Description>Turon Standard Humeral Head, Standard and Offset</Description>
            <Size>38-54mm x 14-26mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>215957</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP962</BillingCode>
            <Name>Delta Shoulder system</Name>
            <Description>DELTA Humeral Head INOX / ST.Steel / Nichtrostender St.</Description>
            <Size>36 - 42 mm in +0-+4</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>126913</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX058</BillingCode>
            <Name>Equinoxe Humeral Head</Name>
            <Description>The humeral head is used in hemi-shoulder and total-shoulder joint replacement procedures and for use in fractures of the proximal humerus and for use in total-shoulder joint replacement procedures in conjunction with an irreparable or nonfunctional rotator cuff. Multiple head heights for each diameter provides surgeon flexibility in patients with soft tissue challenges</Description>
            <Size>38mm - 53mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>265513</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU260</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE174</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Univers Fracture Prostheses</Name>
            <Description>Metal head</Description>
            <Size>43/15 - 51/22</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>308825</ARTG>
                <ARTG>308824</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU261</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE257</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Eclipse Humeral Head Prosthesis</Name>
            <Description>Eclipse Humeral Head Prosthesis Head</Description>
            <Size>39/16 - 55/23</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>308800</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW214</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humeral Head Fixed -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>142278</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW863</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR332</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Primary Shoulder Prostheses</Name>
            <Description>Aequalis Primary Eccentric Humeral Head, CoCr</Description>
            <Size>Diameter: 37, 39, 41, 43, 46, 48, 50, 52, 54mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>206492</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW945</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR434</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Simpliciti - Humeral Head</Name>
            <Description>Anatomic humeral head, centred, CoCr</Description>
            <Size>39 x 14, 41 x 15, 43 x 16, 46 x 17, 48 x 18, 50 x 16, 50 x 19, 52 x 19, 52 x 23</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>211853</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW949</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR438</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Ascend Flex Humeral Head</Name>
            <Description>Cobalt chrome humeral head</Description>
            <Size>Diameter: 37mm, 39mm, 41mm, 43mm, 46mm, 48mm, 50mm, 52mm, 54mm  Height: 13.5mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 23mm, 27mm  Offset: 1.5mm, 3.5mm, 4mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>218733</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ965</BillingCode>
            <Name>Global Shoulder System</Name>
            <Description>Humeral heads</Description>
            <Size>40–56mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>132151</ARTG>
                <ARTG>138288</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC180</BillingCode>
            <Name>SMR Humeral Head</Name>
            <Description>Humeral Head CoCrMo</Description>
            <Size>Diameter (mm) 38 to 54  Offset 2 - 7 mm Eccentric  Shape Standard or Flattened</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>221715</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA448</BillingCode>
            <Name>Affinis Total Shoulder</Name>
            <Description>Humeral Head - CoCr</Description>
            <Size>Diameter 39, 41, 43, 45, 47, 49, 51, 53mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>220762</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN353</BillingCode>
            <Name>GLOBAL ICON Stemless Shoulder System</Name>
            <Description>Humeral Head</Description>
            <Size>40 to 56 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>395271</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST027</BillingCode>
            <Name>Solar Total Shoulder System</Name>
            <Description>Dual Offset Humeral Heads</Description>
            <Size>40-50mm diameter, 15-21mm thickness</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>128450</ARTG>
                <ARTG>12875</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST672</BillingCode>
            <Name>Osteonics Solar Shoulder Prostheses </Name>
            <Description>Humeral head polyethylene</Description>
            <Size>40-55mm by 12-34mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>128450</ARTG>
                <ARTG>12875</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST673</BillingCode>
            <Name>Osteonics Solar Shoulder Prostheses</Name>
            <Description>Dual offset humeral head polyethylene</Description>
            <Size>40,45,50mm Diameter by 15, 18, 21mm Thickness</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>128450</ARTG>
                <ARTG>12875</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI300</BillingCode>
            <Name>Bigliani Shoulder System</Name>
            <Description>Bigliani-Flatow Shoulder - Heads (Cobalt chrome)</Description>
            <Size>40, 46, 52, 52mm diameters</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>207472</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI991</BillingCode>
            <Name>Sidus Stem-Free Shoulder</Name>
            <Description>Humeral Head</Description>
            <Size>38-52mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4067</SubGroupID>
            <ARTGs>
                <ARTG>205725</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC183</BillingCode>
            <Name>SMR Resurfacing CTA Humeral Head</Name>
            <Description>CTA Resurfacing Humeral Head CoCrMo +Poro+Ti+Ha Coated</Description>
            <Size>42 - 54mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4068</SubGroupID>
            <Suffix>EL</Suffix>
            <ARTGs>
                <ARTG>211951</ARTG>
            </ARTGs>
            <MinimumBenefit>5220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW868</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR338</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Resurfacing Shoulder</Name>
            <Description>Resurfacing humeral head</Description>
            <Size>12 head sizes from 37mm x 13.5mm to 54mm x 27mm, 3 stem lengths: 30, 35 and 40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4068</SubGroupID>
            <ARTGs>
                <ARTG>207910</ARTG>
            </ARTGs>
            <MinimumBenefit>3040</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ787</BillingCode>
            <Name>Global CAP Resurfacing Humeral Head Implant</Name>
            <Description>Global CAP Conservative Anatomical Prosthesis (Shoulder Humeral Head Surface Replacement)</Description>
            <Size>40-56mm Diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4068</SubGroupID>
            <ARTGs>
                <ARTG>138288</ARTG>
            </ARTGs>
            <MinimumBenefit>3040</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC182</BillingCode>
            <Name>SMR Resurfacing Humeral Head</Name>
            <Description>Resurfacing Humeral Head CoCrMo + Poro+Ti+HA coated</Description>
            <Size>42 - 54mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4068</SubGroupID>
            <ARTGs>
                <ARTG>211982</ARTG>
            </ARTGs>
            <MinimumBenefit>3040</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM078</BillingCode>
            <Name>Ascension HRA - Humeral Resurfacing Arthroplasty</Name>
            <Description>A anatomic semi constrained, monobody device intended for resurfacing of the humeral head.</Description>
            <Size>40mm x 16mm to 56mm x21mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4068</SubGroupID>
            <ARTGs>
                <ARTG>149178</ARTG>
            </ARTGs>
            <MinimumBenefit>3040</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH055</BillingCode>
            <Name>Comprehensive shoulder - reverse humeral cup</Name>
            <Description>Reverse shoulder humeral bearing, highly cross linked UHMWPE</Description>
            <Size>(Standard or Retentive) x (std, +3) x (31 to 41)mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD035</BillingCode>
            <Name>Reverse Shoulder System</Name>
            <Description>Humeral Socket Insert - UHMWPE</Description>
            <Size>32mm to 44mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>210914</ARTG>
                <ARTG>210933</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX048</BillingCode>
            <Name>Equinoxe Humeral Liner</Name>
            <Description>The Equinoxe Reverse Shoulder System includes a reverse semi-constrained prosthesis for use in total-shoulder joint replacement procedures in cases with an irreparable or nonfunctional rotator cuff.</Description>
            <Size>Liner: 36mm+0, 36mm+2.5, 38mm+0, 38mm+2.5, 42mm+0, 42mm+2.5, 46mm+0, 46mm+2.5  Constrained Humeral Liner: 36mm+0, 36mm+2.5, 38mm+0, 38mm+2.5, 42mm+0, 42mm+2.5, 46mm+0, 46mm+2.5</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>264172</ARTG>
                <ARTG>279721</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW869</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR339</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder Eccentric humeral Insert (High Mobility Cup)</Name>
            <Description>Eccentric Humeral Insert (High Mobility Cup) for Aequalis Reversed Shoulder</Description>
            <Size>36mm and 42mm, 2mm eccentric +6mm and +9mm, 4mm eccentric +9mm and +12mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>209514</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW950</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR439</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Ascend Flex Reversed Insert</Name>
            <Description>Reversed insert/ retentive reversed insert - UHMWPE and Ti Alloy</Description>
            <Size>Diameter: 33mm, 36mm, 39mm, 42mm  Thickness: 6mm, 9mm  Angulation: 7.5º, 12.5º, 17.5º</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>218735</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC176</BillingCode>
            <Name>SMR Reverse Liner (Cup) UHMWPE X-Lima</Name>
            <Description>Reverse Liner UHMWPE X-Lima</Description>
            <Size>36mm x +3/+6mm Standard &amp; Retentive</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>212774</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC177</BillingCode>
            <Name>SMR Reverse Liner (Cup) CoCrMo</Name>
            <Description>Reverse Liner Standard &amp; Excentric CoCrMo</Description>
            <Size>Dia 40 - 44mm x Short to Long</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>212775</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA532</BillingCode>
            <Name>Affinis Inverse inlay</Name>
            <Description>Humeral Cup</Description>
            <Size>36+0 to 42+6mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>215500</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA552</BillingCode>
            <Name>Affinis Inverse inlay ceramys</Name>
            <Description>Ceramic Humeral Cup</Description>
            <Size>Size 36, 39, 42. Height 0mm, 3mm, 6mm.</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>238291</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN170</BillingCode>
            <Name>Delta Shoulder System</Name>
            <Description>Humeral cup</Description>
            <Size>36 to 42</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>126913</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA110</BillingCode>
            <Name>Comprehensive Reverse Humeral Cup</Name>
            <Description>Humeral Cup</Description>
            <Size>Standard or Retentive</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4069</SubGroupID>
            <ARTGs>
                <ARTG>324463</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH341</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Intercalary Segment</Description>
            <Size>30-120mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4073</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>11180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH342</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Humeral Coupler</Description>
            <Size>100mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4073</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>11180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH343</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Anti Rotation Intercalary Segment</Description>
            <Size>30mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4073</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>11180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD002</BillingCode>
            <Name>Turon Shoulder System - Humeral Neck</Name>
            <Description>Turon - Humeral Neck</Description>
            <Size>Neutral and 7.5 Degree</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4076</SubGroupID>
            <ARTGs>
                <ARTG>216043</ARTG>
            </ARTGs>
            <MinimumBenefit>998</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ616</BillingCode>
            <Name>Global AP Shoulder</Name>
            <Description>Ball Taper Adjustable Neck Assembly</Description>
            <Size>N/A</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1276</GroupID>
            <SubGroupID>4076</SubGroupID>
            <ARTGs>
                <ARTG>138288</ARTG>
            </ARTGs>
            <MinimumBenefit>998</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH050</BillingCode>
            <Name>Comprehensive Shoulder - Glenoid Stem</Name>
            <Description>Glenoid Post, Ti Regenerx or Polyethylene</Description>
            <Size>1 size</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>144584</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD004</BillingCode>
            <Name>Turon Shoulder System - All-Poly Glenoid</Name>
            <Description>Turon - All-Poly Glenoid, Keeled and Pegged</Description>
            <Size>38mm, 42mm, 46mm, 50mm, 54mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>210954</ARTG>
                <ARTG>210955</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EX061</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Equinoxe Glenoid, pegged</Name>
            <Description>UHMWPE component used to replace the Glenoid during total shoulder arthroplasty. This component is to be used with the Equinoxe total shoulder replacement</Description>
            <Size>small, medium, large, X-Large</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>278648</ARTG>
                <ARTG>264381</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU262</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE172</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Univers Glenoid Shoulder Prostheses</Name>
            <Description>Cemented glenoid</Description>
            <Size>Small, Medium, Large, Extra-Large</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>308803</ARTG>
                <ARTG>308804</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW947</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR436</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis PerFORM Glenoid - CortiLoc</Name>
            <Description>UHMWPE pegged glenoid with CortiLoc central peg</Description>
            <Size>Small - backside radius of 30mm, 35mm and 40mm  Medium - backside radius of 30mm, 35mm and 40mm  Large - backside radius of 40mm, 50mm and 60mm  Extra large - backside radius of 40mm, 50mm and 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>206662</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW952</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR441</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis PerFORM Pegged Glenoid</Name>
            <Description>UHMWPE pegged glenoid</Description>
            <Size>Small - backside radius: 30mm, 35mm, 40mm  Medium - backside radius: 30mm, 35mm, 40mm  Large - backside radius: 40mm, 50mm, 60mm  Extra large - backside radius: 40mm, 50mm, 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>206662</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW986</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR442</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis PerFORM Keeled Glenoid</Name>
            <Description>UHMWPE keeled glenoid</Description>
            <Size>Small - backside radius: 30mm, 35mm, 40mm  Medium - backside radius: 30mm, 35mm, 40mm  Large - backside radius: 40mm, 50mm, 60mm  Extra large - backside radius: 40mm, 50mm, 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>206662</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ964</BillingCode>
            <Name>Global Shoulder System</Name>
            <Description>Glenoid component</Description>
            <Size>40 to 56mm including XL</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>129404</ARTG>
                <ARTG>138288</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV014</BillingCode>
            <Name>Tornier PerFORM +</Name>
            <Description>Anatomic Keeled Glenoid</Description>
            <Size>Size Small - Medium - Large - Extra Large</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>293660</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC172</BillingCode>
            <Name>SMR Cemented Glenoid</Name>
            <Description>All Poly Glenoid Cemented UHMWPE</Description>
            <Size>Small - Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>211974</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC173</BillingCode>
            <Name>SMR - Glenoid 3 Peg UHMWPE</Name>
            <Description>Glenoid 3 Peg UHMWPE X-Lima</Description>
            <Size>Extra small, Standard, Small, and Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>210963</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH698</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO155</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PE Glenoid</Name>
            <Description>PE glenoid</Description>
            <Size>Small and Standard</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>244654</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA450</BillingCode>
            <Name>Affinis Total Shoulder</Name>
            <Description>Glenoid - UHMWPE</Description>
            <Size>Size 1 to 4</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>219394</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA547</BillingCode>
            <Name>Affinis Glenoid cemented vitamys</Name>
            <Description>Cemented glenoid - vitamys UHMWPE</Description>
            <Size>Sizes 1 - 4</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>238288</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN332</BillingCode>
            <Name>StepTech Anchor Peg Glenoid</Name>
            <Description>Glenoid component</Description>
            <Size>40 to 56 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>381043</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST675</BillingCode>
            <Name>Osteonics Solar Shoulder Prostheses </Name>
            <Description>Glenoid component polyethylene</Description>
            <Size>5,7,9,11</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>128449</ARTG>
                <ARTG>12875</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI304</BillingCode>
            <Name>Bigliani Shoulder System</Name>
            <Description>Bigliani-Flatow shoulder - Glenoid (UHMWPE)</Description>
            <Size>40, 46 and 52mm diameters</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3701</SubGroupID>
            <ARTGs>
                <ARTG>208339</ARTG>
                <ARTG>208639</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH049</BillingCode>
            <Name>Comprehensive shoulder - glenoid</Name>
            <Description>Modular hybrid glenoid base UHMWPE; Titanium</Description>
            <Size>small, medium, large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3702</SubGroupID>
            <ARTGs>
                <ARTG>144584</ARTG>
            </ARTGs>
            <MinimumBenefit>2109</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC038</BillingCode>
            <Name>SMR Shoulder System</Name>
            <Description>Metal Back Glenoid</Description>
            <Size> Small, Small R, Standard, Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3702</SubGroupID>
            <ARTGs>
                <ARTG>218703</ARTG>
            </ARTGs>
            <MinimumBenefit>2109</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF176</BillingCode>
            <Name>Signature PMGA Glenoid Insert</Name>
            <Description>3D porous glenoid insert</Description>
            <Size>5 Sizes, 15 - 30 degree inclination</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3702</SubGroupID>
            <ARTGs>
                <ARTG>313285</ARTG>
            </ARTGs>
            <MinimumBenefit>2109</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EX061</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Equinoxe Glenoid, Cage Pegged</Name>
            <Description>UHMWPE component with Ti Alloy peripheral pegs and a Ti Alloy &amp; Ti plasma-coated central peg. It is used to replace the Glenoid during total shoulder arthroplasty. This component is to be used with the Equinoxe total shoulder replacement.</Description>
            <Size>small, medium, large, X-Large</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3703</SubGroupID>
            <ARTGs>
                <ARTG>270232</ARTG>
                <ARTG>293762</ARTG>
            </ARTGs>
            <MinimumBenefit>3254</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC174</BillingCode>
            <Name>SMR - Glenoid Component UHMWPE</Name>
            <Description>Glenoid - MB Liner - UHMWPE</Description>
            <Size>3 to 6mm thick x small-R to Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3704</SubGroupID>
            <ARTGs>
                <ARTG>221714</ARTG>
            </ARTGs>
            <MinimumBenefit>1862</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ120</BillingCode>
            <Name>Verso Shoulder System - Liner</Name>
            <Description>Verso Shoulder Liner</Description>
            <Size>3-12mm Offsets</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3704</SubGroupID>
            <ARTGs>
                <ARTG>284175</ARTG>
                <ARTG>284176</ARTG>
            </ARTGs>
            <MinimumBenefit>1862</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY437</BillingCode>
            <Name>Epoca Custom Offset Shoulder Prosthesis</Name>
            <Description>Epoca Glenoid Insert</Description>
            <Size>42 - 54mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3704</SubGroupID>
            <ARTGs>
                <ARTG>161142</ARTG>
            </ARTGs>
            <MinimumBenefit>1862</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI529</BillingCode>
            <Name>Zimmer Trabecular Metal Reverse Shoulder System</Name>
            <Description>Polyethylene Liner</Description>
            <Size>Standard 7 Deg. &amp; Retentive 65 Deg; 36mm - Neutral, Plus 3mm, Plus 6mm; 40mm - Neutral, Plus 3mm, Plus 6mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3704</SubGroupID>
            <ARTGs>
                <ARTG>231818</ARTG>
            </ARTGs>
            <MinimumBenefit>1862</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI577</BillingCode>
            <Name>Anatomical Shoulder</Name>
            <Description>Anatomical Inverse/Reverse Humeral Poly inlay</Description>
            <Size>36mm x 0, 3 &amp; 6mm; 40mm x 0, 3 &amp; 6mm.</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>3704</SubGroupID>
            <ARTGs>
                <ARTG>100226</ARTG>
            </ARTGs>
            <MinimumBenefit>1862</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH052</BillingCode>
            <Name>Comprehensive Shoulder - Reverse Glenoid Baseplate</Name>
            <Description>Reverse glenoid baseplate, Ti, Porous coating</Description>
            <Size>28mm, 25mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>144584</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD057</BillingCode>
            <Name>Reverse Shoulder - Glenoid Baseplate</Name>
            <Description>Reverse Glenoid Component, Baseplate</Description>
            <Size>6.5mm x 30mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>210932</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX049</BillingCode>
            <Name>Equinoxe Glenoid Plate</Name>
            <Description>The glenoid plate provides multiple options for screw insertion</Description>
            <Size>0 degree, 8 degree, 10 degree</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>262854</ARTG>
                <ARTG>284693</ARTG>
                <ARTG>284694</ARTG>
                <ARTG>284695</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW879</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR349</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder, Glenoid Base Plate</Name>
            <Description>Glenoid Base Plate (Metaglene) with Long Post option for revision</Description>
            <Size>Standard or Revision (Long Post)  dia 25mm and dia 29mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>209243</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW940</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR427</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder - Hemi Prosthesis Adaptor</Name>
            <Description>Hemi Prosthesis Adaptor including union screw</Description>
            <Size>36mm and 42mm diameter</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>209724</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW990</BillingCode>
            <Name>Aequalis Reversed II Threaded Post Baseplate</Name>
            <Description>Glenoid Base Plate</Description>
            <Size>Length (mm) Post: 20 - 50  Diameter (mm): 25 - 29</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>230918</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ974</BillingCode>
            <Name>Delta Shoulder System</Name>
            <Description>Metaglene</Description>
            <Size>Standard, Revision, +10 to +15mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>126913</ARTG>
                <ARTG>126914</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV012</BillingCode>
            <Name>Perform Reversed Glenoid Baseplate</Name>
            <Description>Reverse glenoid baseplate</Description>
            <Size>25mm, 29mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>386956</ARTG>
                <ARTG>386957</ARTG>
                <ARTG>386959</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC186</BillingCode>
            <Name>SMR Reverse Glenoid Base Plate</Name>
            <Description>Reverse Glenoid Base Plate</Description>
            <Size>Small-R or Small/Standard</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>210956</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA534</BillingCode>
            <Name>Affinis Inverse Metaglene, DP</Name>
            <Description>Metaglene, uncemented. Ti plasma plus CaP coating</Description>
            <Size>One size only</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>215497</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA535</BillingCode>
            <Name>Affinis Inverse revision metaglene</Name>
            <Description>Revision Metaglene, Ti plasma plus CaP Coating</Description>
            <Size>one size only</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>224964</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ117</BillingCode>
            <Name>Verso Shoulder System - Glenoid Baseplate</Name>
            <Description>Verso Shoulder Glenoid Base Plate</Description>
            <Size>Standard, Long (Revision)</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>284178</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA095</BillingCode>
            <Name>Comprehensive Reverse Augmented Baseplate</Name>
            <Description>Augmented Baseplate</Description>
            <Size>25mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>345190</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI533</BillingCode>
            <Name>Zimmer Trabecular Metal Reverse Shoulder System</Name>
            <Description>Trabecular Metal Reverse Base Plate - Ti Alloy &amp; Tantalum</Description>
            <Size>15mm, 25mm, 30mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4078</SubGroupID>
            <ARTGs>
                <ARTG>228451</ARTG>
            </ARTGs>
            <MinimumBenefit>1991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH051</BillingCode>
            <Name>Comprehensive Shoulder - Reverse Glenosphere</Name>
            <Description>Reverse glenosphere</Description>
            <Size>36mm to 41mm  (standard, +3, +6)</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>227969</ARTG>
                <ARTG>324462</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD058</BillingCode>
            <Name>Reverse Shoulder – Glenosphere Head</Name>
            <Description>Glenosphere</Description>
            <Size>32mm to 44mm, neutral or -4mm offset</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>210932</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX050</BillingCode>
            <Name>Equinoxe Glenosphere</Name>
            <Description>The glenosphere aids in glenosphere insertion and protects any remaining intact soft tissues.</Description>
            <Size>36mm, 38mm, 42mm &amp; 46mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>279903</ARTG>
                <ARTG>266161</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW880</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR350</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder, Glenoid Sphere</Name>
            <Description>Glenoid Sphere, standard, eccentric, wear compensation or   lateralised</Description>
            <Size>Diameter 33, 36, 39 and 42mm  Centre, or Eccentricity +2mm, or Wear Compensations 10deg, or Lateralised +6mm / +8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>209244</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ967</BillingCode>
            <Name>Delta Shoulder System</Name>
            <Description>Glenosphere</Description>
            <Size>36 to 42</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>126914</ARTG>
                <ARTG>137537</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV010</BillingCode>
            <Name>Perform Reverse Glenosphere</Name>
            <Description>Glenosphere - standard, eccentric, or lateralised</Description>
            <Size>33mm, 36mm, 39mm, 42mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>386955</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC184</BillingCode>
            <Name>SMR Reverse Poly Gleonsphere</Name>
            <Description>Reverse Glenophere UHMWPE X-Lima Ti6AI4V</Description>
            <Size>40 - 44 Standard &amp; Exxentric</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>211987</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC185</BillingCode>
            <Name>SMR Reverse Glenosphere</Name>
            <Description>Reverse Glenosphere CoCrMo</Description>
            <Size>36mm Standard and Eccentric</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>211985</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA533</BillingCode>
            <Name>Affinis Inverse glenosphere</Name>
            <Description>Glenosphere</Description>
            <Size>36 to 42mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>215499</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA551</BillingCode>
            <Name>Affinis Inverse Glenosphere</Name>
            <Description>Glenosphere vitamys</Description>
            <Size>36mm, 39mm, 42mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>238290</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN358</BillingCode>
            <Name>Delta XTEND Revolution Lateralized Glenoid</Name>
            <Description>Glenosphere</Description>
            <Size>Standard and Eccentric diameter: 38 - 42 mm            Lateralization:  +0 mm  +2 mm      +4 mm       +6 mm      +8 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>217442</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ118</BillingCode>
            <Name>Verso Shoulder System - Glenoid Head</Name>
            <Description>Verso Shoulder Glenoid Head</Description>
            <Size>36mm, 41mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>284177</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI532</BillingCode>
            <Name>Zimmer Trabecular Metal Reverse Shoulder System</Name>
            <Description>Glenosphere - CoCr - Mo Alloy</Description>
            <Size>36mm, 40mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1277</GroupID>
            <SubGroupID>4079</SubGroupID>
            <ARTGs>
                <ARTG>230876</ARTG>
            </ARTGs>
            <MinimumBenefit>2139</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH344</BillingCode>
            <Name>Comprehensive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Modular Regenerex Augment</Description>
            <Size>Small, Large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4080</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>903</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW865</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR334</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Shoulder Prostheses Reverse</Name>
            <Description>CoCr Reverse Humeral Neck</Description>
            <Size>diameter 36 &amp; 42mm wide x 9mm high</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4081</SubGroupID>
            <ARTGs>
                <ARTG>242575</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW942</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR430</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Fracture - Humeral Spacer</Name>
            <Description>Lateralized Spacer</Description>
            <Size>9mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4081</SubGroupID>
            <ARTGs>
                <ARTG>242575</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ968</BillingCode>
            <Name>Delta Shoulder System</Name>
            <Description>Humeral Spacer</Description>
            <Size>36 to 42 +9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4081</SubGroupID>
            <ARTGs>
                <ARTG>126913</ARTG>
                <ARTG>137537</ARTG>
                <ARTG>144505</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC036</BillingCode>
            <Name>SMR Shoulder - Modular Augment</Name>
            <Description>Modular Augment Ti6AI4V</Description>
            <Size>20 - 50mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4081</SubGroupID>
            <ARTGs>
                <ARTG>225458</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI530</BillingCode>
            <Name>Zimmer Trabecular Metal Reverse Shoulder System</Name>
            <Description>Spacer</Description>
            <Size>9mm, 12mm Taper Insert</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4081</SubGroupID>
            <ARTGs>
                <ARTG>94829</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI531</BillingCode>
            <Name>Zimmer Trabecular Metal Reverse Shoulder System</Name>
            <Description>Dual Taper Insert</Description>
            <Size>One Size Only</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4081</SubGroupID>
            <ARTGs>
                <ARTG>232002</ARTG>
            </ARTGs>
            <MinimumBenefit>950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ615</BillingCode>
            <Name>Global AP Shoulder</Name>
            <Description>Fixed 135 Degree Taper Assembly</Description>
            <Size>135 Degree Angle</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4083</SubGroupID>
            <ARTGs>
                <ARTG>138288</ARTG>
            </ARTGs>
            <MinimumBenefit>1008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC117</BillingCode>
            <Name>SMR Shoulder Accessories</Name>
            <Description>SMR Connector and Screw</Description>
            <Size>Small R / Small STD</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4083</SubGroupID>
            <ARTGs>
                <ARTG>210861</ARTG>
            </ARTGs>
            <MinimumBenefit>1008</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH127</BillingCode>
            <Name>Versadial Humeral Head</Name>
            <Description>Eccentric adaptor, taper insert</Description>
            <Size>Std, reverse</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD061</BillingCode>
            <Name>RSP Hemi Adaptor</Name>
            <Description>Adaptor for conversion of Reverse Shoulder Prostheses (RSP) to a hemi arthroplasty prosthesis</Description>
            <Size>One size only</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>302695</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD062</BillingCode>
            <Name>RSP Humeral Stem Adapter</Name>
            <Description>RSP Humeral Stem Adapter for conversion to hemiarthroplasty prostheses</Description>
            <Size>6 &amp; 12mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>302694</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD063</BillingCode>
            <Name>RSP Spacer</Name>
            <Description>Spacer</Description>
            <Size>8mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>284539</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA001</BillingCode>
            <Name>Equinoxe Replicator Plate</Name>
            <Description>The Equinoxe Replicator Plate is intended to connect the humeral head to the stem and to position the replacement humeral head in a variety of positions to match patient’s anatomy.</Description>
            <Size>0mm – 4.5mm Offset</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>266159</ARTG>
                <ARTG>278519</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW943</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR431</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Fracture - Hemi-prosthesis Adaptor</Name>
            <Description>Hemi-prosthesis Adaptor including union screw</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>211056</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC037</BillingCode>
            <Name>SMR Adaptor</Name>
            <Description>Adaptor Eccentric / Neutral / CTA</Description>
            <Size>Standard &amp; long 0 to +8mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>221473</ARTG>
                <ARTG>221712</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC175</BillingCode>
            <Name>SMR Reverse Modular Humeral Body Extension</Name>
            <Description>Reverse Modular Mumeral Body Extension Ti6AI4V</Description>
            <Size>+9mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>168581</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA537</BillingCode>
            <Name>Affinis Inverse head adaptor</Name>
            <Description>Adaptor for conversion tohemi prostheses, includes fixation screw</Description>
            <Size>One size only</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>224965</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA538</BillingCode>
            <Name>Affinis Inverse inlay spacer</Name>
            <Description>Humeral offset spacer. Supplied with screw</Description>
            <Size>+9mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4084</SubGroupID>
            <ARTGs>
                <ARTG>224412</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX062</BillingCode>
            <Name>Equinoxe Reverse Torque Definition Screw Kit</Name>
            <Description>Reverse Torque Definition Screw with Drive</Description>
            <Size>One size only</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>5428</SubGroupID>
            <ARTGs>
                <ARTG>252473</ARTG>
            </ARTGs>
            <MinimumBenefit>1133</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX065</BillingCode>
            <Name>Equinoxe Torque Definition Screw Kit.</Name>
            <Description>Torque Definition Screw with Drive.</Description>
            <Size>One size only.</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>5428</SubGroupID>
            <ARTGs>
                <ARTG>252473</ARTG>
            </ARTGs>
            <MinimumBenefit>1133</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA531</BillingCode>
            <Name>Affinis Fixation Screw</Name>
            <Description>Fixation Screw Long</Description>
            <Size>one size only</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>5428</SubGroupID>
            <ARTGs>
                <ARTG>257052</ARTG>
            </ARTGs>
            <MinimumBenefit>1133</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH054</BillingCode>
            <Name>Comprehensive Shoulder - reverse humeral tray</Name>
            <Description>Modular Reverse Humeral tray, to mount onto Comprehensive stem</Description>
            <Size>Std, +5, +10</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4086</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD064</BillingCode>
            <Name>Turon to RSP Conversion Module</Name>
            <Description>Conversion Module</Description>
            <Size>Neutral and Offset</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4086</SubGroupID>
            <ARTGs>
                <ARTG>302688</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX064</BillingCode>
            <Name>Equinoxe Reverse Shoulder, Fracture Humeral Adapter Tray.</Name>
            <Description>Reverse, fracture humeral adapter tray.</Description>
            <Size>+0mm, +5mm, +10mm, +15mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4086</SubGroupID>
            <ARTGs>
                <ARTG>244994</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW871</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR341</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder - Lateralized Insert</Name>
            <Description>The humeral cup is made of UHMWPE. It comes in two diameters (36 + 42mm) to correspond with the humeral metaphyseal components with the following heights 6, 9, 12  and 15mm.</Description>
            <Size>D. 36mm +6mm, D.36mm +9mm, D.36mm +12mm, D.36mm +15mm, D.42mm +6mm, D. 42mm +9mm, D.42mm +12mm D.42mm +15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4086</SubGroupID>
            <ARTGs>
                <ARTG>209514</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW941</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR429</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Fracture - Humeral Insert</Name>
            <Description>Polyethylene Insert</Description>
            <Size>Height 6.25 -13.5mm, Width 6mm-12mm, Articular Diameter- 36mm &amp; 42mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4086</SubGroupID>
            <ARTGs>
                <ARTG>211016</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW951</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR440</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Ascend Flex Reversed Tray</Name>
            <Description>Reverse humeral tray - Titanium</Description>
            <Size>Thickness: 0mm, 6mm, 12mm  Offset: 0mm, 1.5mm, 3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4086</SubGroupID>
            <ARTGs>
                <ARTG>218734</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA109</BillingCode>
            <Name>Comprehensive Reverse Humeral Tray</Name>
            <Description>Epiphysis</Description>
            <Size>Std, +5, +10</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>131</SubCategoryID>
            <GroupID>1278</GroupID>
            <SubGroupID>4086</SubGroupID>
            <ARTGs>
                <ARTG>324465</ARTG>
            </ARTGs>
            <MinimumBenefit>829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH313</BillingCode>
            <Name>Affixus Hip Fracture Nail System</Name>
            <Description>Short Hip fracture nails</Description>
            <Size>9-13mm diameter, 180mm length</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>177870</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ019</BillingCode>
            <Name>Austofix Femoral and Tibial Nailing System</Name>
            <Description>H2 Hip Nail 4.8/6.5, stainless steel or titanium</Description>
            <Size>Dia 11mm, Lengths 170mm – 240mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ058</BillingCode>
            <Name>F1 Proximal Femoral Nail</Name>
            <Description>F1 Femoral Nail, Titanium</Description>
            <Size>170mm, 200mm&#xD;
120deg, 125deg, 130deg</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW051</BillingCode>
            <Name>WEGO Nailing Systems</Name>
            <Description>Femoral Nail</Description>
            <Size>≤ 200mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>324374</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD015</BillingCode>
            <Name>Proximal Femur Nails</Name>
            <Description>Nails</Description>
            <Size>Diameter 11mm&#xD;
Proximal Diameter 17mm&#xD;
&lt;220mm length</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK246</BillingCode>
            <Name>Gamma LN</Name>
            <Description>Standard - Titanium</Description>
            <Size>120, 125, 130 Deg; Diameter 9-13mm; Length 170mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>95185</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN763</BillingCode>
            <Name>IMHS CP</Name>
            <Description>Intramedullary Hip Nail, stainless steel</Description>
            <Size>10 - 16mm x 19.5cm left and right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN838</BillingCode>
            <Name>Trigen InterTAN Nail</Name>
            <Description>Nail, Titanium</Description>
            <Size>diameter 10-13mm
length 18-46cm
Angle 125°-135°</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ158</BillingCode>
            <Name>PediNail Platform</Name>
            <Description>Pediatric Nailing Platform Femur</Description>
            <Size>7mm x 200mm  Child  Left, Right</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>191587</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY790</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Femoral Nail</Description>
            <Size>9-15mm D &lt;220mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>161140</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI723</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Cephalomedullary, Short Nails, Titanium</Description>
            <Size>10mm to 14.5mm (in 1.5mm increments) x 21.5cm 125 to 135 CCD (in 5 CCD increments) Left and Right.</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3326</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>946</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH314</BillingCode>
            <Name>Affixus Hip Fracture Nail System</Name>
            <Description>Long Hip fracture nails</Description>
            <Size>9-15mm diameter, 260-460mm length</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>177870</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ007</BillingCode>
            <Name>F3 Femoral Nail</Name>
            <Description>F3 Femoral Nail Titanium</Description>
            <Size>Length 320mm to 440mm, left and right</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ018</BillingCode>
            <Name>Austofix Femoral &amp; Tibial Nailing System</Name>
            <Description>F2 Femoral Nail 4.8/6.2; s-s</Description>
            <Size>Dia 9 - 12mm; Lengths 320 - 460mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ067</BillingCode>
            <Name>F1 Proximal Femoral Nail</Name>
            <Description>F1 Femoral Nail - Long</Description>
            <Size>340mm - 460mm&#xD;
120deg, 125deg, 130deg</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW052</BillingCode>
            <Name>WEGO Nailing Systems</Name>
            <Description>Femoral Nail</Description>
            <Size>≥220mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>324374</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD016</BillingCode>
            <Name>Proximal Femur Nail</Name>
            <Description>Femoral Nail</Description>
            <Size>Diameter 11mm&#xD;
Proximal Diameter 17mm&#xD;
Length ≥220mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK214</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>Reconstruction Nail</Description>
            <Size>Recon Nail Left/RightDiameter 9-15mm, Length 240-480mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>95185</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK244</BillingCode>
            <Name>Stryker Intramedullary Nailing System</Name>
            <Description>Gamma Long</Description>
            <Size>120, 125, 130 Deg; Diameter 9-15mm; Length 240-480mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>95185</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL065</BillingCode>
            <Name>Trigen</Name>
            <Description>Femoral Nail, Titanium</Description>
            <Size>9, 10, 11.5 &amp; 13mm diameter</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN521</BillingCode>
            <Name>TriGen</Name>
            <Description>Femoral Nail</Description>
            <Size>8-18mm D ≥ 220mm length</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN764</BillingCode>
            <Name>IMHS CP</Name>
            <Description>Intramedullary Hip Nail, stainless steel</Description>
            <Size>10 - 14mm x 32 - 44cm left and right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ086</BillingCode>
            <Name>PediNail System</Name>
            <Description>Intramedullary Femoral Nail</Description>
            <Size>7-10mm x 12-42cm&#xD;
Left, Right</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>191587</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ157</BillingCode>
            <Name>PediNail Platform</Name>
            <Description>Pediatric Nailing Platform Femur</Description>
            <Size>7-12mm x 220-420mm  Left, Right  Child, Adolescent</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>191587</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY791</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Femoral Nail</Description>
            <Size>9-15mm D ≥ 220mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>161140</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI715</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Cephalomedullary, Femoral Long Nails, Titanium</Description>
            <Size>10mm to 14.5mm (in 1.5mm increments) x 30 to 48cm (in 2cm increments) x 125 &amp; 130 CCD Left and Right.</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI722</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Antegrade Femoral Nails, Greater Trochanter, Titanium</Description>
            <Size>8 to 14mm x 24 to 48cm (in 2cm increments) Left and Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3327</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1266</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AX020</BillingCode>
            <Name>S2 Nail System</Name>
            <Description>Cannulated supracondylar nail, stainless steel</Description>
            <Size>11/13mm x 160-380mm</Size>
            <SupplierCode>AX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>119002</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ064</BillingCode>
            <Name>S2 Nail System</Name>
            <Description>Cannulated supracondylar nail, stainless steel</Description>
            <Size>11/13mm x 160-380mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD019</BillingCode>
            <Name>Femoral Nail</Name>
            <Description>Femoral Nail</Description>
            <Size>Diameter 10 - 12mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN299</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Retrograde Femoral Nail</Description>
            <Size>9-15mm / 160-420mm Length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>161140</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK202</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>SCN</Description>
            <Size>Diameter 8mm - 15mm,   Length 170mm - 480mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>95185</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN522</BillingCode>
            <Name>TriGen</Name>
            <Description>Femoral nail</Description>
            <Size>8.5-13mm x 15-50cm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY264</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Distal Femoral Nail - DFN</Description>
            <Size>9-15mm / 160-420mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>161140</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI721</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Retrograde Femoral Nail - Titanium</Description>
            <Size>10mm to 13mm x 16, 20, 24, 28, 30, 32, 34, 36, 38, 40, 42, 44cm Universal.  </Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3328</SubGroupID>
            <ARTGs>
                <ARTG>169891</ARTG>
            </ARTGs>
            <MinimumBenefit>1011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ012</BillingCode>
            <Name>Austofix Femoral and Tibial Nailing System</Name>
            <Description>Universal Tibial Nail (UTN) 4.0/4.8, stainless steel or titanium</Description>
            <Size>Diameter 8 – 11mm, Lengths 260mm – 420mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW002</BillingCode>
            <Name>WEGO Nailing Systems</Name>
            <Description>Tibial Nail</Description>
            <Size>&gt; 220mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>324375</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU149</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE684</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fibulock, Fibular Nail System</Name>
            <Description>Fibular Nail for Fibular Fracture Fixation</Description>
            <Size>4 Sizes (Left &amp; Right Side Specific)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>350831</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW536</BillingCode>
            <Name>Stryker Intermedullary Nailing System</Name>
            <Description>Femoral Nails</Description>
            <Size>7-15mm Diameter , 140 to 480 lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>95185</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW537</BillingCode>
            <Name>Stryker Intramedullary Nailing System</Name>
            <Description>Tibial nails</Description>
            <Size>8-15mm Diameter, 240- 420mm lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>139722</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD020</BillingCode>
            <Name>Tibial Nail</Name>
            <Description>Tibial Nail</Description>
            <Size>10 - 11mm diameter</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO280</BillingCode>
            <Name>Acumed Fibula Rod System</Name>
            <Description>Intramedullary Nail, fibula lower limb specific</Description>
            <Size>3.00mm &amp; 3.6mm diameter left and right specific rods with lengths of 110mm, 145mm, 180mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>99822</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB078</BillingCode>
            <Name>Mini Nailing System</Name>
            <Description>Mini Nailing System</Description>
            <Size>Diameter 3mm - 4mm, Length 130mm - 230mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>229660</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN841</BillingCode>
            <Name>Trigen META</Name>
            <Description>Metaphyseal Nail, Titanium</Description>
            <Size>8.5-13mm
15x50cm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>117591</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY788</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Tibial Nail</Description>
            <Size>7-19; 200-600mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>161138</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI719</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Tibial Nails - Titanium</Description>
            <Size>8.3mm; 9.3mm; 10mm; 11mm; 12mm; 14mm x 24 to 44cm in 2cm increments</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3329</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH367</BillingCode>
            <Name>Fassier-Duval Telescopic IM System Component: Male</Name>
            <Description>The Fassier-Dual Telescopic IM System is an endomedular nail designed for patients suffering from Osteogenesis Impecfecta (OI), Skeletal Displasia, Congenital Tibial Pseudoarthrosis, Limb lengthening over nail, Segmental Tumour removal and other bone deformities</Description>
            <Size>The system is composed of a total of 108 rods in 9 different diameters per type.  The nail is manufactured in both Ti alloy (Ti6A14V ASTM-136) and medical grade Stainless Steel (315L, ASTM 138).  It is available in five diameters: 3.2, 4,4.8,5.6 and 6.4 mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <Suffix>Gth</Suffix>
            <ARTGs>
                <ARTG>141020</ARTG>
            </ARTGs>
            <MinimumBenefit>3348</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH368</BillingCode>
            <Name>Fassier-Duval Telescopic IM System Component: Female</Name>
            <Description>The Fassier-Duval Telescopic IM System is an endomedular nail designed for patients suffering from Osteogenesis Imperfecta (OI), Skeletal Displasia, Congenital Tibial Pseudoarthrosis, Limb lengthening over nail, Segmental Tumor removal and other bone defo</Description>
            <Size>The system is composed of a total of 108 rods in 9 different diameters per type.  The nail is manufactured in both Ti alloy (Ti6A14V ASTM-136) and medical grade stainless steel (316L, ASTM 138).  It is available in five diameters: 3.2,4.4,8,5.6 and 6.4mm;</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <Suffix>Gth</Suffix>
            <ARTGs>
                <ARTG>141020</ARTG>
            </ARTGs>
            <MinimumBenefit>3348</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK035</BillingCode>
            <Name>Telescopic Nail</Name>
            <Description>The Telescopic Nail consists of two parts, D profile bar (male nail) and suitable D profile tube (female nail) with threaded end. It is made of high grade medical stainless steel. The male and female nails have five different diameter choices. The male nail comes in one length for each diameter. The female nails have five different length choices for each diameter. The Telescopic Nail includes a special designed corkscrew end on the distal part of the male nail that holds the nail firmly in the bone and prevents damage to the growth plate. The Telescopic Nail is indicated for children with long bone deformity corrections, fracture stabilisation, patients with osteoporotic bone and for children older than 18 months who are diagnosed with osteogenesis imperfecta.</Description>
            <Size>Female Nail 3.5mm diameter 110, 120, 130, 140, 150mm lengths.  Angled Female Nail 3.5mm diameter 110, 130, 150mm lengths.  Male Nail 2.0mm diameter 180mm length.    Female Nail 4.0mm diameter 150, 170, 180, 190, 200mm lengths.  Angled Female Nail 4.0mm diameter 150, 180, 200mm lengths.  Male Nail 2.5mm diameter 250mm length.    Female Nail 5.0mm diameter 150, 200, 210, 230, 250mm lengths.  Angled Female Nail 5.0mm diameter 150, 210, 250mm lengths.  Male Nail 3.5mm diameter 300mm length.    Female Nail 6.0mm diameter 250, 270, 280, 290, 300mm lengths.  Angled Female Nail 6.0mm diameter 150, 210, 250mm lengths.  Male Nail 4.0mm diameter 350mm length.    Female Nail 6.5mm diameter 190, 200, 250, 280, 300mm lengths.  Angled Female Nail 6.5mm diameter 150, 210, 250mm lengths.  Male Nail 5.0mm diameter 350mm length.</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <Suffix>Gth</Suffix>
            <ARTGs>
                <ARTG>305115</ARTG>
                <ARTG>307686</ARTG>
                <ARTG>307748</ARTG>
                <ARTG>308017</ARTG>
                <ARTG>310263</ARTG>
            </ARTGs>
            <MinimumBenefit>3348</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ016</BillingCode>
            <Name>Proximal Humeral Nail</Name>
            <Description>Stainless Steel</Description>
            <Size>Diameter 8 mm, Length 170 mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ075</BillingCode>
            <Name>Cannulated Humeral Nail</Name>
            <Description>Humeral Nail</Description>
            <Size>Diameter: 7mm to 9mm  Length: 170mm to 280mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW876</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR346</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Humeral Nail</Name>
            <Description>Humeral Nail, straight, cannulated, Ti</Description>
            <Size>Right/Left, dia 7mm and 8mm, Lg 130mm, 210mm, 230mm, 250mm and 270mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>164794</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO424</BillingCode>
            <Name>ACUMED POLARUS® 3 Solution Nails</Name>
            <Description>ACUMED POLARUS 3 SOLUTION HUMERAL NAILS</Description>
            <Size>A range of proximal and distal nails, 150mm, 200mm, 220mm, 240mm, 260mm, 280mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>99822</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK006</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>Titanium - Humeral Nail</Description>
            <Size>Dia 7,8,9mm length 140 - 320mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>139723</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK199</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>Proximal Humeral Nail</Description>
            <Size>Nail Left/Right</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>139723</ARTG>
                <ARTG>76714</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN740</BillingCode>
            <Name>Trigen</Name>
            <Description>Humeral Nail</Description>
            <Size>7-11cm x 16-30cm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>117600</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY129</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Humeral Nail</Description>
            <Size>6.0 - 12.0 mm length 100 - 400mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>161139</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY416</BillingCode>
            <Name>AO/ASIF Intramedullary Nails ASLS</Name>
            <Description>Intramedullary Angular Stable Locking System</Description>
            <Size>4-6mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>168395</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY689</BillingCode>
            <Name>MultiLoc Humeral Nail</Name>
            <Description>Humeral Nail</Description>
            <Size>7.0mm-9.5mm D, 160mm-315mm L</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>161139</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA071</BillingCode>
            <Name>Affixus Humeral Nail System</Name>
            <Description>Humeral Nails, Universal and Proximal, Titanium, Locking, cannulated</Description>
            <Size>7-11mm x 160-280mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3330</SubGroupID>
            <ARTGs>
                <ARTG>124766</ARTG>
            </ARTGs>
            <MinimumBenefit>878</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO100</BillingCode>
            <Name>LINK Knee Fusion Nail</Name>
            <Description>Cobalt Chromium</Description>
            <Size>180mm, 220mm, 260mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3331</SubGroupID>
            <ARTGs>
                <ARTG>140661</ARTG>
                <ARTG>140663</ARTG>
            </ARTGs>
            <MinimumBenefit>4464</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK337</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>Arthrodesis Nail - Knee</Description>
            <Size>Arthrodesis Nail Left/Right; 11.5mm and 13mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3331</SubGroupID>
            <ARTGs>
                <ARTG>139633</ARTG>
            </ARTGs>
            <MinimumBenefit>4464</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN497</BillingCode>
            <Name>Intramedullary Nailing System</Name>
            <Description>Knee Fusion Nail</Description>
            <Size>Diameter 11- 13 mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3331</SubGroupID>
            <ARTGs>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>4464</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH044</BillingCode>
            <Name>Biomet Phoenix Nail Arthrodesis Nailing System - Nail</Name>
            <Description>Ankle Arthrodesis Locking Nail, Titanium Alloy</Description>
            <Size>9 - 12mm diameter x 150 - 420mm length</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>114474</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW798</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR208</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Valor Hindfoot Fusion System</Name>
            <Description>Valor Hindfoot Fusion Nail, Titanium Alloy</Description>
            <Size>10 &amp; 11.5mm diameter, 150, 200 &amp; 250mm length, left and right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>198549</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW929</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR411</PriorBillingCode>
            </PriorBillingCodes>
            <Name>611 Ankle Fusion Nail</Name>
            <Description>The 611 ankle arthrodesis nail is made out of titanium alloy (Ti6AI4V) and is associated with self locking screws, a plug and an internal screw. The nail is delivered sterile. The self locking screws, plug and internal locking screw are delivered non-sterile with the instrumentation</Description>
            <Size>10mm x 180mm, 6 deg left, 10mm x 180mm, 6 deg right  12mm x 180mm, 6 deg left, 12mm x 180mm, 6 deg right  10mm x 180mm, 11 deg left, 10mm x 180mm, 11 deg right  12mm x 180mm, 11 deg left, 12mmx180mm, 11 right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>198776</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD010</BillingCode>
            <Name>Ankle Arthrodesis Nail</Name>
            <Description>Arthrodesis Nail</Description>
            <Size>10 &amp; 12mm diameter</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM369</BillingCode>
            <Name>Ankle Arthrodesis Nail</Name>
            <Description>Ankle Arthrodesis Nail</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>308941</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB074</BillingCode>
            <Name>Ankle Arthrodesis Nail</Name>
            <Description>Ankle Arthrodesis Nail</Description>
            <Size>10mm - 12mm diameter</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>229660</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF019</BillingCode>
            <Name>Tylos</Name>
            <Description>Ankle arthrodesis nail for Tibial Talo Calcaneal fusion</Description>
            <Size>10 - 12mm diameter</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>274577</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF022</BillingCode>
            <Name>Calcanail</Name>
            <Description>Subtalar fusion and fracture nail</Description>
            <Size>10-12mm Diameter, 45-85mm length</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>274577</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK450</BillingCode>
            <Name>T2 Ankle Arthrodesis Nail</Name>
            <Description>T2 Ankle Arthrodesis Type II Anodized Titanium Alloy (Ti6A14V)</Description>
            <Size>10, 11, 12mm Diameters &amp; 150,200 &amp; 300mm Lengths</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>139633</ARTG>
                <ARTG>16221</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL205</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG100</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Panta Arthrodesis Nail</Name>
            <Description>Ankle Nail, Titanium</Description>
            <Size>Diameter 10 -13 mm  Length - 150-240 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>173962</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN772</BillingCode>
            <Name>Trigen</Name>
            <Description>Hindfoot Fusion Nail, Titanium</Description>
            <Size>10 - 11.5mm Diameter</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>116509</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY130</BillingCode>
            <Name>AO/ASIF Arthrodesis system</Name>
            <Description>Arthrodesis</Description>
            <Size>26 - 240mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>3332</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>3885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH265</BillingCode>
            <Name>Small Bone Fixation System - Small Bone Fixation System Kit</Name>
            <Description>Intramedullary Nail Fixation System Kit</Description>
            <Size>1.6mm and 1.1mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5360</SubGroupID>
            <ARTGs>
                <ARTG>137673</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ072</BillingCode>
            <Name>Elastic Nails</Name>
            <Description>Flexible/Paediatric Nails</Description>
            <Size>1.5mm to 5.5mm diameter, 300mm to 440mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5360</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK506</BillingCode>
            <Name>T2 Kids Paediatric Nail</Name>
            <Description>Paediatric Flexible Nail</Description>
            <Size>1.5-4mm, 300-450mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5360</SubGroupID>
            <ARTGs>
                <ARTG>169585</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ094</BillingCode>
            <Name>PediFlex System</Name>
            <Description>Intramedullary Flexible Nail, Titanium, Stainless Steel, Standard, Tapered Tip, Round Tip</Description>
            <Size>1.5-4.5mm x 300-450mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5360</SubGroupID>
            <ARTGs>
                <ARTG>191587</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY064</BillingCode>
            <Name>Titanium Elastic Nail</Name>
            <Size>1.5mm - 4.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5360</SubGroupID>
            <ARTGs>
                <ARTG>141931</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO159</BillingCode>
            <Name>Polarus Humeral Rod System</Name>
            <Description>Polarus Ulna Rod Titanium</Description>
            <Size>210 to 270mm length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5361</SubGroupID>
            <ARTGs>
                <ARTG>99822</ARTG>
            </ARTGs>
            <MinimumBenefit>1405</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO161</BillingCode>
            <Name>Polarus Humeral Rod System</Name>
            <Description>Polarus Radius Rod Titanium</Description>
            <Size>190 to 230mm length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5361</SubGroupID>
            <ARTGs>
                <ARTG>99822</ARTG>
            </ARTGs>
            <MinimumBenefit>1405</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY781</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Olecranon Osteotomy Nail</Description>
            <Size>63mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5361</SubGroupID>
            <ARTGs>
                <ARTG>161139</ARTG>
            </ARTGs>
            <MinimumBenefit>1405</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH542</BillingCode>
            <Name>Precice Intramedullary Limb Lengthening System , Nail</Name>
            <Description>Precice Intramedullary Nail</Description>
            <Size>(8.5 -13)mm diameter x (130- 365)mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5362</SubGroupID>
            <ARTGs>
                <ARTG>244568</ARTG>
                <ARTG>244569</ARTG>
                <ARTG>290819</ARTG>
            </ARTGs>
            <MinimumBenefit>16741</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK015</BillingCode>
            <Name>ISKD Internal Limb Lengthening System</Name>
            <Description>Titanium Alloy</Description>
            <Size>Diameter 12.5 - 14.5mm</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5362</SubGroupID>
            <ARTGs>
                <ARTG>118320</ARTG>
                <ARTG>189940</ARTG>
                <ARTG>189941</ARTG>
            </ARTGs>
            <MinimumBenefit>16741</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU013</BillingCode>
            <Name>Lync Intramedullary Implant</Name>
            <Description>Lync is a titanium intramedullary implant</Description>
            <Size>12mm to 20mm Length, Angled 0 degrees and 10 degrees</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>235763</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER380</BillingCode>
            <Name>Paragon 28 Phantom Lapidus Nail System-Intramedullary nail, foot</Name>
            <Description>Phantom Lapidus intramedullary nail, foot, left or right</Description>
            <Size>dia 5.5 mmx length (38-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>290443</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER387</BillingCode>
            <Name>Paragon 28 Hammer Tube System</Name>
            <Description>Paragon 28 Hammer tube, proximal interphalangeal joint arthrodesis; solid or cannulated, Peek, sterile</Description>
            <Size>dia (2.50-3.75 mm); angle 0-10°; length (14-16mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>290441</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU157</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE550</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RetroFusion</Name>
            <Description>Implant for PIP Arthrodesis for Hammertoe and Clawtoe Deformity</Description>
            <Size>20mm Length  24mm Length</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>350672</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW787</BillingCode>
            <Name>SALVATION 2 Midfoot Nail</Name>
            <Description>Intramedullary Nail</Description>
            <Size>60-160mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>328561</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW821</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR252</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-toe VO</Name>
            <Description>Hammertoe Fixation System</Description>
            <Size>Small, Large, Straight &amp; Angled</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>198485</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW839</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR298</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Phalinx / Pro-toe VO*</Name>
            <Description>Hammertoe Fixation System Implants</Description>
            <Size>Extra Small - Large, Straight &amp; Angled</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW981</BillingCode>
            <Name>SALVATION Limb Salvage System Intramedullary Fusion Bolts</Name>
            <Description>Intramedullary Fusion Bolts</Description>
            <Size>5 - 7mm x 50 - 170mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>198549</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM246</BillingCode>
            <Name>Duafit</Name>
            <Description>Interphalangeal implant</Description>
            <Size>11 - 20 mm implant length, zero, 10.0 or 17.0 degrees of plantarflexion</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>236773</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM300</BillingCode>
            <Name>Intramedullary Arthrodesis Implant</Name>
            <Description>Implant for small joint Arthrodesis</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>164980</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN045</BillingCode>
            <Name>Newclip Hammertoe</Name>
            <Description>Proximal Interphalangeal Implant</Description>
            <Size>XS, S, M, L</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>299344</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN061</BillingCode>
            <Name>Interphalangeal implants</Name>
            <Description>Interphalangeal implants</Description>
            <Size>XS, S, M, L</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>299344</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK038</BillingCode>
            <Name>Fusion Beaming System</Name>
            <Description>The Fusion Beaming System has been designed to address the specific demands of advanced deformity and trauma reconstructions of foot and ankle applications. The system was developed for the treatment of neuropathic deformities, such as Charcot, requiring fusion of the medial and/or lateral columns, with or without corrective osteotomies as well as for joint fusions within the mid and hindfoot. The Fusion Beaming System consists of two different diameter implant ranges, designed for optimal implant selection for wide ranging patient anatomies, and an instrumentation including the dedicated Sterilization Tray. The Fusion Beaming System is designed with an instrumentation and technique that have been developed to simplify the surgery.</Description>
            <Size>5.4mm diameter implants: Lengths - 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm, 110mm, 115mm, 120mm, 125mm, 130mm, 135mm, 140mm, 145mm, 150mm, 155mm, 160mm, 165mm, 170mm.  7.4mm diameter implants: Lengths - 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm, 110mm, 115mm, 120mm, 125mm, 130mm, 135mm, 140mm, 145mm, 150mm, 155mm, 160mm, 165mm, 170mm, 175mm, 180mm, 185mm, 190mm, 195mm, 200mm.</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>295285</ARTG>
                <ARTG>307583</ARTG>
                <ARTG>307749</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI980</BillingCode>
            <Name>Nextra hammertoe Correction Prosthesis</Name>
            <Description>Interdigital Fusion Implant</Description>
            <Size>3.5mm MPI / 3.2mm PI  4.5mm MPI / 3.2mm PI  5.5mm MPI / 3.2mm PI  4.5mm MPI / 4.5mm PI  5.5mm MPI / 4.5mm PI</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>5474</SubGroupID>
            <ARTGs>
                <ARTG>293060</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ079</BillingCode>
            <Name>Austofix Orthofuse</Name>
            <Description>Titanium Intramedullary Fusion Devices</Description>
            <Size>3.3mm Prox, 4.3mm Mid  2.8mm Prox, 3.8mm Mid  </Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>6561</SubGroupID>
            <Suffix>Interphalangeal</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU219</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE715</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dynanite PIP Hammertoe Implant</Name>
            <Description>PIP Arthrodesis Implant</Description>
            <Size>12mm, 14mm, 16mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>6561</SubGroupID>
            <Suffix>Interphalangeal</Suffix>
            <ARTGs>
                <ARTG>354292</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN205</BillingCode>
            <Name>Hammerlock</Name>
            <Description>Intramedulary Nitinol Implant</Description>
            <Size>Small to large</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>6561</SubGroupID>
            <Suffix>Interphalangeal</Suffix>
            <ARTGs>
                <ARTG>95685</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO451</BillingCode>
            <Name>ToeGrip</Name>
            <Description>toe interphalangeal joint arthrodesis implant</Description>
            <Size>Extra-small, small, medium, large, extra large</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>6561</SubGroupID>
            <Suffix>Interphalangeal</Suffix>
            <ARTGs>
                <ARTG>369250</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB073</BillingCode>
            <Name>Hammer Fusion System</Name>
            <Description>Interphalangeal Arthrodesis Implant</Description>
            <Size>2.0mm - 4.0mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>6561</SubGroupID>
            <Suffix>Interphalangeal</Suffix>
            <ARTGs>
                <ARTG>229660</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF025</BillingCode>
            <Name>TicTac</Name>
            <Description>Interphalangeal implant</Description>
            <Size>Straight and angled</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>6561</SubGroupID>
            <Suffix>Interphalangeal</Suffix>
            <ARTGs>
                <ARTG>290541</ARTG>
            </ARTGs>
            <MinimumBenefit>548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB064</BillingCode>
            <Name>C Nail</Name>
            <Description>Intramedullary Nail</Description>
            <Size>60mm - 100mm </Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>7362</SubGroupID>
            <ARTGs>
                <ARTG>229660</ARTG>
            </ARTGs>
            <MinimumBenefit>1138</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK039</BillingCode>
            <Name>C-Nail</Name>
            <Description>C-Nail is an intramedullary nail for minimal-invasive fixation of intraarticular calcaneal fractures. The principle is to stabilise with the nail the four to five main fragments of the fractured calcaneus in conjunction with up to seven interlocking screws and thus creating angular stable fixation. The maximum stability is achieved by fixing the sustentacular fragment towards the nail with two interlocking screws guided by a very precise aiming devise. The design of the nail is clearly marked "L" for left foot and "R" for right foot. The nail length is 65mm with a diameter of 8mm. The nail can be extended and closed with an end cap that comes in 0mm, 5mm, 10mm, 15mm and 20mm sizes.</Description>
            <Size>C-Nail: 65mm length x 8mm diameter (Left and Right option).</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1228</GroupID>
            <SubGroupID>7362</SubGroupID>
            <ARTGs>
                <ARTG>301836</ARTG>
                <ARTG>305133</ARTG>
                <ARTG>308207</ARTG>
                <ARTG>308208</ARTG>
                <ARTG>308209</ARTG>
                <ARTG>308210</ARTG>
            </ARTGs>
            <MinimumBenefit>1138</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK490</BillingCode>
            <Name>Gamma</Name>
            <Description>U-Blade Lag Screw Set</Description>
            <Size>Dia. 10.5mm, 70-130mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>139625</ARTG>
            </ARTGs>
            <MinimumBenefit>448</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY285</BillingCode>
            <Name>AO/ASIF Intramedullary nails</Name>
            <Description>Helical blade</Description>
            <Size>50-150mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>448</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL066</BillingCode>
            <Name>TriGen</Name>
            <Description>Integrated Lag / Compression Screw Kit</Description>
            <Size>65 mm - 120 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <Suffix>Comp</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>243</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL067</BillingCode>
            <Name>TriGen</Name>
            <Description>Compression Screw</Description>
            <Size>35 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <Suffix>Comp</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>243</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN774</BillingCode>
            <Name>IMHS CP</Name>
            <Description>Captured Compression Screw, Stainless Steel</Description>
            <Size>19mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <Suffix>Comp</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>243</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST035</BillingCode>
            <Name>Stryker Intramedullary Nailing System</Name>
            <Description>Compression Screw -Titanium</Description>
            <Size>0 – 35mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <Suffix>Comp</Suffix>
            <ARTGs>
                <ARTG>139625</ARTG>
                <ARTG>313420</ARTG>
            </ARTGs>
            <MinimumBenefit>243</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH315</BillingCode>
            <Name>Affixus Hip Fracture Nail System</Name>
            <Description>Lag Screw</Description>
            <Size>70-130mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>177876</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ011</BillingCode>
            <Name>Austofix Femoral and Tibial Nailing System</Name>
            <Description>6.2/6.5 Hip Screw, stainless steel or titanium</Description>
            <Size>Diameter 6.2-6.5mm, Lengths 70-120mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ059</BillingCode>
            <Name>F1 Proximal Femoral Nail</Name>
            <Description>F1 10.4mm Helical Blade</Description>
            <Size>10.4mm width, 60-120mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ060</BillingCode>
            <Name>F1 Proximal Femoral Nail</Name>
            <Description>10.4mm Hip Screw</Description>
            <Size>10.4mm width, 60-120mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW046</BillingCode>
            <Name>WEGO Nailing Systems</Name>
            <Description>Femoral Neck Lag Screw</Description>
            <Size>75 - 120mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>324374</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD017</BillingCode>
            <Name>Proximal Femur Lag Screws</Name>
            <Description>Lag Screws</Description>
            <Size>80-110mm Length</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM370</BillingCode>
            <Name>Intramedullary Nail Screw</Name>
            <Description>Intramedullary Nail Screw</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK243</BillingCode>
            <Name>Gamma LN</Name>
            <Description>Lag Screw - Titanium</Description>
            <Size>10.5mmx70mm - 10.5mmx130mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>139625</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL026</BillingCode>
            <Name>Compresion Hip Screw</Name>
            <Description>Lag Screws</Description>
            <Size>55-140mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
                <ARTG>104370</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL228</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG137</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Panta Arthrodesis Nail</Name>
            <Description>Partially threaded lag Screw, Titanium</Description>
            <Size>Diameter 5 mm Length - 20 - 110 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN761</BillingCode>
            <Name>IMHS CP</Name>
            <Description>Subtrochanteric lag screw</Description>
            <Size>12.7mm x 70mm to 12.7mm x 140mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY126</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Spiral blade</Description>
            <Size>Length 20 - 150mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>133923</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY803</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Femoral Neck Screw Perforated</Description>
            <Size>70mm - 130mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI713</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Lag Screws, Titanium</Description>
            <Size>10.5mm x 70 to 130mm in 5mm increments</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3341</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF023</BillingCode>
            <Name>Calcanail Screw</Name>
            <Description>Cannulated Screw</Description>
            <Size>5mm diameter, 28 - 40mm length</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>274577</ARTG>
            </ARTGs>
            <MinimumBenefit>253</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK203</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>SCN</Description>
            <Size>Condyle Screws 5mm x (40mm-120mm)</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>139625</ARTG>
                <ARTG>76714</ARTG>
            </ARTGs>
            <MinimumBenefit>253</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK215</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>Reconstruction Nail</Description>
            <Size>Recon Lag Screw</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>139625</ARTG>
                <ARTG>76714</ARTG>
            </ARTGs>
            <MinimumBenefit>253</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AX021</BillingCode>
            <Name>S2 Nail System</Name>
            <Description>6.2mm condylar screws</Description>
            <Size>6.5mm x 60-85mm</Size>
            <SupplierCode>AX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>119002</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ065</BillingCode>
            <Name>S2 Nail System</Name>
            <Description>6.2mm condylar screws</Description>
            <Size>6.5mm x 60-85mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB079</BillingCode>
            <Name>Mini Nailing System Reconstruction Screw</Name>
            <Description>Mini Nailing System Reconstruction Screw</Description>
            <Size>10mm - 40mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF021</BillingCode>
            <Name>Tylos</Name>
            <Description>Tylos trans-calcaneal reconstruction pin</Description>
            <Size>0-35, 0-45, 0-55, 10-35, 10-45, 10-55, 20-35, 20-45, 20-55, 30-35, 30-45, 30-55, 40-35, 40-45, 40-55</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>274577</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL229</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG138</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Panta Arthrodesis Nail</Name>
            <Description>Fully threaded lag Screw, Titanium</Description>
            <Size>Diameter 5 mm Length - 20 - 110 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN519</BillingCode>
            <Name>TriGen</Name>
            <Description>Capture Reconstruction Screws Titanium</Description>
            <Size>6.4mm diameter 65-125mm length</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY263</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>Reconstruction Screw, Titanium Alloy</Description>
            <Size>26-200mm Length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>227971</ARTG>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK036</BillingCode>
            <Name>C-Nail Bone Screws</Name>
            <Description>C-Nail is an intramedullary nail for minimally invasive fixation of intraarticular calcaneal fractures. The principle is to stabilise with the nail the four to five main fragments of the fractured calcaneus in conjunction with up to seven interlocking screws and thus creating angular stable fixation. The maximum stability is achieved by fixing the sustentacular fragment towards the nail with two interlocking screws guided by a very precise aiming device. The design of the nail is clearly marked "L" for left foot and "R" for right foot. The nail length is 65mm with a diameter of 8mm. The nail can be extended and closed with an end cap that comes in 0mm, 5mm, 10mm, 15mm and 20mm sizes.</Description>
            <Size>Self-tapping cortical bone screws 3.5mm in diameter with 2.5mm hexagonal head. Lengths 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm, 40mm, 42mm, 44mm 46mm, 48mm, 50mm, 52mm, 54mm, 56mm, 58mm, 60mm, 62mm, 64mm, 66mm, 68mm, 70mm.</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>308210</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA069</BillingCode>
            <Name>Affixus Humeral Nail System</Name>
            <Description>Cancellous Screws Titanium - Partially Threaded &amp; Fixed Angle</Description>
            <Size>4x34mm - 4x80mm (in 2mm increments)</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>274566</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI717</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Cancellous Screws Titanium - Partially Threaded &amp; Fixed Angle</Description>
            <Size>6.0mm x 50 to 145mm at 5mm increments</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3712</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH046</BillingCode>
            <Name>Biomet Phoenix Ankle Nailing System - 5mm Double-lead thread screw</Name>
            <Description>Double lead screw - Ti-6Al-4V Standard or osseotite finish</Description>
            <Size>5mm Dia x (20 to 110)mm length</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>114474</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ024</BillingCode>
            <Name>Austofix Femoral and Tibial Nailing System</Name>
            <Description>4.0/4.8 Screws, Locking, stainless steel or titanium</Description>
            <Size>Diameter 4.0-4.8mm, Lengths 20-90mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ063</BillingCode>
            <Name>F1 Proximal Femoral Nail</Name>
            <Description>Set Screw</Description>
            <Size>Single Size</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER382</BillingCode>
            <Name>Paragon 28 Phantom Lapidus Nail-Screw, small (2.71mm – 4.49mm)</Name>
            <Description>Paragon 28 Phantom Lapidus Nail-Screw, small</Description>
            <Size>dia 3.5 mm x length (10-46 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>290443</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW003</BillingCode>
            <Name>WEGO Nailing Systems</Name>
            <Description>Locking Screw for IM Nails</Description>
            <Size>4.0-6.5mm x 18-130mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>324374</ARTG>
                <ARTG>324375</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD011</BillingCode>
            <Name>Screws - Reconstruction</Name>
            <Description>Screws</Description>
            <Size>3.5 - 5 mm diameter</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD018</BillingCode>
            <Name>Nail Set Screw</Name>
            <Description>Nail Set Screw</Description>
            <Size>Static &amp; Dynamic</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC187</BillingCode>
            <Name>SMR Revision Modular Locking Ring</Name>
            <Description>Modular Locking Collar (Ring) Ti6AI4V</Description>
            <Size>One Size</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>168582</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH541</BillingCode>
            <Name>Precice Intramedullary Limb Lengthening System</Name>
            <Description>Precice  Locking Screw</Description>
            <Size>Diameter (3.5 -5.0)mm diameter x (20- 80)mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>244568</ARTG>
                <ARTG>244569</ARTG>
                <ARTG>290819</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY006</BillingCode>
            <Name>Dual Cone Locking Extension (as a component of the Orthodynamics The Integral Leg Prosthesis</Name>
            <Description>Orthodynamics The Integral Leg Prosthesis-Dual Cone Locking Extension</Description>
            <Size>6 sizes</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>109214</ARTG>
                <ARTG>195008</ARTG>
                <ARTG>195009</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB075</BillingCode>
            <Name>Intramedullary Nailing System Locking Screw </Name>
            <Description>Intramedullary Nailing System Locking Screw </Description>
            <Size>5.0mm - 6.0mm </Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF020</BillingCode>
            <Name>Tylos Screw</Name>
            <Description>Cortical Screw for Tibio Talo Calcaneal fusion</Description>
            <Size>5mm x 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>274577</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK216</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>Reconstruction Nail</Description>
            <Size>Blocking Screw</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>139625</ARTG>
                <ARTG>313420</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK245</BillingCode>
            <Name>Stryker Intramedullary Nailing System</Name>
            <Description>Locking Screw - Titanium</Description>
            <Size>25mm - 120mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>139625</ARTG>
                <ARTG>313420</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK247</BillingCode>
            <Name>Gamma LN</Name>
            <Description>Set Screw - Titanium</Description>
            <Size>8x17.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>139625</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN467</BillingCode>
            <Name>Compressing Screw</Name>
            <Description>For Intramedullary and compression Hip Screw Systems</Description>
            <Size>19mm &amp; 28.5mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN739</BillingCode>
            <Name>Trigen</Name>
            <Description>Self Tapping Cortical Screw</Description>
            <Size>20mm - 110mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN762</BillingCode>
            <Name>IMHS CP</Name>
            <Description>Captured locking screw</Description>
            <Size>4.5mm x 22mm to 4.5mm x 64mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN775</BillingCode>
            <Name>IMHS CP</Name>
            <Description>Set Screw, Stainless Steel</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST043</BillingCode>
            <Name>Stryker Intramedullary Nailing System</Name>
            <Description>Locking Screw - Titanium</Description>
            <Size>20-120mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>139625</ARTG>
                <ARTG>313420</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY789</BillingCode>
            <Name>AO/ASIF intramedullary Nails</Name>
            <Description>Locking Screws/Bolts/Nuts, Titanium Alloy</Description>
            <Size>3.0mm-6.0mm D 10mm- 150mm L</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI718</BillingCode>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Cortical Screws - Fixed Angle (Fully Threaded) Titanium</Description>
            <Size>4.0mm &amp; 5.0mm x 20 to 60mm (2.5mm increments); 4.0mm &amp; 5.0mm x 65 to 100mm (5mm increments)</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>3713</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH045</BillingCode>
            <Name>Biomet Phoenix Arthrodesis Nailing System - End Cap</Name>
            <Description>Offset end cap, Titanium</Description>
            <Size>0mm - 20mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>114474</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH316</BillingCode>
            <Name>Affixus Hip Fracture Nail System</Name>
            <Description>End Caps</Description>
            <Size>5mm, flush or impinging</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>177871</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BR007</BillingCode>
            <Name>OPRA System - Graft Screw</Name>
            <Description>Graft Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>BR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>145488</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ021</BillingCode>
            <Name>Austofix Femoral and Tibial Nailing System</Name>
            <Description>M8 End Cap, Intramedullary Nails, stainless steel or titanium</Description>
            <Size>1mm-20mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ061</BillingCode>
            <Name>F1 Proximal Femoral Nail</Name>
            <Description>F1 Helical End Cap</Description>
            <Size>5mm, 10mm, 15mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ062</BillingCode>
            <Name>F1 Proximal Femoral Nail</Name>
            <Description>Screw End Cap</Description>
            <Size>5mm, 10mm, 15mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ071</BillingCode>
            <Name>Elastic Nails</Name>
            <Description>End Caps</Description>
            <Size>1.5mm to 5.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW012</BillingCode>
            <Name>WEGO Nailing Systems</Name>
            <Description>End Cap for Nails</Description>
            <Size>0-20mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>324374</ARTG>
                <ARTG>324375</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW797</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR207</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Valor Hindfoot Fusion System - Endcap</Name>
            <Description>Valor Endcap</Description>
            <Size>n/a</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>198549</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW931</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR413</PriorBillingCode>
            </PriorBillingCodes>
            <Name>611 Ankle Fusion Nail - Component: PLUGS</Name>
            <Description>The 611 ankle arthrodesis nail, 2mm &amp; 7mm plugs are made out of titanium alloy (Ti6AI4V). They are delivered non-sterile</Description>
            <Size>0mm - 7.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>198776</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD012</BillingCode>
            <Name>Nail Caps</Name>
            <Description>Nail Cap</Description>
            <Size>0, 5, 10 &amp; 11mm diameter</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>222647</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH540</BillingCode>
            <Name>Precice Intramedullary Limb Lengthening System</Name>
            <Description>Precice  End Cap</Description>
            <Size>0-20mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>244568</ARTG>
                <ARTG>244569</ARTG>
                <ARTG>290819</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO200</BillingCode>
            <Name>Polarus Humeral Fixation System</Name>
            <Description>End cap screw, titanium</Description>
            <Size>0-6mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>99822</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY007</BillingCode>
            <Name>Orthodynamics The Integral Leg Prostheses-Central Screw (as a component of the Orthodynamics The Integral Leg Prosthesis</Name>
            <Description>Orthodynamics The Integral Leg Prosthesis-Central Screw</Description>
            <Size>1 size</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>109214</ARTG>
                <ARTG>195008</ARTG>
                <ARTG>195009</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB065</BillingCode>
            <Name>End Cap</Name>
            <Description>Nail End Cap</Description>
            <Size>One size</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>229660</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK248</BillingCode>
            <Name>Gamma LN</Name>
            <Description>Proximal/Extension Plug - Titanium</Description>
            <Size>0mm, 5mm, 10mm, 15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>144000</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK491</BillingCode>
            <Name>U-Blade End Cap</Name>
            <Description>U-Blade Lag Screw End Cap</Description>
            <Size>One size 9mm x 10.5mm (diameter)</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>139625</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL206</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG102</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Panta Arthrodesis Nail</Name>
            <Description>End Cap, Titanium</Description>
            <Size>One Size</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>173962</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN498</BillingCode>
            <Name>Intramedullary Nailing System</Name>
            <Description>Nail Cap</Description>
            <Size>0 - 30 mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
                <ARTG>104370</ARTG>
                <ARTG>137602</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN713</BillingCode>
            <Name>Trigen</Name>
            <Description>Stable-Lok Nut</Description>
            <Size>One Size Only</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>141019</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ087</BillingCode>
            <Name>Intramedullary Nail End Caps</Name>
            <Description>PediNail End Caps&#xD;
PediFlex End Caps</Description>
            <Size>0-20mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>191587</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST045</BillingCode>
            <Name>Stryker Intramedullary Nailing System</Name>
            <Description>End Caps - Titanium</Description>
            <Size>Standard to +35mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>144000</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY125</BillingCode>
            <Name>AO/ASIF Intramedullary Nails</Name>
            <Description>End caps - Femoral, Tibial, Nailing Systems - TFNA, TNA, FRNA, RFNA, ETN, PFNA</Description>
            <Size>0 - 40mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>182344</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK037</BillingCode>
            <Name>C-Nail End Caps</Name>
            <Description>C-Nail is an intramedullary nail for minimally invasive fixation of intraarticular calcaneal fractures. The principle is to stabilise with the nail the four to five main fragments of the fractured calcaneus in conjunction with up to seven interlocking screws and thus creating angular stable fixation. The maximum stability is achieved by fixing the sustentacular fragment towards the nail with two interlocking screws guided by a very precise aiming device. The design of the nail is clearly marked "L" for left foot and "R" for right foot. The nail length is 65mm with a diameter of 8mm. The nail can be extended and closed with an end cap that comes in 0mm, 5mm, 10mm, 15mm and 20mm sizes.</Description>
            <Size>End Cap: 0mm, 5mm, 10mm, 15mm, 20mm.</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>308209</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA064</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI710</PriorBillingCode>
                <PriorBillingCode>ZI711</PriorBillingCode>
                <PriorBillingCode>ZI720</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Zimmer Natural Nail System</Name>
            <Description>Nail caps - titanium</Description>
            <Size>0-15mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA070</BillingCode>
            <Name>Affixus Humeral Nail System</Name>
            <Description>End caps for Affixus Humeral Nail System</Description>
            <Size>0mm, 8.5x0mm - 8.5x20mm, 9.5x5mm - 9.5x20mm, 10.5x2.5mm - 10.5x7.5mm, 11x2.5mm - 11x7.5mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1229</GroupID>
            <SubGroupID>5363</SubGroupID>
            <ARTGs>
                <ARTG>170659</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU196</BillingCode>
            <Name>Stainless Steel Square Wedge Tibial Osteotomy Plate</Name>
            <Description>Steel Square Wedge Tibial Osteotomy Plate with 4 non locking holes </Description>
            <Size>3mm - 17.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU198</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE094</PriorBillingCode>
            </PriorBillingCodes>
            <Name> Anterior Posterior Sloped Stainless Steel Tibial Osteotomy Plate</Name>
            <Description>Anterior Posterior Sloped Stainless Steel Tibial Osteotomy Plate with 4 non locking holes</Description>
            <Size>5 - 15mm length</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG087</BillingCode>
            <Name>Newdeal Femoral Osteosynthesis Plates</Name>
            <Description>Composition - 316L Stainless Steel.  To be used only with Newdeal screws/lock screws</Description>
            <Size>8/9/10 hole, left and right</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT001</BillingCode>
            <Name>Hawk Anterior Ankle Fusion Set</Name>
            <Description>Anatomically contoured 6 hole plate and screw set for anterior fixation of the ankle joint.</Description>
            <Size>77mm in length&#xD;
22mm in width&#xD;
23mm depth</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>177278</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK075</BillingCode>
            <Name>Stryker Plating System Basic Fragment Set</Name>
            <Description>4.5mm Reconstruction Plate</Description>
            <Size>3-9 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL200</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG088</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal Distal Femoral Varus Osteotomy Plate</Name>
            <Description>Stainless steel periarticular anatomically shaped plate fixed with 3 locking screws into femoral condyle </Description>
            <Size>1 Size </Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL201</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG089</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal Femoral Varus and De-rotation Osteotomy Plates</Name>
            <Description>Stainless steel periarticular anatomic plate fixed with locking screws into proximal femur </Description>
            <Size>Newdeal Femoral Varus and De-rotation Osteotomy Plates - 3 holes, Newdeal Femoral Varus and De-rotation Osteotomy Plates - 4 holes, Newdeal Reinforced Femoral Newdeal and De-rotation Osteotomy Plates - left and right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN143</BillingCode>
            <Name>TC 100 </Name>
            <Description>4.5mm Reconstruction Plate         </Description>
            <Size>&lt; 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ075</BillingCode>
            <Name>PediPlates Plating System</Name>
            <Description>I-Plate&#xD;
Center Hole</Description>
            <Size>16-32mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY622</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non Locking Specialty Plates</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI752</BillingCode>
            <Name>ZPS-Zimmer Plate &amp; Screw System</Name>
            <Description>3.5mm and 4.5mm pelvic plates</Description>
            <Size>6 holes or less</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU104</BillingCode>
            <Name>Ankle Fusion Plate</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>One Universal Size</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU113</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE348</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Calcaneal Step Plate</Name>
            <Description>Calcaneal Step Plate</Description>
            <Size>5mm, 7.5mm, 10mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW716</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR067</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Displacement Plate - DPS</Name>
            <Description>Unique steep plate design allows for controlled fixation of displacement calcaneal osteotomies. 3 step variations allows for accurate corrections. 3.5mm Titanium locking plate</Description>
            <Size>6, 8 &amp; 10mm step, 4 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG090</BillingCode>
            <Name>Newdeal Proximal Humeral Plate</Name>
            <Description>Composition - 316L Stainless Steel. To be used only with Newdeal screws/lock screws</Description>
            <Size>6  holes</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT014</BillingCode>
            <Name>Superior Fusion Plate System - Plate</Name>
            <Description>Anatomically contoured 6 hole plate and screw set with locking screw hole option, for&#xD;
anterior fixation of ankle joint. Used for Primary, Revision and Pantalar fusions.</Description>
            <Size>The fixation plate is 77mm in length, 22mm in width and 23mm in depth. 6 hole plate</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>177278</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM367</BillingCode>
            <Name>Calcaneal Osteotomy Device</Name>
            <Description>Calcaneal Osteotomy Device</Description>
            <Size>All sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL202</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG091</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal HTO Plates</Name>
            <Description>Stainless steel anatomically shaped plates for high tibial osteotomy;4 or 5 holes </Description>
            <Size>Opening wedge HTO plates, left and right. Closing wedge HTO plates, left and right. Reinforced closing wedge HTO plates, left and right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ077</BillingCode>
            <Name>PediLoc Plating System</Name>
            <Description>4.5mm Locking Plate</Description>
            <Size>2-6 Holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ111</BillingCode>
            <Name>Iso-Elastic SuperCable Trochanteric Grips and Cable-Plates System</Name>
            <Description>Cable Plates Titanium</Description>
            <Size>6 Hole 185mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>260681</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU199</BillingCode>
            <Name>Titanium Anterior Posterior Sloped Tibial Osteotomy Plate</Name>
            <Description>Titanium Anterior Posterior Sloped Tibial Osteotomy Plate with 4 variable angle locking holes and 6 variable angle locking holes </Description>
            <Size>0-17.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com,VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU200</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE217</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Titanium Femoral Osteotomy Plate </Name>
            <Description>Titanium Femoral Osteotomy Plate with 7 Variable Angle Locking Holes </Description>
            <Size>5mm - 17.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>Com,VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX014</BillingCode>
            <Name>ARMAR 4.5mm Meril Locking Plate System ≤ 6 holes</Name>
            <Description>TiCP locking plates</Description>
            <Size>2-6 Holes&#xD;
44-120mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ001</BillingCode>
            <Name>Flexit System, Flexit HTO Opening Wedge Tibial Plate</Name>
            <Description>Anatomic Locking Tibial Plates</Description>
            <Size>51mm,63mm,2.8mm thick 4-6 holes</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>206422</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK532</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Compression Anatomical Shape</Description>
            <Size>2-6 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK535</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Reconstruction Plates</Description>
            <Size>5.0mm, 4-6 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL176</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large Fragment Plate – Locking</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL198</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG083</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal Reinforced Bendable Osteosynthesis Plates</Name>
            <Description>Stainless Steel 2 - 4 Holes </Description>
            <Size>2 holes, 4 holes/77mm, 4 holes/112mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL199</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG084</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal Bendable Osteosynthesis Plates</Name>
            <Description>Composition - 316L Stainless Steel.  To be used only with Newdeal screws/lock screws.</Description>
            <Size>3-6 holes </Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ149</BillingCode>
            <Name>PediLoc Plating System</Name>
            <Description>PediFrag Clavicle Plates</Description>
            <Size>2.7-3.5mm&#xD;
6 Holes&#xD;
Left, Right</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ150</BillingCode>
            <Name>PediLoc Plating System</Name>
            <Description>PediFrag Clavicle Plates</Description>
            <Size>2.7-3.5mm&#xD;
7-8 Holes&#xD;
Left, Right</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY116</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Large Fragement Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN058</BillingCode>
            <Name>Plating system Com, LK</Name>
            <Description>Plating system Com, LK</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN076</BillingCode>
            <Name>Newclip pelvis plates</Name>
            <Description>Pariarticular anatomic pelvis plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>563</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH281</BillingCode>
            <Name>ALPS LFS</Name>
            <Description>4.5mm titanium plates</Description>
            <Size>1-6 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER610</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, tibial (≤ 6 holes), Periarticular, Posterior, TT</Name>
            <Description>Paragon 28 Gorilla Silverback tibiotalar (TTC) posterior ankle fusion plate, left or  right, variable ankle locking, complex shape, left or right</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN008</BillingCode>
            <Name>Newclip Activmotion HTO Plate</Name>
            <Description>Fixation plates for high tibial osteotomy (HTO)</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH188</BillingCode>
            <Name>Small / Large  Fragment Set</Name>
            <Description>3.5mm Titanium plates</Description>
            <Size>2 to 6 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU105</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE651</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mesh Plate</Name>
            <Description>Plate for Fracture fixation and Arthrodesis</Description>
            <Size>Short  Long</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG086</BillingCode>
            <Name>Newdeal Distal Humeral Plates</Name>
            <Description>Composition - 316L Stainless Steel.  To be used only with Newdeal screws/lock screws</Description>
            <Size>4 holes</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM066</BillingCode>
            <Name>TriMed Olecranon Sled</Name>
            <Description>Washer</Description>
            <Size>one size</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL243</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Large Fragment Plate –  Non Locking </Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>368492</ARTG>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN071</BillingCode>
            <Name>TC 100</Name>
            <Description>4.5mm Straight Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN942</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>4.5 Straight Non Locking Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ074</BillingCode>
            <Name>PediPlates Plating System</Name>
            <Description>O-Plate, Delta Plate, Center Hole</Description>
            <Size>12-24mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST039</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>L-Plates</Description>
            <Size>4-6hole</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>25735</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY603</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non Locking Fragment plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK027</BillingCode>
            <Name>eight-Plate Plus</Name>
            <Description>The guided growth plate system plus consists of different sizes of eight-Plate plus. The device is designed for the gradual correction of paediatric congenital as well as acquired deformities in both upper and lower extremities.</Description>
            <Size>12mm  16mm  20mm</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5255</SubGroupID>
            <ARTGs>
                <ARTG>289399</ARTG>
            </ARTGs>
            <MinimumBenefit>446</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH199</BillingCode>
            <Name>Periarticular Plating System</Name>
            <Description>Tibial Plate - Titanium</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>884</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ078</BillingCode>
            <Name>PediLoc System ≥7 to ≤15 holes, screw size ≥4.5mm</Name>
            <Description>4.5mm Bowed locking compression femur 10, 12, 14 hole plates&#xD;
4.5mm contour locking compression femur 8, 10, 12, 14 hole plates left and right</Description>
            <Size>4.5mm bowed 10, 12, 14 hole&#xD;
4.5mm contour 8,10,12,14 hole right&#xD;
4.5mm contour 8, 10, 12, 14 hole left</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>884</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY814</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non Locking Fragment Plate</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>884</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU148</BillingCode>
            <Name>Ankle Fusion Plating System</Name>
            <Description>Fusion Plate</Description>
            <Size>Anterior Plate </Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU305</BillingCode>
            <Name>Anterolateral Pilon Fusion Plate</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>7-15 Holes  </Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ112</BillingCode>
            <Name>Iso-Elastic SuperCable Trochanteric Grips and Cable-Plates System</Name>
            <Description>Cable Plates Titanium</Description>
            <Size>8 Hole 240mm  10 Hole 290mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>260681</ARTG>
            </ARTGs>
            <MinimumBenefit>1295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI948</BillingCode>
            <Name>Ankle Fix - Plate ≥ 7 to ≤ 15 holes</Name>
            <Description>Ankle Fusion plate</Description>
            <Size>Standard and Large</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>140687</ARTG>
            </ARTGs>
            <MinimumBenefit>1295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER541</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes), Tibiotalarcalcaneal (TTC)</Name>
            <Description>Paragon 28 Gorilla Silverback tibiotalarcalcaneal (TTC) anterior ankle fusion plate, left or right, variable ankle locking, complex shape, flat or contoured, left or right</Description>
            <Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com,VAL</Suffix>
            <ARTGs>
                <ARTG>290443</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW956</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR446</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC Universal Ankle Fusion Plating System</Name>
            <Description>The ORTHOLOC Universal Ankle Fusion Plating System is intended to facilitate arthrodesis of the ankle including tibiotalocalcaneal and tibiotalar joints and tibiocalcaneal arthrodeses, in conjunction with osteotomies and fractures of the distal tibia, talus, and calcaneus.</Description>
            <Size>82mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com,VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN360</BillingCode>
            <Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name>
            <Description>VAL compression plate, proximal femur hook plates, stainless steel</Description>
            <Size>≥7 to ≤15 holes, left &amp; right profile</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com,VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
                <ARTG>286609</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK633</BillingCode>
            <Name>VariAx Wrist plates</Name>
            <Description>Wrist plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>Com,VAL</Suffix>
            <ARTGs>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH065</BillingCode>
            <Name>Sternalock</Name>
            <Description>Plate, locking, &gt;6 hole, Various shapes </Description>
            <Size>8-12 hole</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119508</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU203</BillingCode>
            <Name>Ankle Fusion Plating System</Name>
            <Description>Fusion Plate for Ankle Joint Arthritis</Description>
            <Size>Anterior, Posterior, Lateral</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU303</BillingCode>
            <Name>Posterior Pilon Fusion Plate</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>13-15 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG085</BillingCode>
            <Name>Newdeal Bendable Osteosynthesis Plates</Name>
            <Description>Stainless steel bendable plates 7 - 9 holes </Description>
            <Size>7-9 holes     </Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX015</BillingCode>
            <Name>ARMAR 4.5mm Meril Locking Plate System ≥ 7 to ≤ 15 holes</Name>
            <Description>TiCP humeral locking plates</Description>
            <Size>7-15 Holes&#xD;
118-283mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ002</BillingCode>
            <Name>FlexiSystem, Flexit HTO Opening wedge Tibial Plate</Name>
            <Description>Anatomic Locking Tibial Plates</Description>
            <Size>80mm, 7-15 holes</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>206422</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK533</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Compression Anatomical Shape</Description>
            <Size>7-15 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK536</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Reconstruction Plates</Description>
            <Size>5.0mm, 8-14 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL177</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large Fragment Plate – Locking </Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY636</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LC-LCP Fragment Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN038</BillingCode>
            <Name>Newclip Activmotion HTO Plate</Name>
            <Description>Fixation plates for high tibial osteotomy (HTO)</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN060</BillingCode>
            <Name>Plating System Com, LK</Name>
            <Description>Plating System Com, LK</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN077</BillingCode>
            <Name>Newclip pelvis plates</Name>
            <Description>Pariarticular anatomic pelvis plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>721</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH282</BillingCode>
            <Name>ALPS LFS</Name>
            <Description> 4.5mm titanium plates,</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER609</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes), Periarticular, Posterior, TT</Name>
            <Description>Paragon 28 Gorilla Silverback tibiotalar (TT) posterior ankle fusion plate, left or right</Description>
            <Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>290443</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER611</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes), Periarticular, Posterior, TTC</Name>
            <Description>Paragon 28 Gorilla Silverback tibiotalarcalcaneal (TTC) posterior ankle fusion plate, left or right, variable ankle locking, complex shape, flat or contoured, left or right</Description>
            <Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>290443</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM524</BillingCode>
            <Name>Ankle Fusion Plate</Name>
            <Description>Ankle Fusion Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN043</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>VAL Locking plates</Description>
            <Size>Standard ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU114</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE342</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PEEKPower HTO Plate</Name>
            <Description>Medial High Tibial Osteotomy Implant Device System</Description>
            <Size>One Universal Size</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU176</BillingCode>
            <Name>Arthrex Clavicle Plating System</Name>
            <Description>Locking clavicle plate and screw system for fixation of clavicle fractures.</Description>
            <Size>7-10 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK544</BillingCode>
            <Name>Stryker Plating System Basic Fragment Set</Name>
            <Description>4.5mm Reconstruction Plate</Description>
            <Size>7-15 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL244</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Large Fragment Plate –  Non Locking </Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN098</BillingCode>
            <Name>TC-100</Name>
            <Description>4.5mm Reconstruction Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN133</BillingCode>
            <Name>TC-100</Name>
            <Description>4.5mm Straight Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN943</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>4.5 Straight Non Locking Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY813</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non Locking Fragment Plate</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI168</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cable System</Name>
            <Description>Cable-Ready 8 Hole Plate - Stainless Steel</Description>
            <Size>246mm long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI795</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>4.5mm Broad Compression Plate</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5256</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>646</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ079</BillingCode>
            <Name>PediLoc - Periarticular Locking Plating System Femur- &gt; 16 holes, screw size ≥4.5mm</Name>
            <Description>4.5mm Bowed locking compression femur 16 hole plate&#xD;
4.5mm Bowed locking compression femur 18 hole plate&#xD;
4.5mm contour locking compression femur 16 hole plate right&#xD;
4.5mm contour locking compression femur 18 hole plate right&#xD;
4.5mm contour locking compression femur 20 hole plate right&#xD;
4.5mm contour locking compression femur 16 hole plate left&#xD;
4.5mm contour locking compression femur 18 hole plate left&#xD;
4.5mm contour locking compression femur 20 hole plate left</Description>
            <Size>4.5mm Bowed, 16 hole&#xD;
4.5mm Bowed, 18 hole&#xD;
4.5mm contour,16 hole, right&#xD;
4.5mm contour,18 hole, right&#xD;
4.5mm contour,20 hole, right&#xD;
4.5mm contour,16 hole, left&#xD;
4.5mm contour,18 hole, left&#xD;
4.5mm contour,20 hole, left</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>1062</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY716</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non Locking specialty Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1062</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU106</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE572</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plantar Lapidus Plates</Name>
            <Description>Arthrodesis Plate</Description>
            <Size>Short and Standard  Left &amp; Right side specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1378</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU306</BillingCode>
            <Name>Anterolateral Pilon Fusion Plate</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>&gt;16 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1378</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN356</BillingCode>
            <Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name>
            <Description>VAL compression plate, proximal femur plates, stainless steel</Description>
            <Size>≥16 holes, left &amp; right profile</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
                <ARTG>286609</ARTG>
            </ARTGs>
            <MinimumBenefit>1378</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN359</BillingCode>
            <Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name>
            <Description>VAL compression plate, proximal femur hook plates, stainless steel</Description>
            <Size>≥16 holes, left &amp; right profile</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>286609</ARTG>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1378</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI943</BillingCode>
            <Name>Ankle Fix -Plate ≥ 16 holes</Name>
            <Description>Ankle fusion plate</Description>
            <Size>One size only</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>140687</ARTG>
            </ARTGs>
            <MinimumBenefit>1378</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU304</BillingCode>
            <Name>Posterior Pilon Fusion Plate</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>≥ 16 Holes  </Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX016</BillingCode>
            <Name>ARMAR 4.5mm Meril Locking Plate System ≥ 16 holes</Name>
            <Description>TiCP locking plates</Description>
            <Size>16-26 Holes&#xD;
262-481mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK534</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Compression Anatomical Shape</Description>
            <Size>16-22 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>237797</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK537</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Reconstruction Plates</Description>
            <Size>5.0mm, 16-22 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL178</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large Fragment Plate – Locking </Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY637</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LC-LCP Plates</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN078</BillingCode>
            <Name>Newclip pelvis plates</Name>
            <Description>Pariarticular anatomic pelvis plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN034</BillingCode>
            <Name>Newclip Femoral Plate</Name>
            <Description>Variable angle plates for femur</Description>
            <Size>Standard ≥ 16 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK545</BillingCode>
            <Name>Stryker Plating System Basic Fragment Set</Name>
            <Description>4.5mm Reconstruction Plate</Description>
            <Size>16-22 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>531</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN078</BillingCode>
            <Name>TC-100</Name>
            <Description>4.5mm Straight Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>531</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN784</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Plates, Stainless Steel, Non-Locking, Broad, Left &amp; Rights</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>531</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY661</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non Locking Large Fragment Plates</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5257</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>531</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW708</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR050</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte MTP Fusion System</Name>
            <Description>MTP plate, stainless steel</Description>
            <Size>Left &amp; Right extended,9 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG106</BillingCode>
            <Name>B-BOP Plantar Basal Osteotomy Plate (Sterile)</Name>
            <Description>Titanium, 4 hole plate for fixation of osteotomy of the base of the first metatarsal</Description>
            <Size>Moderate Correction(5°) Left, Right. Severe Correction (10°) Left, Right</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG128</BillingCode>
            <Name>Spider Limited Wrist Fusion System</Name>
            <Description>Recessed, circular stainless steel plate</Description>
            <Size>6 hole</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>177622</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK546</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>T-Plates, pre-shaped</Description>
            <Size>2-6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL125</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN800</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>3.5mm Recon Plate </Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST738</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Leibinger profyle hand &amp; small  fragment system, fixation, 3D plate, titanium</Description>
            <Size>1.7mm system, 2x2 holes</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>124318</ARTG>
                <ARTG>64730</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY704</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Specialty Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI786</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>3.5mm T-Plates</Description>
            <Size>2 holes - 6 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI930</BillingCode>
            <Name>Sternalock</Name>
            <Description>≤ 6 holes, various shapes</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EF001</BillingCode>
            <Name>Merete TTF Anterior Ankle Plate</Name>
            <Description>Anterior Ankle Plates</Description>
            <Size>≤ 6 holes Left and right</Size>
            <SupplierCode>EF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>203737</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU107</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE644</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Proximal 1st Metatarsal Osteotomy Plate</Name>
            <Description>1st Metatarsal Osteotomy Plate</Description>
            <Size>Petite - Left and Right Side Specific  Standard - Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU174</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE565</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Lisfranc Plates</Name>
            <Description>Arthrodesis Plate</Description>
            <Size>Small, Medium, Large  Plates come in Left &amp; Right</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU175</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE555</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking POW Plate</Name>
            <Description>Wedged Fusion Plate</Description>
            <Size>0-7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU186</BillingCode>
            <Name>Titanium Plate with Wedge</Name>
            <Description>Titanium Plate with Wedge. Left and right side specific.</Description>
            <Size>6-10mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU192</BillingCode>
            <Name>Locking Lateral Hook Plate</Name>
            <Description>Locking Lateral Hook Plate for Fracture Fixation of the Lateral Malleolus</Description>
            <Size>3-5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU194</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE417</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Medial Hook Plate</Name>
            <Description>Locking Medial Hook Plate for Fixation of medial malleolus fractures</Description>
            <Size>3-5 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW707</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR049</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte MTP Fusion System</Name>
            <Description>MTP plate, stainless steel</Description>
            <Size>Left &amp; Right small &amp; standard, 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW711</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR057</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Lapidus Plate</Name>
            <Description>Titanium locking plate with unique stepped displacement in 1mm increments permits accurate plantarisation and lateralisation in midfoot fusions.</Description>
            <Size> 3.5mm: neutral, 1-6mm step</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW715</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR066</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arthrodesis Flat Plate - AFP</Name>
            <Description>Flat plate intended for use in isolated tarsal fusions, titanium locking plate, 2mm thickness</Description>
            <Size>12, 14 &amp; 16mm length - 4 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW902</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR378</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - Small Plates ≤ 6 holes</Name>
            <Description>Small variable angle locking plates, titanium, ≤ 6 holes</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW936</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR423</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System – Edgelock II STP Plate</Name>
            <Description>Calcaneal displacement osteotomies locking plate, Titanium.</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW978</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR069</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TOM Plate</Name>
            <Description>Designed for base osteotomies and fusions of MT1 with correction achieved through one cut. It is a titanium locking plate, anatomically designed with a smaller radius to fit the contour of the first metatarsal and 5 step variation in 1mm increments for ac</Description>
            <Size>- L &amp; R: neutral, 1-5mm step, 4 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM125</BillingCode>
            <Name>TriMed Sidewinder</Name>
            <Description>Ankle Fixation Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM291</BillingCode>
            <Name>Forearm Locking Plate</Name>
            <Description>Forearm plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF083</BillingCode>
            <Name>Islay Universial Locking Plate</Name>
            <Description>Titanium Plate with or without wedge with 4 and non locking holes. Left and right side specific.</Description>
            <Size>Various length plates from 18-24mm with and without wedges (2-7mm), plates with valugus angle built in range.</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF119</BillingCode>
            <Name>Islay Arthrodesis Wedge Plate</Name>
            <Description>Islay Arthrodesis Wedge Plate</Description>
            <Size>Arthrodesis Wedge Plate 0mm-8mm(AWP), - 30mm (3.5mm universal locking plate 12mm - 30mm (3.5ULP))</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF126</BillingCode>
            <Name>Islay Recon Plate</Name>
            <Description>Islay Recon Plate</Description>
            <Size>Recon Plate, 6 Hole (RRP)&#xD;
Recon Plate, 8 Hole (RRP)&#xD;
Recon Plate, 14 Hole (RRP)</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL130</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL217</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG117</PriorBillingCode>
            </PriorBillingCodes>
            <Name>UNI-CP Compression plating system</Name>
            <Description>2 or 4 hole stainless steel compression plate, with 3 plate configurations (2 or 4 hole 'straight' design, 4 hole T-design)</Description>
            <Size>2 or 4 hole, 4 interaxis sizes: 17, 20, 25 and 30mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL227</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG136</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Uni-CP Compression plating system</Name>
            <Description>4 hole U design</Description>
            <Size>4 hole, 3 interaxis sizes: 17,19,21mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ154</BillingCode>
            <Name>PediLoc Plating System</Name>
            <Description>Locking Cannulated Blade Plate</Description>
            <Size>Infant, Child, Adolescent, 90-130 degrees, 0-14 mm offset, 25-80 mm blade, 2-4 holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY703</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Specialty Locking Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN028</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>Complex Locking Bone Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI543</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>3.5mm Locking T plate</Description>
            <Size>3 hole head 5 hole shaft 73mm length; 4 hole head 6 hole shaft 85mm length; 3 hole head 3 hole shaft left 51mm length; 3 hole head 4 hole shaft left 63mm length; 3 hole head 3 hole shaft right 51mm length; 3 hole head 4 hole shaft right 63mm length.</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>709</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH242</BillingCode>
            <Name>ALPS Foot System</Name>
            <Description>Complex periarticular foot plates</Description>
            <Size>small to large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO080</BillingCode>
            <Name>APTUS Foot</Name>
            <Description>TriLock Plates</Description>
            <Size>2.8</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER480</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, small (≤ 6 holes);variable angle locking, complex</Name>
            <Description>Paragon28 Gorilla, small titanium compression plates; universal; variable angle locking; compression; various complex shapes</Description>
            <Size>thickness 1.3 - 2.0 mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU242</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE763</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxForce MTP</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW596</BillingCode>
            <Name>Stryker Locked Plating System</Name>
            <Description>Periarticular variable angle locking plate - clavicle</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>237797</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW713</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR064</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MPJ Fusion Plate</Name>
            <Description>Titanium locking plate with built-in 1- degree valgus angle for anatomic fixation of 1st MTP joint</Description>
            <Size>Small, Medium &amp; Revision, Left &amp; Right, 0, 5 &amp; 10 degree</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM304</BillingCode>
            <Name>OsteoMed FPS</Name>
            <Description>Titanium locking footplates</Description>
            <Size>3.5mm and 4mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM518</BillingCode>
            <Name>OMNI Plating System</Name>
            <Description>X and Dog Bone Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN357</BillingCode>
            <Name>VA-LCP Periprosthetic Proximal Femur Plating System </Name>
            <Description>VAL compression plate, locking attachment plate, stainless steel</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
                <ARTG>286609</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL223</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG132</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TIBIAXYS Distal Tibia System - Ankle Arthrodesis - Medial anterior plate</Name>
            <Description>Titanium medial anterior plate with 6 holes; left or right</Description>
            <Size>3mm thick, 77mm long</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU023</BillingCode>
            <Name>Airlock Plating System</Name>
            <Description>Airlock Plating System</Description>
            <Size>None Plates 2 - 6 Holes</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>235766</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ031</BillingCode>
            <Name>Valetis Ankle - Plates</Name>
            <Description>1/3 Tubular Plate</Description>
            <Size>4 to 6 hole</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ033</BillingCode>
            <Name>Valens Shoulder and Elbow - Plates</Name>
            <Description>Locking Compression Plates</Description>
            <Size>3.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ035</BillingCode>
            <Name>Valens Shoulder and Elbow - Plates</Name>
            <Description>LCP, Right/Oblique Angled, T-Plate</Description>
            <Size>1-6 Holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW047</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Locking Plate Systems</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW068</BillingCode>
            <Name>Equinox Trauma Systems</Name>
            <Description>Clavicle Midshaft Locking Compression Plate </Description>
            <Size>6 holes left, 6 holes right</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW069</BillingCode>
            <Name>Equinox Trauma Systems </Name>
            <Description>Clavicle Midhsaft Locking Plates </Description>
            <Size>6 holes left, 6 holes right</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU108</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE455</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile T-Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>2-4 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU109</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE533</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Posterolateral Distal Fibula Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>4-6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU110</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE568</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Posterolateral Distal Fibula Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU164</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE372</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile MTP Plate</Name>
            <Description>Athrodesis Plate - 6 hole plates</Description>
            <Size>Contoured small left,contoured small right, contoured standard right,contoured standard left</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU165</BillingCode>
            <Name>Locking Reconstruction Plate</Name>
            <Description>Reconstruction Plate for communited Fibula Shaft Fractures</Description>
            <Size>4-6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU166</BillingCode>
            <Name>Locking Third Tubular Plate</Name>
            <Description>Plate for fracture fixation of the Fibula</Description>
            <Size>4-6 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU167</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE453</PriorBillingCode>
            </PriorBillingCodes>
            <Name>X Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>Medium, Large</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU168</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE457</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile Straight Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>2-5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU169</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE504</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Double Compression Plate System</Name>
            <Description>Fixation plates for surgical compression across fusion sites.</Description>
            <Size>Double Compression Plate, 2 Hole, 20 mm   Double Compression Plate, 2 Hole, 25 mm   Double Compression Plate, 2 Hole, 30 mm   Double Compression Plate, 3 Hole, 20 mm   Double Compression Plate, 3 Hole, 25 mm   Double Compression Plate, 3 Hole, 30 mm   Double Compression Plate, 4 Hole, Straight, 20 mm   Double Compression Plate, 4 Hole, Straight, 25 mm   Double Compression Plate, 4 Hole, Straight, 30 mm   Double Compression Plate, 4 Hole, Square, 20 mm   Double Compression Plate, 4 Hole, Square, 25 mm   Double Compression Plate, 4 Hole, Square, 30 mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU170</BillingCode>
            <Name>MTP Plate</Name>
            <Description>1st MTP Arthrodesis Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU201</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE285</PriorBillingCode>
            </PriorBillingCodes>
            <Name> Titanium Lapidus Arthrodesis Plate </Name>
            <Description>Titanium Lapidus Arthrodesis Plate with locking holes and compresion slot</Description>
            <Size>Small, Large</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU317</BillingCode>
            <Name>H-Plates</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM122</BillingCode>
            <Name>TriMed Periarticular Plate</Name>
            <Description>Periarticular Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX006</BillingCode>
            <Name>ARMAR LPS Reconstruction Plates</Name>
            <Description>3.5 mm Reconstruction plates</Description>
            <Size>2-6 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX009</BillingCode>
            <Name>ARMAR LPS Cloverleaf Plate</Name>
            <Description>3.5 mm cloverleaf reconstruction plate</Description>
            <Size>MT-PT1303088&#xD;
MT-PT1304104&#xD;
MT-PT1305120&#xD;
MT-PT1306136</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK538</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Compression Anatomical Shape</Description>
            <Size>2-6 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK540</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Reconstruction Plates</Description>
            <Size>4.0mm, 4-6 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK542</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking One Third Tubular Plates</Description>
            <Size>3.0mm, 2-6 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL086</BillingCode>
            <Name>PERI-LOC</Name>
            <Description>Clavicle plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN796</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Locking 1/3 Tubular &amp; 3.5mm Straight Plates </Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN914</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Clavicle plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ138</BillingCode>
            <Name>PediLoc Plating System</Name>
            <Description>3.5mm Locking Plate,&#xD;
PediLoc, PediFrag, PLEO</Description>
            <Size>2-6 Hole</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY723</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Plates</Description>
            <Size>≤6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN026</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>Locking Bone Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI800</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>3.5mm One Third Tubular Locking Plate</Description>
            <Size>5-6 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI810</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>3.5mm Dual Compression Locking Plates</Description>
            <Size>4 - 6 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>360</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH273</BillingCode>
            <Name>ALPS - Anatomic Locked Plating System</Name>
            <Description>3.5mm titanium plate</Description>
            <Size>2-6 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO135</BillingCode>
            <Name>APTUS</Name>
            <Description>Variable Angle Locking Plate </Description>
            <Size>≤ 6 holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER479</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, small (≤ 6 holes), variable angle locking</Name>
            <Description>Paragon28 Gorilla, small titanium compression plates; universal; variable angle locking; compression; various shapes</Description>
            <Size>Length 15-35 mm; thickness 1.15 - 2.0 mm; multi screw diameter purchage 2.7/3.5/4.2mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER568</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, tibial (≤ 6 holes)</Name>
            <Description>Paragon 28 Gorilla Silverback tibiotalar posterior(TT) ankle fusion plate, left or right</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU111</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE525</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dorsal Distal Radius Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>4 Holes Standard (Left &amp; Right)  4 Holes Narrow (Left &amp;  Right)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU112</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE535</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dorsal L Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>5 Holes (Left &amp; Right)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU171</BillingCode>
            <Name>MTP Plate, Straight</Name>
            <Description>Metatarso-Phalangeal Fusion plate for 1st MTP</Description>
            <Size>Small and Standard, ≤ 6 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU285</BillingCode>
            <Name>Dynanite Compression Plates</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>2-4 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>355042</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU301</BillingCode>
            <Name>Lateral Hook Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>3-5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU302</BillingCode>
            <Name>Lateral Hook Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW535</BillingCode>
            <Name>VariAx Compression Plating System</Name>
            <Description>VAL 1/3 Tubular Plate</Description>
            <Size>&gt;/=6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>237797</ARTG>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW979</BillingCode>
            <Name>Locking Plate</Name>
            <Description>Titanium locking plates anatomically contoured for forefoot and midfoot osteotomies.</Description>
            <Size>Small (screw size 2.71mm – 4.49mm)  ≤ 6 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW991</BillingCode>
            <Name>VariAx 2 Locking Plate System – Distal Ulna</Name>
            <Description>VAL Fixation Plates for Distal Ulna Fractures</Description>
            <Size>625102  625102S</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>357433</ARTG>
                <ARTG>340044</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW994</BillingCode>
            <Name>Ortholoc Fracture System - Plates</Name>
            <Description>Universal</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG116</BillingCode>
            <Name>TIBIAXYS Distal Tibial Osteotomy System - Fibula plate</Name>
            <Description>Titanium 4 or 6 hole fibula plate</Description>
            <Size>4 hole plate - 48.7mm length; 6 hole plate - 68.5mm length</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD021</BillingCode>
            <Name>1/3 Tubular Plate</Name>
            <Description>1/3 Tubular Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD022</BillingCode>
            <Name>MTP Plate</Name>
            <Description>Fusion Plates</Description>
            <Size>Left and Right</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV002</BillingCode>
            <Name>VariAx Wrist Plating System – Distal Radius</Name>
            <Description>VAL Fixation Plates for Distal Radius Fractures</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>340042</ARTG>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM516</BillingCode>
            <Name>OMNI plating system</Name>
            <Description>MTP, Lapidus, Straight, T Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN297</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>3.5 mm LCP Medial Anterior Clavicle Plate  </Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL096</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN938</BillingCode>
            <Name>Peri-Loc VLP</Name>
            <Description>VAL/LK 3.5 1/3 Tubular</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN979</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Fibula Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ178</BillingCode>
            <Name>PediFoot Deformity Correction System</Name>
            <Description>3.5mm Plates, Compression/Neutral, Recon, Angle Iron, Wedge, Clover    </Description>
            <Size>7-70mm length, 4-6mm wedge length, 2-6 holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN050</BillingCode>
            <Name>VAL plates screw size 2.71-4.49</Name>
            <Description>VAL complex plates</Description>
            <Size>screw size 2.71-4.49 &#xD;
≤  6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN067</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>VAL Locking plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW034</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Small Fragment Plating System</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU150</BillingCode>
            <Name>Dual Syndesmosis Tightrope Plate</Name>
            <Description>Buttress plate for syndesmosis repair</Description>
            <Size>1 size (2 Hole Plate)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU320</BillingCode>
            <Name>Wedged Profile Plate</Name>
            <Description>Wedged Profile Plate</Description>
            <Size>2 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG096</BillingCode>
            <Name>Basal Osteotomy Plate</Name>
            <Description>Titanium</Description>
            <Size>5 Deg, Left and Right, 10Deg, Left and Right</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM121</BillingCode>
            <Name>'TriMed Wire Plates</Name>
            <Description>Wire Fixation plate</Description>
            <Size>3 &amp; 5 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO446</BillingCode>
            <Name>Acumed Small Fragment Plates</Name>
            <Description>One Third Tubular Plates</Description>
            <Size>3 to 6 Holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK548</BillingCode>
            <Name>Stryker Plating System Small Fragment Set</Name>
            <Description>3.5mm Reconstruction Plate</Description>
            <Size>4-6 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL094</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN012</BillingCode>
            <Name>TC-100 &amp; Peri-Loc</Name>
            <Description>1/3 Tubular Plates</Description>
            <Size>≤ 6 holes.</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN044</BillingCode>
            <Name>TC-100 &amp; Peri-Loc</Name>
            <Description> 3.5mm Straight Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN109</BillingCode>
            <Name>TC100</Name>
            <Description>3.5mm Reconstruction Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN136</BillingCode>
            <Name>TC-100 </Name>
            <Description>Small right angle &amp; T plates </Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST037</BillingCode>
            <Name>Stryker Plating System Small Fragment Set </Name>
            <Description>One Third Tubular Plate with Collar</Description>
            <Size>2-6 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST730</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Hand system, fixation plate, L-shape, right/left</Description>
            <Size>1.7mm, 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY702</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DCS DHS Plate, Angled blade, Osteotomy</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY726</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non-Locking Fragment Plates</Description>
            <Size>≤6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK016</BillingCode>
            <Name>Orthofix eight-Plate</Name>
            <Description>Guided growth plate for correction of angular deformities over an open growth plate. Titanium, two screw holes, wire guided.</Description>
            <Size>12mm, 16mm</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>118320</ARTG>
                <ARTG>189806</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK028</BillingCode>
            <Name>Quad Plate Plus</Name>
            <Description>The Guided Growth Plate System Plus consists of different sizes of quad- Plate plus, different cannulated and solid screw options. The device is designed for the gradual correction of paediatric congenital as well as acquired deformities in both the upper and lower extremities, provided that the physics are not fused. The plates feature a contoured waist and low profile for paediatric usage. There is a centre hole in the plates for a temporary guide pin to be implanted to aid application and removal of the plate. The plates are attached to the external surface of the bone over the growth plate by screws. These screws are not locked to the plate, but rather are allowed to swivel and diverge in their position as bone growth occurs. The implant acts like a flexible hinge, permitting growth at the growth plate to gradually straighten the limb.</Description>
            <Size>16mm plate  22mm plate</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>289399</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI778</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>3.5mm Straight Compression Plate</Description>
            <Size>2-6 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI781</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>3.5mm ZPS One Third Tubular Plates</Description>
            <Size>2-6 holes left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI789</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>3.5mm Straight Reconstruction Plates</Description>
            <Size>3-6 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5258</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG127</BillingCode>
            <Name>Spider Limited Wrist Fusion System - Spider Plate</Name>
            <Description>Recessed, circular stainless steel plate</Description>
            <Size>8 holes</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>177622</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO208</BillingCode>
            <Name>Acumed Bone Plate</Name>
            <Description>Wrist Fusion Plate - Titanium</Description>
            <Size>Standard/Mini 7-9 holes.      </Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK547</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>T-Plates, pre-shaped</Description>
            <Size>7-13 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL126</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN069</BillingCode>
            <Name> TC-100 </Name>
            <Description>3.5mm Reconstruction Plates </Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN801</BillingCode>
            <Name>Peri-Loc </Name>
            <Description>3.5mm Recon Plates   </Description>
            <Size>  &gt; 7 to &lt; 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN936</BillingCode>
            <Name>TC-100</Name>
            <Description>3.5mm Curved Reconstruction Plate</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST051</BillingCode>
            <Name>Stryker Plating System Small Fragment Set</Name>
            <Description>Cloverleaf Plate</Description>
            <Size>8-15 Holes</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>25735</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY037</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Specialty Plate</Description>
            <Size>7-15 hole</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU191</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE420</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Lateral Hook Plate</Name>
            <Description>Locking Lateral Hook Plate for Fixation of Lateral Malleolus</Description>
            <Size>7 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU193</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE418</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Medial Hook Plate</Name>
            <Description>Locking Medial Hook Plate for fixation of Medial malleolus fractures</Description>
            <Size>7 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG064</BillingCode>
            <Name>Integra Total Wrist Fusion System - Plates</Name>
            <Description>Straight (bendable), Standard bend, Short Bend</Description>
            <Size>1 size only of each type of plate:&#xD;
Straight: 105.5mm length&#xD;
Standard and short bend: 110mm length</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>177662</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM126</BillingCode>
            <Name>TriMed Sidewinder</Name>
            <Description>Ankle Fixation Plate</Description>
            <Size>7 hole sidewinder plate</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM337</BillingCode>
            <Name>Trimed Plates</Name>
            <Description>Elbow, Forearm, clavicle and Wrist Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN209</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Specialty Plate</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>286609</ARTG>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB017</BillingCode>
            <Name>Ankle Fusion Locking Plate</Name>
            <Description>Ankle Fusion Locking Plate</Description>
            <Size>7 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL138</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Small Fragment plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN029</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>Locking bone plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN032</BillingCode>
            <Name>Newclip Calcaneal Plates</Name>
            <Description>Plates for calcaneus</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH244</BillingCode>
            <Name>ALPS foot system</Name>
            <Description>periarticular foot, metatarsal and tarsal plates</Description>
            <Size>small to large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO081</BillingCode>
            <Name>APTUS Foot</Name>
            <Description>TriLock Plates</Description>
            <Size>2.8</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER482</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, small ( ≥ 7 to ≤ 15 holes); variable angle locking, complex</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, small, titanium, malleus/column rescue/stradle/arch (proximal or distal), variable angle locking, complex</Description>
            <Size>Thickness 1.5mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU243</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE760</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxForce MTP</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>7-8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW598</BillingCode>
            <Name>Stryker Locked Plate System</Name>
            <Description>Periarticular variable angle locking plate - clavicle</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>196764</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW934</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR420</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - Small Complex VAL Plates &gt;6 holes</Name>
            <Description>Small complex variable angle lockig plates, Titanium, &gt;6 holes</Description>
            <Size>&gt; 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM213</BillingCode>
            <Name>Fusion Cup</Name>
            <Description>PEEK curved and round plate</Description>
            <Size>7, 9, 10, 11 &amp; 12 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>229707</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM471</BillingCode>
            <Name>TriMed ASET Foot Plating System</Name>
            <Description>Lapidus Plate</Description>
            <Size>≥ 7 Holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM519</BillingCode>
            <Name>OMNI Plating System</Name>
            <Description>Lisfranc Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL215</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG114</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TIBIAXYS Distal Tibial Osteotomy System: Medial right/lateral left osteotomy plate: lateral right/medial left osteotomy plate</Name>
            <Description>Titanium contoured right and left design plates for wedge osteotomy of distal tibia</Description>
            <Size>8 hole; Lateral plates 75.2mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL219</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG119</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HALLU-Lock MTP Arthrodesis System - HALLU-Lock S Plate</Name>
            <Description>Titanium contoured Hallu-Lock S plate for revision of Keller osteotomy, failed arthroplasty, failed fusion</Description>
            <Size>7 holes, sizes 0 to 3, length 40 to 55mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL222</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG131</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TIBIAXYS Distal Tibia System - Ankle Arthrodesis - Lateral anterior plate</Name>
            <Description>Titanium lateral anterior plate with 8 holes; left or right</Description>
            <Size>3mm thick, 92mm long</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY798</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Variable Angle Locking Specialty Plate</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN066</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>VAL Locking plates</Description>
            <Size>7 to  15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN074</BillingCode>
            <Name>Newclip Foot Plate</Name>
            <Description>Variable-Angle Locking anatomic plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ032</BillingCode>
            <Name>Valetis Ankle - Plates</Name>
            <Description>1/3 Tubular Plate</Description>
            <Size>7 to 12 hole</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ034</BillingCode>
            <Name>Valens Shoulder and Elbow - Plates</Name>
            <Description>Locking Compression Plates</Description>
            <Size>3.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW048</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Locking Plate Systems</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU183</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE441</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medial Column Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>Small, Medium, Large (Left and Right)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU187</BillingCode>
            <Name>Locking Third Tubular Plate</Name>
            <Description>Plate for fracture of the Fibula</Description>
            <Size>7-12 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU188</BillingCode>
            <Name>Locking Reconstruction Plate</Name>
            <Description>Reconstruction Plate for communited Fibula Shaft Fractures</Description>
            <Size>7-12 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU321</BillingCode>
            <Name>Locking Distal Fibular Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM123</BillingCode>
            <Name>TriMed Periarticular Plate</Name>
            <Description>Periarticular Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN335</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Specialty Plates, LCP Clavicle, MatrixRIB, Titanium</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX007</BillingCode>
            <Name>ARMAR LPS Reconstruction Plates</Name>
            <Description>3.5 mm reconstruction plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK539</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Compression Anatomical Shape</Description>
            <Size>7-14 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK541</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Reconstruction Plates</Description>
            <Size>4.0mm, 7-14 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK543</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking One Third Tubular Plates</Description>
            <Size>3.0mm, 7-14 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL087</BillingCode>
            <Name>PERI-LOC</Name>
            <Description>Clavicle plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN797</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Locking 1/3 Tubular &amp; 3.5mm Straight Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ081</BillingCode>
            <Name>PediLoc-Periarticular Locking Plating System Femur - &gt;7 to &gt;15 holes, screw size 2.71 - 4.49mm</Name>
            <Description>3.5mm Contour or Bowed Locking Compression, 8-14 Hole Plate, Left-Right</Description>
            <Size>3.5mm Bowed, 14 hole&#xD;
3.5mm contour, 8 - 14 Hole Left-Right</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ192</BillingCode>
            <Name>PediLoc Plating System</Name>
            <Description>3.5mm Locking Plate</Description>
            <Size>8 Hole</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY722</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP T, L, Straight Plates, Stainless Steel, Titanium</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
                <ARTG>286609</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN027</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>Locking Bone Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI801</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>3.5mm One Third Tubular Locking Plate</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI811</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>3.5mm Dual Compression Locking Plates</Description>
            <Size>7 - 14 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>388</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH274</BillingCode>
            <Name>ALPS - Anatomic Locked Plating System</Name>
            <Description>3.5mm Titanium  plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO133</BillingCode>
            <Name>APTUS</Name>
            <Description>Variable angle locking plate </Description>
            <Size>7 - 15 holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO134</BillingCode>
            <Name>APTUS </Name>
            <Description>Clavicle Variable Angle Locking Plates </Description>
            <Size>7 - 15 holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO136</BillingCode>
            <Name>APTUS </Name>
            <Description>Variable Angle Locking Plates </Description>
            <Size>7 - 15 holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER481</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, small ( ≥ 7 to ≤ 15 holes); variable angle locking</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, small, titanium, malleus/column rescue/stradle/arch (proximal or distal)</Description>
            <Size>Thickness 1.5/2.0 mm ; multi screw diameter purchase 2.7/3.5/4.2mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER604</BillingCode>
            <Name>Paragon 28 Gorilla Plates- ≥ 7 to ≤ 15 holes, medial, anterior, anterolateral</Name>
            <Description>Paragon 28 Gorilla Plates- tibia  ≥ 7 to ≤ 15 holes, medial, anterior, anterolateral. left or right, variable angle locking, complex shapes</Description>
            <Size>≥ 7 to ≤ 15 holes, thickness 1.8 mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>290443</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU123</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE531</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Wrist Spanning Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>9 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU177</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE505</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MTP Plate, Straight , Long</Name>
            <Description>1st MTP Arthrodesis Plate , Straight, Long - 8 Holes</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU299</BillingCode>
            <Name>Locking Distal Fibula Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU308</BillingCode>
            <Name>Posterolateral Fibula Plate</Name>
            <Description>Plate for Fracture fixation</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU309</BillingCode>
            <Name>Posterolateral Fibula Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU310</BillingCode>
            <Name>Anatomic Posterolateral Distal Fibula Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>4-6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU311</BillingCode>
            <Name>Anatomic Posterolateral Distal Fibula Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU312</BillingCode>
            <Name>Locking Medial Hook Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU314</BillingCode>
            <Name>Locking Medial Hook Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>&amp;lt;6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW533</BillingCode>
            <Name>VariAx Compression Plating System</Name>
            <Description>Periarticular variable angle locking plate</Description>
            <Size>≥ 7 to ≤ 15</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW811</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR238</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ortholoc Fracture System - Plates</Name>
            <Description>Universal</Description>
            <Size>8 Hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW992</BillingCode>
            <Name>VariAx 2 Locking Plate System – Distal Ulna</Name>
            <Description>VAL Fixation Plates for Distal Ulna Fractures</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>357433</ARTG>
                <ARTG>340044</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD023</BillingCode>
            <Name>1/3 Tubular Plate</Name>
            <Description>1/3 Tubular Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV003</BillingCode>
            <Name>VariAx Wrist Plating System – Distal Radius</Name>
            <Description>VAL Fixation Plates for Distal Radius Fractures</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>340044</ARTG>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT078</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH513</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RECOS Ulna Shortening and Radius Reconstruction System</Name>
            <Description>Ulna Shortening / Radius Reconstruction plates</Description>
            <Size>80/90mm x 10mm short / long, 70mm x 21-24mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>236206</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM309</BillingCode>
            <Name>Osteomed FPS</Name>
            <Description>Tubular Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM360</BillingCode>
            <Name>MTP Plate</Name>
            <Description>MTP Plate</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM517</BillingCode>
            <Name>OMNI Plating System</Name>
            <Description>Straight Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN210</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Variable Angle Locking  Plate</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN296</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA-LCP Anterior Clavicle Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN298</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>3.5 mm LCP Medial Anterior Clavicle Plate  </Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB076</BillingCode>
            <Name>Marathon variable angle Fibula Plate</Name>
            <Description>Marathon variable angle Fibula Plate</Description>
            <Size>1 - 6 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB077</BillingCode>
            <Name>Marathon variable angle Fibula plates</Name>
            <Description>Marathon variable angle Fibula plates</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL095</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL216</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG115</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TIBIAXYS Distal Tibial Osteotomy System - Medial osteotomy plate</Name>
            <Description>Inverted T-shape medial osteotomy plate to fit medial malleolus</Description>
            <Size>8 hole; 70mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN939</BillingCode>
            <Name>Peri-Loc VLP</Name>
            <Description>VAL/LK 3.5mm 1/3 Tubular Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN980</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Fibula Plates</Description>
            <Size>≥ 7 to   ≤15 Holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ174</BillingCode>
            <Name>PediFoot Deformity Correction System</Name>
            <Description>3.5mm Plates, Recon</Description>
            <Size>70mm length, 8 holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN044</BillingCode>
            <Name>Newclip Clavicle Plate</Name>
            <Description>Plate for fixation of fractures of the clavicle or Locking Clavicle Plate</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN051</BillingCode>
            <Name>VAL plates screw size 2.71-4.49</Name>
            <Description>VAL complex plates screw size 2.71-4.49</Description>
            <Size>7≥ to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN063</BillingCode>
            <Name>Newclip Locking plates</Name>
            <Description>Variable Angle Locking Plate</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN071</BillingCode>
            <Name>Periarticular Clavicle plate</Name>
            <Description>Periarticular plate for clavicle    </Description>
            <Size>  ≥ 7 to ≤ 15 holes  </Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA082</BillingCode>
            <Name>ALPS Clavicle Plating System</Name>
            <Description>clavicle variable angle locking plates  </Description>
            <Size>7-15 holes  </Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
                <ARTG>275084</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW066</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>1/3 Tubular Plate</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM372</BillingCode>
            <Name>Tibial Osteotomy Plates</Name>
            <Description>Tibial Osteotomy Plates</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM376</BillingCode>
            <Name>Fibular Osteotomy Plates</Name>
            <Description>Fibular Osteotomy Plates</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM377</BillingCode>
            <Name>Fibular Osteotomy Plates</Name>
            <Description>Fibular Osteotomy Plates</Description>
            <Size>Sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM379</BillingCode>
            <Name>Ankle Fusion Plate</Name>
            <Description>Ankle Fusion Plate</Description>
            <Size>Suitable for patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO445</BillingCode>
            <Name>Acumed Small Fragment Plates</Name>
            <Description>One Third Tubular Plates</Description>
            <Size>7 to 15 Holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK099</BillingCode>
            <Name>Stryker Plating System Small Fragment Set</Name>
            <Description>One Third Tubular Plate with Collar</Description>
            <Size>7-14 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK549</BillingCode>
            <Name>Stryker Plating System Small Fragment Set</Name>
            <Description>3.5mm Reconstruction Plate</Description>
            <Size>7-14 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL097</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN118</BillingCode>
            <Name>TC-100 &amp; Peri-Loc </Name>
            <Description>3.5mm Straight Plates </Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN130</BillingCode>
            <Name>TC-100 &amp; Peri-Loc </Name>
            <Description> 3.5mm Straight Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY721</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non-Locking Fragment Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN059</BillingCode>
            <Name>Periarticular Clavicle plate</Name>
            <Description>Periarticular plate for clavicle</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI779</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>3.5mm Straight Compression Plate</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI782</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>3.5mm ZPS One Third Tubular Plates</Description>
            <Size>7 holes - 15 holes left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI790</BillingCode>
            <Name>ZPS-Zimmer Plate and Screw System</Name>
            <Description>3.5mm Straight Reconstruction Plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5259</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU124</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE642</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dorsal Midfoot Fusion Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL127</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN134</BillingCode>
            <Name>TC-100</Name>
            <Description>3.5mm Reconstruction Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN937</BillingCode>
            <Name>TC-100</Name>
            <Description>3.5mm Curved Reconstruction Plate</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY717</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non Locking Specialty Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO427</BillingCode>
            <Name>ACUMED ACU-LOC Wrist Spanning Plate</Name>
            <Description>Wrist Spanning Plate</Description>
            <Size>Plates available in 13 hole configerations.</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL139</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY809</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Specialty Plate</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW058</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Locking Compression Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>806</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM124</BillingCode>
            <Name>TriMed Periarticular Plate</Name>
            <Description>Periarticular Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>806</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX008</BillingCode>
            <Name>ARMAR LPS Reconstruction Plates</Name>
            <Description>3.5 mm reconstruction locking plates</Description>
            <Size>16-22 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>806</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN798</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Plates, Stainless Steel, Locking, Compression, Lefts and Rights</Description>
            <Size>3.5mm, 20 - 22 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>806</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ083</BillingCode>
            <Name>PediLoc - Anterolateral and Medial Distal Tibial Paediatric Locking Plate</Name>
            <Description>3.5 mm distal tibial locking compression plate (narrow/wide; 2-5 holes)</Description>
            <Size>3.5mm anterolateral left (2,3,4,5, holes)&#xD;
3.5mm anterolateral right (2,3,4,5 holes)&#xD;
3.5mm Narrow Left (2,3,4,5, holes)&#xD;
3.5mm narrow right (2,3,4,5 holes)&#xD;
3.5mm wide left (2,3,4,5 holes)&#xD;
3.5mm wide right (2,3,4,5 holes)</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>806</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY810</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Specialty Plate</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>806</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO114</BillingCode>
            <Name>APTUS</Name>
            <Description>Variable angle locking plates</Description>
            <Size>≥ 16 holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1067</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER605</BillingCode>
            <Name>Paragon 28 Gorilla Plates- ≥ 16 holes, medial, anterolateral</Name>
            <Description>Paragon 28 Gorilla Plates- tibia  ≥ 16 holes, medial, anterolateral, left or right, variable angle locking, complex shapes</Description>
            <Size>≥ 16 holes, thickness 1.8 mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1067</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU300</BillingCode>
            <Name>Locking Distal Fibula Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>&gt;16 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1067</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW534</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Variable Angle Locking Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
                <ARTG>237797</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>1067</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK550</BillingCode>
            <Name>Stryker Plating System Small Fragment Set</Name>
            <Description>3.5mm Reconstruction Plate</Description>
            <Size>16-22 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN011</BillingCode>
            <Name>TC-100 &amp;Peri-Loc </Name>
            <Description>Sterile, 14 - 26 hole</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY724</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non-Locking Fragment Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5260</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU172</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE554</PriorBillingCode>
            </PriorBillingCodes>
            <Name>LPS Cotton Osteotomy Plates</Name>
            <Description>Wedged Fusion Plate</Description>
            <Size>Flat, 2mm - 8mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU266</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE215</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Titanium Metatarsal Opening Wedge Osteotomy Plate </Name>
            <Description>Titanium Metatarsal Opening Wedge Osteotomy Plate with 4 non locking holes and square wedge </Description>
            <Size>2mm - 8mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM209</BillingCode>
            <Name>Jones Fracture Plate</Name>
            <Description>Fracture Fixation Systems</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK591</BillingCode>
            <Name>Diamond Plate/Carpal Button</Name>
            <Description>Carpal Fusion Plate</Description>
            <Size>Large, Small</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>155633</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL136</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN068</BillingCode>
            <Name>TC 100</Name>
            <Description>Plate: Condylar</Description>
            <Size>1.5mm, 2.0mm &amp;2.7mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR086</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Plates including Locking, Standard and Compression</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
                <ARTG>237797</ARTG>
                <ARTG>239452</ARTG>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST786</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Leibinger Forefoot Reconstruction System, straight plate, Titanium</Description>
            <Size>4 holes</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>124318</ARTG>
                <ARTG>64730</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST787</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Leibinger Forefoot Reconstruction System, straight plate, Titanium</Description>
            <Size>6 holes</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>124318</ARTG>
                <ARTG>64730</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY747</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Condylar plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW013</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Locking Compression Plates</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU173</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE442</PriorBillingCode>
            </PriorBillingCodes>
            <Name>X Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>Small</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW899</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR375</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mini MaxLock Extreme System - Mini Plates ≤ 6 holes</Name>
            <Description>Mini variable angle locking plates, Titanium, ≤ 6 holes</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV006</BillingCode>
            <Name>SternalPlate Closure System - Plates</Name>
            <Description>Titanium Sternal Fixation System</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>386783</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO395</BillingCode>
            <Name>RibLoc Rib fracture plating System</Name>
            <Description>RibLoc Plate</Description>
            <Size>46mmL X 8-14mm W</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>158695</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF118</BillingCode>
            <Name>Islay MTP Plate</Name>
            <Description>Islay MTP / TMT Plate</Description>
            <Size>2.7mm Univeral locking plate 18mm (2.7ULP), up to 24mm &#xD;
Open wedge locking plate 4mm (OW) up to 7mm&#xD;
Open wedge locking plate 0mm&#xD;
Open wedge osteotomy plate 4mm to 7.00mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF123</BillingCode>
            <Name>Islay Opening Wedge Locking plate</Name>
            <Description>Islay Opening Wedge Locking plate</Description>
            <Size>universal locking plate 12 MM - 30mm/&#xD;
Opening Wedge Locking plate 0MM-7MM&#xD;
Opening Wedge osteotomy plate OMM-7MM</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL133</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN930</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>2.7mm LK Reconstruction Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ139</BillingCode>
            <Name>PediLoc - Plating System ≤ 6 holes, screw size ≤ 2.7mm</Name>
            <Description>2.7mm Locking Plate</Description>
            <Size>3-6 Hole</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY808</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Pre-contoured locking plates</Description>
            <Size>≤6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY817</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking plates</Description>
            <Size>Less than 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA104</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tritium SCP (Sternal Cable Plate)</Name>
            <Description>V Shaped Titanium Sternal Plate, 4 Holes, Locking Screw/Plate, Complex Shape</Description>
            <Size>one size</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI946</BillingCode>
            <Name>Normed fracture fixation plates</Name>
            <Description>Titanium locking foot plates</Description>
            <Size>4/6 hole and 2.7mm screws</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>140687</ARTG>
            </ARTGs>
            <MinimumBenefit>1129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO060</BillingCode>
            <Name>Aptus Wrist Arthrodesis</Name>
            <Description>STT Fusion Plate</Description>
            <Size>2.0 system</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO082</BillingCode>
            <Name>APTUS Hand and Foot</Name>
            <Description>TriLock Plates</Description>
            <Size>1.2 - 2.3</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER484</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, mini (≤ 6 holes);variable angle locking, complex</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, titanium mini plate, compression, variable angle locking, complex</Description>
            <Size>thickness 1.1mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU244</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE755</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hook Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW825</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR266</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Plate</Name>
            <Description>Titanium locking plates anatomically contoured for forefoot and midfoot osteotomies.</Description>
            <Size>2.7mm &amp; 3.5mm. Neutral, 1mm, 2mm, 3mm, 4mm, 4.5mm, 5mm, 5.5mm, 6mm, 6.5mm, 7mm, 8mm, 10mm. 4-6Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW829</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR279</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biotech Easy Lock System</Name>
            <Description>Easy Lock Plating System</Description>
            <Size>Various</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>291615</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW968</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR459</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC 2 Small Bones Plates – Complex and VAL – up to 6 holes</Name>
            <Description>Titanium mini plates, complex, variable angle locking, up to 6 holes, various designs (Hook plate, Y-plates and Pinch plates).</Description>
            <Size>Up to 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT087</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH534</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand Fracture System - Plates</Name>
            <Description>Various Size and Shapes plates</Description>
            <Size>1 to 6 hole</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>236206</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM470</BillingCode>
            <Name>TriMed ASET Foot Plating System </Name>
            <Description>Lapidus and Universal Plates</Description>
            <Size>≤ 6 holes  </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM481</BillingCode>
            <Name>Complex Variable Locking Hand Plates</Name>
            <Description>Complex Variable Locking Hand Plates</Description>
            <Size>6 holes or less</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>337193</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO433</BillingCode>
            <Name>ACUMED Hand Fracture System</Name>
            <Description>0.8mm Avulsion Hook Plate</Description>
            <Size>0.8mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB023</BillingCode>
            <Name>Mallet Finger Plate</Name>
            <Description>Finger Plates</Description>
            <Size>1 &amp; 2 Holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>229660</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL035</BillingCode>
            <Name>VLP</Name>
            <Description>VAL mini plates</Description>
            <Size>Mini Plates ≤2.7mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY713</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP, Condylar, Mini Fragment Plates - Various</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ074</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arix Hand Plating System</Name>
            <Description>Mini Locking Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>239812</ARTG>
            </ARTGs>
            <MinimumBenefit>1272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU028</BillingCode>
            <Name>Airlock Plate</Name>
            <Description>Airlock Plating System</Description>
            <Size>Left and Right, Size 0 - 6</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>235766</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ039</BillingCode>
            <Name>Mini-Fragment Plates</Name>
            <Description>Locking Compression Plates</Description>
            <Size>1.5mm, 2.0mm, 2.5mm, 2.7mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW040</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Locking Compression Plates</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU181</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE444</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile Straight Plate</Name>
            <Description>Plate for Fusion</Description>
            <Size>4-6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU182</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE443</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile T-Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>3-6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW792</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR077</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte LisfrancReconstruction System - Bridge Plate.</Name>
            <Description>Stainless steel plate for stabilisation of the tarsometatarsal joint.</Description>
            <Size>4, 6, 5 &amp; 9 hole.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV005</BillingCode>
            <Name>SternalPlate Closure System - Plates</Name>
            <Description>Titanium Sternal Fixation System</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>386783</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM342</BillingCode>
            <Name>Orthopaedic Fixation Plate</Name>
            <Description>Orthopaedic Fixation Plates</Description>
            <Size>Screw size 2.7mm or less&#xD;
6 holes or less</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM361</BillingCode>
            <Name>Jones Fracture Plate</Name>
            <Description>Jones Fracture Plate</Description>
            <Size>6 holes or less</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB026</BillingCode>
            <Name>Plates ≤ 6 holes</Name>
            <Description>Plates ≤ 6 holes</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB028</BillingCode>
            <Name>Mini Locking System - Condylar Locking Plates ≤ 6 holes</Name>
            <Description>Condylar Locking Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY737</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Plates</Description>
            <Size>≤6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY806</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Pre-contoured locking plates</Description>
            <Size>≤6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER483</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, mini (≤ 6 holes); variable angle locking</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, titanium mini plate, compression, variable angle locking, variable sizes and shapes</Description>
            <Size>thickness 1.1/1.3 mm; multi screw diameter purchase 2.0/2.5mm or 2.7/3.5/4.2 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER492</BillingCode>
            <Name>Paragon 28 Proximal Rotational Metatarsal Osteotomy (“PROMO”) Plating System</Name>
            <Description>PROMO left or right contoured plates designed specifically around the angle of the osteotomy, allowing space for optimal cross screw trajectory. Plates are used with  Paragon 28 Baby Gorilla or Mini Monster screws.</Description>
            <Size>Size 1-4, osteotomy angles 13-55°</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU276</BillingCode>
            <Name>V-Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU281</BillingCode>
            <Name>Straight Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU286</BillingCode>
            <Name>Rotation Correction Plate</Name>
            <Description>Plate for arthrodesis</Description>
            <Size>5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU287</BillingCode>
            <Name>Bridge Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU289</BillingCode>
            <Name>T- Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU290</BillingCode>
            <Name>T-Plate, Wide</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU291</BillingCode>
            <Name>Straight Plate, Reinforced</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU293</BillingCode>
            <Name>T-Plate, Reinforced</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU294</BillingCode>
            <Name>Y-Plate</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW563</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Profyle hand and small fragment plate system</Description>
            <Size>screw size ≤2.7mm   ≤ 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>340042</ARTG>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW969</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR460</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC 2 Small Bones Plates – VAL – up to 6 holes</Name>
            <Description>Titanium mini plates, variable angle locking, up to 6 holes, various designs (Straight plates, T-plate and Jones Fracture Plates).</Description>
            <Size>Up to 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT086</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH533</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand Fracture System - Plates</Name>
            <Description>Various Size and Shaped Plates</Description>
            <Size>1 to 6 Hole</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>236206</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM254</BillingCode>
            <Name>OsteoMed FPS</Name>
            <Description>Titanium locking footplates</Description>
            <Size>2mm and 2.7mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM473</BillingCode>
            <Name>TriMed ASET Foot Plating System</Name>
            <Description>Straight and T Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM479</BillingCode>
            <Name>Variable Locking Hand Plates</Name>
            <Description>Variable Locking Hand Plates</Description>
            <Size>6 holes or less</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>337193</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO436</BillingCode>
            <Name>Acumed Hand Fracture System</Name>
            <Description>Straight Plates Variable Angle Locking</Description>
            <Size>6 hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO447</BillingCode>
            <Name>Acumed Small Fragment Plates</Name>
            <Description>2.7mm Fragment Plates</Description>
            <Size>6 Hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB056</BillingCode>
            <Name>Marathon VA System</Name>
            <Description>Variable Angle Bone Plates</Description>
            <Size>&lt;6 Holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL039</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>Mini Plates Straight</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL068</BillingCode>
            <Name>VLP</Name>
            <Description>VAL mini plates - Hand</Description>
            <Size>Mini Plates ≤2.7mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL218</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG118</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HALLU-Lock MTP Arthrodesis System - HALLU-Lock C Plate</Name>
            <Description>Titanium contoured plate for 1st MTP arthrodesis, fixation of fractures and osteotomies</Description>
            <Size>4, 5 or 6 holes; sizes 0 to 3, length 35 to 50mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN940</BillingCode>
            <Name>Peri-Loc VLP</Name>
            <Description>VAL/LK, 2.7mm Quarter Tubular Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ182</BillingCode>
            <Name>PediFoot Deformity Correction System</Name>
            <Description>2.7mm Plates, Compression/Neutral, Recon, Angle Iron, Wedge, Clover</Description>
            <Size>5-56mm length, 2-4mm wedge length, 2-6 holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY804</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Plates</Description>
            <Size>≤6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY821</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Hand Plates</Description>
            <Size>2-6 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN046</BillingCode>
            <Name>VAL plates screw size ≤2.7mm</Name>
            <Description>Variable angle locking complex plates</Description>
            <Size>Mini : screw size ≤2.7mm  &lt;= 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN072</BillingCode>
            <Name>Newclip Anatomic Locking plates</Name>
            <Description>Variable Angle Anatomic Locking Plate</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ073</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arix Hand Plating System</Name>
            <Description>Mini Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>239812</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO084</BillingCode>
            <Name>APTUS Hand</Name>
            <Description>Fixation Plates</Description>
            <Size>1.2 - 2.3</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW026</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Non-Locking Plate Systems</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU125</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE575</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Straight Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>2-5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO202</BillingCode>
            <Name>Acumed Bone Plate</Name>
            <Description>MCP Fusion Plate - Titanium</Description>
            <Size> 4 Hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB029</BillingCode>
            <Name>Mini Locking System - Condylar Plates ≤ 6 holes</Name>
            <Description>Condylar Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL038</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>VAL mini plates - Hand</Description>
            <Size>Mini Plates ≤2.7mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN073</BillingCode>
            <Name>TC-100 </Name>
            <Description>Mini L Plates &amp; T Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN083</BillingCode>
            <Name>TC-100</Name>
            <Description>2.0mm T Plates </Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN088</BillingCode>
            <Name>TC-100</Name>
            <Description>Semitubular Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN116</BillingCode>
            <Name>TC-100  </Name>
            <Description>2.7mm T Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN928</BillingCode>
            <Name>TC-100</Name>
            <Description>Quarter Tubular Plates, L/E 6 holes</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN932</BillingCode>
            <Name>TC-100</Name>
            <Description>2.0mm Straight Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST788</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Leibinger System, anatomical shap, Titanium</Description>
            <Size>screw size ≤2.7mm ≤ 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>340042</ARTG>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY736</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non-Locking Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5261</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM210</BillingCode>
            <Name>Jones Fracture Plate</Name>
            <Description>Fracture Fixation Systems</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>536</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL137</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>536</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY748</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Condylar plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>536</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH064</BillingCode>
            <Name>Sternalock</Name>
            <Description>plates, various shapes</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW033</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Locking Compression Plate</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW900</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR376</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mini MaxLock Extreme System - Mini Plates &gt; 6 holes</Name>
            <Description>Mini Variable angle locking plates, Titanium, &gt; 6 holes</Description>
            <Size>&gt; 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV007</BillingCode>
            <Name>SternalPlate Closure System - Plates</Name>
            <Description>Titanium Sternal Fixation System  </Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>386783</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO393</BillingCode>
            <Name>RibLoc rib fracture plating system</Name>
            <Description>RibLoc Plate</Description>
            <Size>61mm-76mm L X8-14mm W</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>158695</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO428</BillingCode>
            <Name>ACUMED Total Wrist Fusion Plating System</Name>
            <Description>Total Wrist Fusion System</Description>
            <Size>Plates available in 9 and 10 hole configurations</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB027</BillingCode>
            <Name>Mini Locking System - Locking Plates ≥ 7 to ≤ 15 holes</Name>
            <Description>Foot &amp; hand plates - steel - titanium multiple hole</Description>
            <Size>2-2.7 mm, ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL140</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN931</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>2.7mm LK Reconstruction Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ140</BillingCode>
            <Name>PediLoc - Plating System ≥ 7 to ≤ 15 holes, screw size ≤ 2.7mm</Name>
            <Description>2.7mm Locking Plate</Description>
            <Size>7-15 Hole</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY807</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Pre-contoured locking plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY818</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH367</BillingCode>
            <Name>ALPS Hand Fracture System - Locking Plate</Name>
            <Description>1.5mm and 2.5mm titanium hand plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO061</BillingCode>
            <Name>Aptus Wrist Arthrodesis</Name>
            <Description>RSL Fusion Plate</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO094</BillingCode>
            <Name>APTUS Hand and Foot</Name>
            <Description>TriLock Plates</Description>
            <Size>1.2 - 2.3</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER486</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 7 to ≤ 15 holes); variable angle locking, complex</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, mini, Titanium, compression, variable angle locking, complex shapes</Description>
            <Size>thickness 1.1mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU126</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE587</PriorBillingCode>
            </PriorBillingCodes>
            <Name>5th Metatarsal Fracture Plate</Name>
            <Description>Hook Plate for Fracture fixation</Description>
            <Size>2 Sizes Side Specific  Long Left - 7 Holes  Long Right - 7 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT085</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH532</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand Fracture System - Plates</Name>
            <Description>Various size and shaped plates</Description>
            <Size>7 to 15 hole</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>236206</ARTG>
                <ARTG>276674</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM263</BillingCode>
            <Name>OsteoMed HPS</Name>
            <Description>Low Profile hand plates</Description>
            <Size>1.2/1.6/2.0/2.4mm 4-12 hole; Complex</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM482</BillingCode>
            <Name>Complex Variable Locking Hand Plates</Name>
            <Description>Complex Variable Locking Hand Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>337193</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO432</BillingCode>
            <Name>ACUMED Hand Fracture System</Name>
            <Description>0.8mm Offset Plate</Description>
            <Size>0.8mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO434</BillingCode>
            <Name>ACUMED Hand Fracture System</Name>
            <Description>1.3mm Rolando Fracture Hook Plate</Description>
            <Size>1.3mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY799</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP, Condylar, Mini Fragment Plates - Various</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>286609</ARTG>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY802</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ076</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arix Hand Plating System</Name>
            <Description>Mini Locking Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>239812</ARTG>
            </ARTGs>
            <MinimumBenefit>1072</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ040</BillingCode>
            <Name>Mini Fragment Plates</Name>
            <Description>Locking Compression Plates</Description>
            <Size>1.5mm, 2.0mm, 2.5mm, 2.7mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW017</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Locking Compression Plate</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU179</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE456</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile Straight Plate</Name>
            <Description>Plate for fusion</Description>
            <Size>7-8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU180</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE454</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile T-Plate</Name>
            <Description> Plate for fusion</Description>
            <Size>7-9 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU195</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE373</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Low Profile MTP Plate</Name>
            <Description>Arthodesis Plate - 8 Hole plate</Description>
            <Size>8 Hole plate</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV004</BillingCode>
            <Name>SternalPlate Closure System - Plates</Name>
            <Description>Titanium Sternal Fixation System</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>386783</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM343</BillingCode>
            <Name>Orthopaedic Fixation Plate</Name>
            <Description>Orthopaedic Fixation Plate</Description>
            <Size>Screw size 2.7mm or less&#xD;
7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ151</BillingCode>
            <Name>PediLoc Plating System</Name>
            <Description>PediFrag Wrist Fusion Plates</Description>
            <Size>2.7/3.5mm&#xD;
99-112mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY624</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Reconstruction, J, Low Profile</Description>
            <Size>7-14 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY628</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP, Condylar , mini Fragment Plates - Various</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>498</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH297</BillingCode>
            <Name>ALPS Hand Fracture System - Locking Plate</Name>
            <Description>1.0 - 2.5mm titanium hand plates</Description>
            <Size>7 to 25 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH366</BillingCode>
            <Name>ALPS Hand Fracture System - Locking Plate</Name>
            <Description>1.5mm and 2.5mm titanium hand plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER485</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 7 to ≤ 15 holes); variable angle locking</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, mini, Titanium, compression, variable angle locking, various shapes (e.g. straight/oblique, right/left)</Description>
            <Size>thickness 1.1 mm, multi screw diameter purchase 2.0/2.5mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU245</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE753</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Reinforced T-Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU246</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE754</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Wide T-Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>10 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU275</BillingCode>
            <Name>Triangle Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU277</BillingCode>
            <Name>V-Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>10 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU282</BillingCode>
            <Name>Straight Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>10 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU283</BillingCode>
            <Name>Z-Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>10 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU284</BillingCode>
            <Name>Cage Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>10 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU288</BillingCode>
            <Name>T- Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU292</BillingCode>
            <Name>Straight Plate, Reinforced</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU295</BillingCode>
            <Name>Y-Plate</Name>
            <Description>Plate for Arthrodesis</Description>
            <Size>8 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW564</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Profyle hand and small fragment plate system</Description>
            <Size>size ≤2.7mm ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>340042</ARTG>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW826</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR267</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Plate</Name>
            <Description>Titanium locking plates anatomically contoured for forefoot and midfoot osteotomies.</Description>
            <Size>2.7mm &amp; 3.5mm, neutral, 1mm, 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 7-9 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW970</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR461</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC 2 Small Bones Plates – VAL – 7 to 15 holes</Name>
            <Description>Titanium mini plates, variable angle locking, 7-15 holes, various designs (Straight plate, T-plates).</Description>
            <Size>From 7 to 15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT084</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH531</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand Fracture System - Plates</Name>
            <Description>Various size and shaped plates</Description>
            <Size>7 to 15 hole</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>236206</ARTG>
                <ARTG>276674</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT094</BillingCode>
            <Name>RECOS Ulna </Name>
            <Description>Ulna Plate</Description>
            <Size>Short 80mm, Long 90mm x 10mm  </Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>236206</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM253</BillingCode>
            <Name>OsteoMed FPS</Name>
            <Description>Titanium locking footplates</Description>
            <Size>2mm and 2.7mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM262</BillingCode>
            <Name>Osteomed Plates</Name>
            <Description>Low Profile plates</Description>
            <Size>1.2/1.6/2.0/2.4mm 4-12 hole; straight, L, T</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM472</BillingCode>
            <Name>TriMed ASET Foot Plating System </Name>
            <Description>MTP Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM480</BillingCode>
            <Name>Variable Locking Hand Plates</Name>
            <Description>Variable Locking Hand Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>337193</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN306</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>VA Locking Patella Plate</Description>
            <Size>13 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN309</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA-LCP Clavicle Plates, Shaft</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
                <ARTG>286609</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN336</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>VA Locking Patella Plate Titanium</Description>
            <Size>13 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO430</BillingCode>
            <Name>ACUMED Hand Fracture System, plates</Name>
            <Description>Hand plating System, including plates and screws</Description>
            <Size>Plates available in 7 to 12 hole configurations</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO448</BillingCode>
            <Name>Acumed Small Fragment Plates</Name>
            <Description>2.7mm Fragment Plates</Description>
            <Size>7 to 15 Holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB058</BillingCode>
            <Name>Marathon VA System</Name>
            <Description>Variable Angle Bone plates</Description>
            <Size>&gt;7 - &lt;15 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL032</BillingCode>
            <Name>VLP</Name>
            <Description>VAL mini plates</Description>
            <Size>Mini Plates ≤2.7mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL040</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>Mini Plates Straight</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL069</BillingCode>
            <Name>VLP</Name>
            <Description>VAL mini plates - Hand</Description>
            <Size>Mini Plates ≤2.7mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL098</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN941</BillingCode>
            <Name>Peri-Loc VLP</Name>
            <Description>VAL/LK, 2.7mm Quarter Tubular Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ177</BillingCode>
            <Name>PediFoot Deformity Correction System</Name>
            <Description>2.7mm Plates, Recon</Description>
            <Size>56mm length, 8 holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR089</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Periarticular Plates, Locking</Description>
            <Size>4-6</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>124319</ARTG>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR090</BillingCode>
            <Name>Stryker Locking Plates System</Name>
            <Description>Locking Plates</Description>
            <Size>7-13</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>35241</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY822</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA Locking Plates</Description>
            <Size>7-12 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ075</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Plate System</Name>
            <Description>Variable Locking Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>239812</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO085</BillingCode>
            <Name>APTUS Hand</Name>
            <Description>Fixation Plates</Description>
            <Size>1.2 - 2.3</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW004</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Non-Locking Plate Systems</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB030</BillingCode>
            <Name>Mini Locking System - Condylar Plates ≥ 7 to ≤ 15 holes</Name>
            <Description>Condylar Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB031</BillingCode>
            <Name>Mini Locking System - Non Locking Plates</Name>
            <Description>Non Locking Plate</Description>
            <Size>screw size ≤ 2.7mm, ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN087</BillingCode>
            <Name>TC-100</Name>
            <Description>Semi-tubular plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN929</BillingCode>
            <Name>TC-100</Name>
            <Description>Quarter Tubular Plates, G/E 7 to L/E 15 holes</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN934</BillingCode>
            <Name>TC-100</Name>
            <Description>1.5mm Mini Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR087</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Plates including Locking, Standard and Compression</Description>
            <Size>7-15 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>124319</ARTG>
                <ARTG>340042</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY735</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non-Locking Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5262</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>364</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL141</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1136</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY819</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Pre-contoured Locking plate</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1136</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO062</BillingCode>
            <Name>Aptus Wrist Arthrodesis</Name>
            <Description>Total Wrist Fusion Plate, Straight, long bend and short bend</Description>
            <Size>&gt;16 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1379</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER500</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER420</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 16 holes);variable angle locking, complex</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, mini, titanium, compression, variable angle locking, various complex shapes and sizes, left or right</Description>
            <Size>thickness 2.0mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1379</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM483</BillingCode>
            <Name>Complex Variable Locking Hand Plates</Name>
            <Description>Complex Variable Locking Hand Plates</Description>
            <Size>16 holes or more</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>337193</ARTG>
            </ARTGs>
            <MinimumBenefit>1379</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR088</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Plates including Locking, Standard, and Compression</Description>
            <Size>16 hole</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>1379</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY800</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP, Condylar, Mini Fragment Plates - Various</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1379</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY820</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Pre-contoured Locking plate</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>Com, VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1379</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV009</BillingCode>
            <Name>SternalPlate Closure System - Plates</Name>
            <Description>Titanium Sternal Fixation System</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>386783</ARTG>
            </ARTGs>
            <MinimumBenefit>893</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER499</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER420</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 16 holes);variable angle locking</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, mini, titanium, compression, variable angle locking, various shapes and sizes (small-extra large)</Description>
            <Size>thickness 1.1-2.0 mm; multi screw diameter purchase</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN305</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA Locking Patella Plating System</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN339</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA Locking Patella Plating System Titanium</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL033</BillingCode>
            <Name>VLP</Name>
            <Description>VAL mini plates</Description>
            <Size>Mini Plates ≤2.7mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL041</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>Mini Plates Straight</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL099</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment Plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR091</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Locking Plates</Description>
            <Size>≥16 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY111</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Specially manufactured plate</Description>
            <Size>1.0mm - 6.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1207</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO086</BillingCode>
            <Name>APTUS Hand</Name>
            <Description>Fixation Plates</Description>
            <Size>1.2 - 2.3</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW015</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Non-Locking Plate Systems</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW788</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Non-locking Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <ARTGs>
                <ARTG>340042</ARTG>
                <ARTG>357433</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL131</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Small Fragment plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN933</BillingCode>
            <Name>TC-100</Name>
            <Description>2.0mm Straight Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN935</BillingCode>
            <Name>TC-100</Name>
            <Description>1.5mm Mini Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY629</BillingCode>
            <Name>'AO/ASIF Plates</Name>
            <Description>Non-locking Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5263</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>532</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY606</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DHS Plates</Description>
            <Size>2-6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK551</BillingCode>
            <Name>Omega3 Compression Hip Screw System</Name>
            <Description>Omega3 Locking Plate</Description>
            <Size>2-6 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>139622</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY609</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DHS Plates</Description>
            <Size>2-6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL158</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SN471</PriorBillingCode>
                <PriorBillingCode>SN473</PriorBillingCode>
                <PriorBillingCode>SN476</PriorBillingCode>
                <PriorBillingCode>SN926</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Compression Hip Screw System</Name>
            <Description>Compression Hip Screw Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>290</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN488</BillingCode>
            <Name>Intermediate Osteotomy System</Name>
            <Description>Compressing</Description>
            <Size>One size only</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <ARTGs>
                <ARTG>108429</ARTG>
            </ARTGs>
            <MinimumBenefit>290</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN493</BillingCode>
            <Name>Paediatric Osteotomy System</Name>
            <Description> Paediatric Osteotomy System</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>290</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN912</BillingCode>
            <Name>Intermediate Osteotomy System</Name>
            <Description>Plate (hip screw)</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>290</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI768</BillingCode>
            <Name>Zimmer Internal Fixation System: Compression Hip Screw</Name>
            <Description>Versa Fx II CHS Tube Plates</Description>
            <Size>2-6 holes left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5264</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>290</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY607</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DHS Plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5265</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>604</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY610</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DHS Plates</Description>
            <Size>8-14 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5265</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>604</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK552</BillingCode>
            <Name>Omega3 Compression Hip Screw System</Name>
            <Description>Omega3 Locking Plate</Description>
            <Size>7-14 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5265</SubGroupID>
            <ARTGs>
                <ARTG>139622</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL157</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SN470</PriorBillingCode>
                <PriorBillingCode>SN475</PriorBillingCode>
                <PriorBillingCode>SN927</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Compression Hip Screw System</Name>
            <Description>Compression Hip Screw Plates</Description>
            <Size>  ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5265</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN913</BillingCode>
            <Name>Intermediate Osteotomy System</Name>
            <Description>Plate (hip screw)</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5265</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI769</BillingCode>
            <Name>Versa Fx II Compression Hip Screw</Name>
            <Description>Versa Fx II CHS Tube Plates</Description>
            <Size>7-15 holes left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5265</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>586</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY608</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DHS Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5266</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY611</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DHS Plates</Description>
            <Size>≥ 16-20 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5266</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY738</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Osteotomy, Dynamic Supracondylar Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5267</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW055</BillingCode>
            <Name>WEGO Trauma Systems </Name>
            <Description>Supracondylar Femur Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5267</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK553</BillingCode>
            <Name>Stryker Compression Hip Screw System</Name>
            <Description>Omega3 Supracondylar Plate</Description>
            <Size>6 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5267</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>139622</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN922</BillingCode>
            <Name>Compression Hip Screw System</Name>
            <Description>Classic Supracondylar Plate</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5267</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>572</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY641</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DCS DHS plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5267</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>572</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI770</BillingCode>
            <Name>Versa Fx II Compression Hip Screw</Name>
            <Description>Versa Fx II CHS Tube Plates</Description>
            <Size>2-6 holes left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5267</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>572</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY739</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Osteotomy, Dynamic Supracondylar Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5268</SubGroupID>
            <Suffix>Com</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW014</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Supracondylar Femur Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5268</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK554</BillingCode>
            <Name>Stryker Compression Hip Screw System</Name>
            <Description>Omega3 Supracondylar Plate</Description>
            <Size>8-14 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5268</SubGroupID>
            <Suffix>Com, LK</Suffix>
            <ARTGs>
                <ARTG>139622</ARTG>
            </ARTGs>
            <MinimumBenefit>850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN923</BillingCode>
            <Name>Compression Hip Screw System</Name>
            <Description>Classic Supracondylar Plate</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5268</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY642</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DCS DHS plate</Description>
            <Size>7- 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5268</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI771</BillingCode>
            <Name>Versa Fx II Compression Hip Screw</Name>
            <Description>Versa Fx II CHS Tube Plates</Description>
            <Size>7-15 holes left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5268</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>522</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY740</BillingCode>
            <Name>Ao/ASIF Plates</Name>
            <Description>Osteotomy, Dynamic Supracondylar Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5269</SubGroupID>
            <Suffix>COM</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1069</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY643</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>DCS DHS plate</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5269</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1069</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE148</BillingCode>
            <Name>ASDM Clavicle Plating System - Plates</Name>
            <Description>Clavicle fracture plating system consisting of anatomic pre-contoured stainless steel locking compression plates and screws (cortical, cancellous &amp; locking)</Description>
            <Size>6 holes(L&amp;R),</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>258572</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ005</BillingCode>
            <Name>Valens Shoulder and Elbow - Clavicle</Name>
            <Description>Clavicle - Superior, Anterior, Hook, Locking Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW067</BillingCode>
            <Name>WEGO Trauma Systems - Titanium Alloy</Name>
            <Description>Clavicle Plating System - Titanium Alloy</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN294</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Clavicle Hook Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO371</BillingCode>
            <Name>Acumed Locking Scapula Plate System</Name>
            <Description>Locking Bone Plate, Scapula</Description>
            <Size>≤6 hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO384</BillingCode>
            <Name>Acumed Locking Clavical Plating System</Name>
            <Description>Locking Clavicle Plates Mid Shaft Anterior and Distal</Description>
            <Size>≥ 6 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX022</BillingCode>
            <Name>ARMAR LPS Clavicle Hook Plates</Name>
            <Description>3.5 mm anatomical clavicle hook locking plate</Description>
            <Size>4-6 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX023</BillingCode>
            <Name>ARMAR Superior Anterior Clavicle Plates</Name>
            <Description>Superior Anterior Clavicle anatomical plates</Description>
            <Size>3-6 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY616</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Clavicle - superior, anterior, hook</Description>
            <Size>1-6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY617</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Pre-contoured, anatomic rib</Description>
            <Size>1-6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1261</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ006</BillingCode>
            <Name>Valens Shoulder and Elbow - Clavicle</Name>
            <Description>Clavicle – Superior, Anterior, Hook, Locking Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1456</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW595</BillingCode>
            <Name>Stryker Locked Plating System</Name>
            <Description>Periarticular variable angle locking plate - clavicle</Description>
            <Size>1-6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>196764</ARTG>
            </ARTGs>
            <MinimumBenefit>1456</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN323</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA-LCP Clavicle Plate 2.7 System - Button Hook Plate</Description>
            <Size> ≤ 6 holes, 9-, 12- and 15-mm hook depth</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1456</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL142</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Clavicle</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5270</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1456</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE153</BillingCode>
            <Name>ADSM Clavicle Plating System - Plates</Name>
            <Description>Clavicle fracture plating system consisting of anatomic pre-contoured stainless steel locking compression plates and screws (cortical, cancellous &amp; locking)</Description>
            <Size>8-13 holes (L &amp; R),</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>258572</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW049</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Clavicle Plating System</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM184</BillingCode>
            <Name>Trimed Clavicle Fixation Plates</Name>
            <Description>Plates for fixation of fractures of the clavicle</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN295</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Clavicle Hook Plates</Description>
            <Size>≥7 to ≤ 15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO372</BillingCode>
            <Name>Acumed Locking Scapula plate System</Name>
            <Description>Locking Bone Plate, Scapula</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO385</BillingCode>
            <Name>Acumed Locking Clavical Plating System</Name>
            <Description>Locking Clavicle Plates Mid Shaft, Anterior and Distal</Description>
            <Size>≥7 to  ≤15 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX024</BillingCode>
            <Name>ARMAR LPS Clavicle Hook Plates</Name>
            <Description>3.5mm anatomical clavicle hook plates</Description>
            <Size>7 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX025</BillingCode>
            <Name>ARMAR Superior Anterior Clavicle Plate</Name>
            <Description>3.5mm anatomical clavicle plate</Description>
            <Size>7-8 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL088</BillingCode>
            <Name>PERI-LOC</Name>
            <Description>Clavicle plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY618</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Clavicle - superior, anterior, hook</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO126</BillingCode>
            <Name>APTUS Shoulder Clavicle</Name>
            <Description>Lateral clavicle plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW597</BillingCode>
            <Name>Stryker Locked Plate System</Name>
            <Description>Periarticular variable angle locking plate - clavicle</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>196764</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW907</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR384</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - Clavicle Plates</Name>
            <Description>Clavicle Variable angle locking plates, Titanium</Description>
            <Size>9 to 13 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN308</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA-LCP Clavicle Plates, Lateral &amp; Medial</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
                <ARTG>286609</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN327</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>VA-LCP Clavicle Plate 2.7 System - Short and Long Hook Plates</Description>
            <Size>9, 11  holes; 9-, 12- and 15-mm hook depths</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL153</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Clavicle</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY619</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Clavicle - Anterior</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN062</BillingCode>
            <Name>Newclip Clavicle plates</Name>
            <Description>Locking Clavicle plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA081</BillingCode>
            <Name>ALPS Clavicle Plating System</Name>
            <Description>clavicle variable angle locking plates  </Description>
            <Size>7-15 holes  </Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
                <ARTG>275084</ARTG>
            </ARTGs>
            <MinimumBenefit>1652</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN019</BillingCode>
            <Name>NewClip Clavicle Plate</Name>
            <Description>Locking Clavicle plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5271</SubGroupID>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
                <ARTG>260232</ARTG>
                <ARTG>260229</ARTG>
            </ARTGs>
            <MinimumBenefit>1466</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO386</BillingCode>
            <Name>Acumed Locking Clavical Plating System</Name>
            <Description>Lockinh Clavicle Plates Mid Shaft, Anterior and Distal.</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5272</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ001</BillingCode>
            <Name>Valens Shoulder and Elbow - Elbow</Name>
            <Description>Distal Humerus, Lateral, Medial, Olecranon, Locking Plates</Description>
            <Size>1-6 Holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW035</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Distal Humerus Plating System</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX001</BillingCode>
            <Name>ARMAR LPS Humerus Plates</Name>
            <Description>TiCP humeral locking plates</Description>
            <Size>3-6 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL184</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Periarticular Anatomical Plate - Humerus</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN916</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Humerus Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY680</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Locking Periarticular Anatomic Humerus plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1248</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ073</BillingCode>
            <Name>Austofix Proximal Humeral Plating System - Austofix Proximal Humeral Plate</Name>
            <Description>Anatomic Periarticular Humeral Variable Angle Locking Plate, Titanium</Description>
            <Size>3-5 holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW551</BillingCode>
            <Name>VariAx Elbow Plating System</Name>
            <Description>Periarticular anatomic humerus</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>1542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO352</BillingCode>
            <Name>Acumed Tap Loc Elbow plates</Name>
            <Description>Variable angle locking plate system</Description>
            <Size>≤6 holes lateral</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL143</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Humerus</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI743</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Variable Angle Locking Plate - Humerus - Ti Alloy</Description>
            <Size>80 - 93mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>1542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI929</BillingCode>
            <Name>Proximal Humerus Plating System</Name>
            <Description>Proximal Humerus Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>275084</ARTG>
            </ARTGs>
            <MinimumBenefit>1542</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX003</BillingCode>
            <Name>ARMAR Distal Humerus Plates</Name>
            <Description>TiCP anatomic humeral locking plates</Description>
            <Size>3-6 holes and left and right</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5273</SubGroupID>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW036</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Humerus Plating Systems</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO425</BillingCode>
            <Name>ACUMED POLARUS® 3 Solution Plates</Name>
            <Description>ACUMED POLARUS 3 SOLUTION, includes plates, intramedullary nails, screws and accessories designed to address fractures, fusions and osteotomies of the humerus</Description>
            <Size>12 and 14 hole plates</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX002</BillingCode>
            <Name>ARMAR LPS Humerus Plates</Name>
            <Description>TiCP anatomical humeral locking plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK555</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Proximal Humerus Anatomical Locking Plates</Description>
            <Size>11-14 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL185</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Periarticular Anatomical Plate - Humerus</Description>
            <Size> ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN917</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Humerus Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY762</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Locking Perarticular Anatomic Humerus plate</Description>
            <Size>≥ 7 - ≤ 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN033</BillingCode>
            <Name>Newclip Humerus Plates</Name>
            <Description>Plates for fixation of fractures of the distal humerus and proximal ulnar</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH290</BillingCode>
            <Name>ALPS Elbow System</Name>
            <Description>Humeral Titanium Plates</Description>
            <Size>Small - Large, 7 to 15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ002</BillingCode>
            <Name>Valens Shoulder and Elbow - Elbow</Name>
            <Description>Distal Humerus, Lateral, Medial, Olecranon, Locking Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ025</BillingCode>
            <Name>Austofix PHP - Proximal Humeral Plating System</Name>
            <Description>Anatomic Periarticular Humeral Variable Angle Locking Plate, Titanium</Description>
            <Size>7-15 Hole</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO078</BillingCode>
            <Name>Aptus Elbow</Name>
            <Description>Distal Humerus Plpates, Lateral,Middle and Posterolateral</Description>
            <Size>2.8mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW803</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR225</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Ortholco EPS System - Distal Humerus</Name>
            <Description>Stainless Steel, Polyaxial Locking Plate, Straight, Coronal, Medial, Lateral, Posterolateral</Description>
            <Size>Right &amp; left, 2.7 &amp; 3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW953</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR443</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC SPS Humeral Plates - Standard &amp; Posterior</Name>
            <Description>Stainless steel variable angle locking periarticular anatomic humeral plate, standard and posterior.</Description>
            <Size>≥ 7 to ≤ 15 holes, right &amp; left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>370409</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW957</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR447</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC SPS Greater Tuberosity Plate</Name>
            <Description>Stainless steel peri-articular anatomic variable angle locking plate for greater tuberosity fixation</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>370409</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD006</BillingCode>
            <Name>CarboFix Piccolo Proximal Humerus Plate Systems – Plate component</Name>
            <Description>CFR-PEEK proximal humerus plate</Description>
            <Size>100mm, 120mm, 154mm, 190mm, 262mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM275</BillingCode>
            <Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Plates</Name>
            <Description>Proximal Humerus Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>182168</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO353</BillingCode>
            <Name>Acumed Tap Loc Elbow plates</Name>
            <Description>Variable angle locking plate system</Description>
            <Size>≥7 to ≤15 holes medial lateral</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>199824</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK569</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Stryker locked plating system</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL135</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Humerus</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY763</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Locking Perarticular Anatomic Humerus plate</Description>
            <Size>≥ 7 - ≤ 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN013</BillingCode>
            <Name>Newclip Distal Humerus Plates - Periarticular 7-15 holes</Name>
            <Description>Plates for the fixation of fractures of the elbow</Description>
            <Size>Periarticular anatomic - Humerus ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN020</BillingCode>
            <Name>Newclip Proximal Humerus Plate</Name>
            <Description>Proximal Humerus Plate</Description>
            <Size>1/2/3</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI744</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Variable Angle Locking Plate - Humerus - Ti Alloy</Description>
            <Size>7 - 12 Holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI930</BillingCode>
            <Name>Proximal Humerus Plating System</Name>
            <Description>Proximal Humerus Plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
                <ARTG>275084</ARTG>
            </ARTGs>
            <MinimumBenefit>1551</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX004</BillingCode>
            <Name>ARMAR Distal Humerus Plates</Name>
            <Description>TiCP distal humeral anatomical locking plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5274</SubGroupID>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW023</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Humerus Plating Systems</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO429</BillingCode>
            <Name>ACUMED POLARUS* 3 Solution, Humeral Plates, Sterile and Non-Sterile</Name>
            <Description>ACUMED POLARUS 3 SOLUTION, includes plates, intramedullary nails, screws and accessories designed to address fractures, fusions and osteotomies of the humerus</Description>
            <Size>16 , 18 , 22 , 26  and 30 hole plates</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK556</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Proximal Humerus Anatomical Locking Plates</Description>
            <Size>16-27 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY754</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Locking Humerus Plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN042</BillingCode>
            <Name>Newclip Humerus Plates</Name>
            <Description>Plates for fixation of fractures of the distal humerus and proximal ulna</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO079</BillingCode>
            <Name>Aptus Elbow</Name>
            <Description>Distal Humerus Plates Posterolateral</Description>
            <Size>2.8mm System</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO087</BillingCode>
            <Name>Aptus Shoulder (Proximal Humerus Plates)</Name>
            <Description>Proximal Humerus Fixation plates</Description>
            <Size>3.5mm System</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW804</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR226</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Ortholco EPS System - Distal Humerus</Name>
            <Description>Stainless Steel, Polyaxial Locking Plate, Straight, Coronal, Medial, Lateral, Posterolateral</Description>
            <Size>Right &amp; left, 2.7 &amp; 3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW958</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR448</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC SPS Humeral Plates - Standard (Long)</Name>
            <Description>Stainless steel variable angle locking periarticular anatomic humeral plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>370409</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM276</BillingCode>
            <Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Plate ≥ 16 holes</Name>
            <Description>Proximal Humerus Plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>182168</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO354</BillingCode>
            <Name>Acumed Tap Loc Elbow plates</Name>
            <Description>Variable angle locking plate system</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK570</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Stryker locked plating system</Description>
            <Size>16-17 Hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL128</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Humerus</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY755</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Locking Humerus Plate</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN012</BillingCode>
            <Name>Newclip Disal Humerus Plates - Perarticular 16+ holes</Name>
            <Description>Plates for the fixation of fractures of the elbow</Description>
            <Size>Periarticular anatomic - Humerus ≥ 16 holes, VAL</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN070</BillingCode>
            <Name>Newclip Humerus Plates</Name>
            <Description>Periarticular plate for humerus</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA114</BillingCode>
            <Name>Proximal Humerus Plating System</Name>
            <Description>Proximal Humerus Plates</Description>
            <Size>&gt;15 holes</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
                <ARTG>275084</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI745</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Variable Angle Locking Plate - Humerus - Ti Alloy</Description>
            <Size>17 Holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>1643</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX005</BillingCode>
            <Name>ARMAR Distal Humerus Plates</Name>
            <Description>TiCP distal humeral locking plates</Description>
            <Size>16-18 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5275</SubGroupID>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1074</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW038</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Radius Plating Systems</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM211</BillingCode>
            <Name>Trimed Volar &amp; Dorsal Hook Plate</Name>
            <Description>Wrist Fixation System - Volar &amp; Dorsal Hook Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO194</BillingCode>
            <Name>Acumed Congruent Plate System</Name>
            <Description>Elbow plate  titanium, locking radial head</Description>
            <Size>Locking radial head, 3 hole std curve 31mm, 5 hole std curve 46mm, 3 hole curve 31mm, 5 hole curve 46mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>126428</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO362</BillingCode>
            <Name>Anatomic Midshaft Forearm Plates</Name>
            <Description>Internal Fixation Plate Anatomic Forearm, Radius</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO366</BillingCode>
            <Name>Acu-Loc Distal Radius Plating System</Name>
            <Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra-articular plates</Description>
            <Size>Radius ≤6 holes`</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX026</BillingCode>
            <Name>ARMAR 2.4 Locking Distal Radial Plate System - ≤ 6 holes</Name>
            <Description>TiCP Distal Radial Locking Plates</Description>
            <Size>3-6 Holes&#xD;
40-57 Length&#xD;
Left, Straight and Right</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN920</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Radius Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY675</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Distal Radius; Ulna Column Plate System</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA112</BillingCode>
            <Name>ALPS Elbow System</Name>
            <Description>Proximal Radius Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ003</BillingCode>
            <Name>Valens Shoulder and Elbow - Elbow</Name>
            <Description>Locking Compression Plate Proximal Radius</Description>
            <Size>1-6 Holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO067</BillingCode>
            <Name>Aptus Wrist</Name>
            <Description>2.5 TriLock Distal Radius Small Fragment Plates</Description>
            <Size>2.5mm diameter system</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER543</BillingCode>
            <Name>Osteomed ExtremiLock Plate (≤ 6 holes)</Name>
            <Description>VDR Radial/Intermediate Column; Standard; Left or Right and Styloid Plates; 6 hole  </Description>
            <Size>6 holes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>337239</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU127</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE563</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Volar Hook PLate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>4 Holes  6 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU128</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE579</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Radial Styloid Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU178</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE470</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Titanium Volar Distal Radius Plating System</Name>
            <Description>Fixation Plate for Distal Radius Fractures</Description>
            <Size>6 holes or less</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT072</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH472</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IXOS Radius Plating System</Name>
            <Description>Straight/L plate R&amp;L</Description>
            <Size>7.5-15mm x 43-52mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>236206</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM140</BillingCode>
            <Name>TriMed Wrist Fixation System</Name>
            <Description>TriMed Volar Bearing Plate</Description>
            <Size>3 and 5 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM321</BillingCode>
            <Name>GEMINUS Volar Distal Radius Plates</Name>
            <Description>Fixation Plate for Distal Radius Fractures</Description>
            <Size>3 and 4 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK571</BillingCode>
            <Name>Universal Distal Radius System</Name>
            <Description>SMARTLock Column Locking Plates</Description>
            <Size>4-6 Hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL075</BillingCode>
            <Name>VLP</Name>
            <Description>Distal Radius Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL148</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular anatomic Radius Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY676</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Distal Radius Ulna Column Plate System</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN021</BillingCode>
            <Name>Xpert 2.4 Distal Radius Platform</Name>
            <Description>Fragment specific radius plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1376</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW913</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR392</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix MTP Fusion System</Name>
            <Description>A bendable stainless steel bone plate and screw system with unique low profile locking screw option.  Indicated for use in primary MTP fusion</Description>
            <Size>Left 2 + 3; Right 2 + 3</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <ARTGs>
                <ARTG>177214</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM033</BillingCode>
            <Name>Trimed Wrist Fixation System, Volar Peg Plate</Name>
            <Description>Stainless Steel</Description>
            <Size>Volar Peg Plate 3-hole, Right &amp; Left, 4 and 5 Peg; Volar Peg Plate 5-hole, Right &amp; Left, 4 and 5 Peg</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM117</BillingCode>
            <Name>TriMed Radial Column Plates</Name>
            <Description>Radial Column Plate</Description>
            <Size>3 &amp; 5 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM119</BillingCode>
            <Name>TriMed Ulna Column Plates</Name>
            <Description>Ulna Column Plate</Description>
            <Size>3 &amp; 5 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK590</BillingCode>
            <Name>SCS Distal Radius Plate System</Name>
            <Description>Left and Right, Tined</Description>
            <Size>Small and Large 3 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5276</SubGroupID>
            <ARTGs>
                <ARTG>141005</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ009</BillingCode>
            <Name>VRP Distal Radius Fixation System Volar Distal Radius Plate - Standard</Name>
            <Description>Volar Distal Radius Plate - Standard</Description>
            <Size>Standard, 3 and 4 hole, left and right</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>149433</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW041</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Radius Plating Systems</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW973</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR048</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Radial Head Plate</Name>
            <Description>Evolve Radial Plate System Stainless Steel</Description>
            <Size>32mm x 20-26mm in 2mm increments, 7 &amp; 8 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM212</BillingCode>
            <Name>Trimed Volar &amp; Dorsal Hook Plate</Name>
            <Description>Wrist Fixation System - Volar &amp; Dorsal Hook Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM318</BillingCode>
            <Name>PROTEAN Plate</Name>
            <Description>Plate</Description>
            <Size>One size</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO363</BillingCode>
            <Name>Anatomic Midshaft Forearm Plates</Name>
            <Description>Internal Fixation Plate Anatomic Forearm, Radius</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO406</BillingCode>
            <Name>Acu-Loc Distal Radius Plating System</Name>
            <Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra-articular plates</Description>
            <Size>&gt;7 - &gt;15</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX027</BillingCode>
            <Name>ARMAR 2.4 Locking Distal Radial Plate System - ≥ 7 to ≤ 15 holes</Name>
            <Description>TiCP Distal Radial Locking Plates</Description>
            <Size>7-15 Holes&#xD;
43-120mm Length&#xD;
Left, Straight and Right</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN921</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Radius Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY677</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Locking Radial Plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA113</BillingCode>
            <Name>ALPS Elbow System</Name>
            <Description>Proximal Radius Plate</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH253</BillingCode>
            <Name>Distal Radius Plating System</Name>
            <Description>DVR titanium radius plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>209306</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH256</BillingCode>
            <Name>Distal Radius Fracture Repair System</Name>
            <Description>Fragment locking plate, titanium</Description>
            <Size>Right, left, straight, Y</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>97981</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ022</BillingCode>
            <Name>VRP Distal Radius Fixation System</Name>
            <Description>Volar Distal Radius Plate</Description>
            <Size>Standard, wide, narrow, long, short - left, right and universal</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>149433</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO068</BillingCode>
            <Name>APTUS Wrist</Name>
            <Description>2.5 TriLock Distal Radius Plates, Adaptive, Volar, Dorsal, Correction, Extra-articular</Description>
            <Size>2.5mm diameter system</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER558</BillingCode>
            <Name>Osteomed ExtremiLock Plate (≥ 7 to ≤ 15 holes)</Name>
            <Description>VDR Narrow, standard, PQ sparing plates, left or right    </Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>337239</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW022</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Radius Plating Systems</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU153</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE471</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Titanium Volar Radius Plating System</Name>
            <Description>Fixation Plate for Distal Radius Fractures</Description>
            <Size>7- 15 holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD005</BillingCode>
            <Name>CarboFix Piccolo Distal Radius Plate System – Plate component</Name>
            <Description>CFR-PEEK distal volar radius plate</Description>
            <Size>Right 52mm, 60mm, 90mm&#xD;
Left 52mm, 60mm, 90mm&#xD;
Narrow Right 50mm, 58mm&#xD;
Narrow Left 50mm, 58mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT070</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH470</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IXOS Radius Plating System</Name>
            <Description>Titanium Radial Plates</Description>
            <Size>23-27mm x 43-71mm - &gt;7 to &amp;lt;15 Holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>236206</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM057</BillingCode>
            <Name>Ascension Radial Head Locking Plate and Screws</Name>
            <Description>Titanium pre-formed anatomical radial head plate</Description>
            <Size>small and large</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>118638</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM141</BillingCode>
            <Name>TriMed Wrist Fixation System</Name>
            <Description>TriMed Volar Bearing Plate</Description>
            <Size>7,9 and 11 Hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM322</BillingCode>
            <Name>GEMINUS Volar Plating System</Name>
            <Description>Plates</Description>
            <Size>7 hole, Long (207mm) and Short (160mm)</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM365</BillingCode>
            <Name>Distal Radius Plates</Name>
            <Description>Distal Radius Plates</Description>
            <Size>Multiple Sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO407</BillingCode>
            <Name>Acu-Loc Distal Radius Plating System</Name>
            <Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra articular plates</Description>
            <Size>≥ 7 to ≤ 15</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB057</BillingCode>
            <Name>Distal Radius Plate</Name>
            <Description>Distal Radius Plating System</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK572</BillingCode>
            <Name>Universal Distal Radius System</Name>
            <Description>SMARTLock Column Locking Plates</Description>
            <Size>7 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK573</BillingCode>
            <Name>Universal Distal Radius System</Name>
            <Description>Universal SMARTLock Locking plates</Description>
            <Size>9-15 Hole</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK632</BillingCode>
            <Name>VariAx Volar plates</Name>
            <Description>Volar Plate Polyaxial Locking</Description>
            <Size>Radius 7-15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>155633</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL027</BillingCode>
            <Name>D-RAD SMART PACK</Name>
            <Description>D-RAD SMART PACK Plate Kit</Description>
            <Size>Standard, Wide</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
                <ARTG>214894</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL076</BillingCode>
            <Name>VLP</Name>
            <Description>Distal Radius Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL149</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular anatomic Radius Plate</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY678</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Variable Angle Locking Radial Plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN035</BillingCode>
            <Name>Newclip Radius Plates</Name>
            <Description>Variable Angle plates for the radius</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN057</BillingCode>
            <Name>Periarticular radius plate</Name>
            <Description>Periarticular VAL radius plate</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN075</BillingCode>
            <Name>Newclip distal radius plates</Name>
            <Description>Pariarticular anatomic radius plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1305</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM118</BillingCode>
            <Name>TriMed Radial Column Plates</Name>
            <Description>Radial Column Plate</Description>
            <Size>7 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM120</BillingCode>
            <Name>TriMed Ulna Column Plates</Name>
            <Description>Ulna Column Plate</Description>
            <Size>7 hole</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5277</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW030</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Radius Plating Systems</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO364</BillingCode>
            <Name>Acumed Acu-Loc Radius Plating system</Name>
            <Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra-articular plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX030</BillingCode>
            <Name>ARMAR 2.4 Locking Distal Radial Plate System - ≥ 16 holes</Name>
            <Description>TiCP Distal Radial Locking Plate</Description>
            <Size>16 Holes&#xD;
140mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY679</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Locking Radial Plates</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH254</BillingCode>
            <Name>Distal Radius Fracture Repair System</Name>
            <Description>DVR-A, distal volar radius locking plate, titanium</Description>
            <Size>16 to 20 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO069</BillingCode>
            <Name>APTUS Wrist</Name>
            <Description>2.5 TriLock Distal Radius Plates, Volar, Dorsal, Correction</Description>
            <Size>2.5mm diameter system</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT071</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH471</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IXOS Radius Plating System</Name>
            <Description>Titanium Radial Plates</Description>
            <Size>23mm - 32mm x 60mm - 95mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>236206</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM382</BillingCode>
            <Name>Volar Distal Radius Plates</Name>
            <Description>Fixation Plate for Distal Radius Fractures</Description>
            <Size>16 holes or more</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN201</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical  Radial Plates</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK574</BillingCode>
            <Name>Universal Distal Radius System</Name>
            <Description>Universal SMARTLock Locking Plates</Description>
            <Size>17 Hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK576</BillingCode>
            <Name>VariAx Plate</Name>
            <Description>Volar Plate, Polyaxial Locking</Description>
            <Size>16-22 Hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN047</BillingCode>
            <Name>Periarticular anatomic plates VAL Radius &gt;=16 holes</Name>
            <Description>Periarticular anatomic plates VAL Radius</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5278</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1580</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW042</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Ulna Plating System</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>956</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO361</BillingCode>
            <Name>Anatomic Midshaft Forearm Plates</Name>
            <Description>Internal Fixation Plate Anatomic Forearm, Ulna</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>956</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX020</BillingCode>
            <Name>ARMAR 3.5 LPS Olecranon Plates</Name>
            <Description>3.5 mm anatomical olecranon locking plates</Description>
            <Size>2- 6 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>956</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN918</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Olecranon Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>956</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY743</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Ulna Plates</Description>
            <Size>≤6  Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>956</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH292</BillingCode>
            <Name>ALPS Elbow System</Name>
            <Description>Ulna Titanium Plates</Description>
            <Size>Small – Large, 3 to 6 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1345</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO059</BillingCode>
            <Name>APTUS</Name>
            <Description>Ulna Plates</Description>
            <Size>&lt;  or = 6 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1345</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL144</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Ulna</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1345</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO349</BillingCode>
            <Name>Acumed Tap Loc Elbow plates</Name>
            <Description>Variable angle locking plates</Description>
            <Size>≤6 holes Coronoid</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5279</SubGroupID>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>869</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW025</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Perarticular Ulna Plating Systems</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW802</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR221</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Ortholoc EPS System - Olecranon Plate</Name>
            <Description>Stainless Steel, Polyaxial Locking Plate, Olecranon, Right &amp; Left</Description>
            <Size>Right &amp; Left, 2.7 &amp; 3.5mm, 9-16 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO360</BillingCode>
            <Name>Anatomic Midshaft Forearm Plates</Name>
            <Description>Internal Fixation Plate Anatomic Forearm, Ulna</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX021</BillingCode>
            <Name>ARMAR 3.5 LPS Olecranon Plates</Name>
            <Description>3.5mm anatomical olecranon locking plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN919</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Olecranon Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY767</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Locking Periarticular Ulna Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1126</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH293</BillingCode>
            <Name>ALPS Elbow System</Name>
            <Description>Ulna Titanium Plates</Description>
            <Size>Small – Large, 7 to 15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ004</BillingCode>
            <Name>Valens Shoulder and Elbow - Elbow</Name>
            <Description>Ulna Hook Locking Compression Plate</Description>
            <Size>7 Holes</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO063</BillingCode>
            <Name>Aptus Elbow</Name>
            <Description>Olecranon Plates Right, Left, Straight and Tension</Description>
            <Size>&gt; 7 to &lt; 15 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO070</BillingCode>
            <Name>APTUS Wrist</Name>
            <Description>2.5 TriLock Y Plate</Description>
            <Size>2.5mm diameter system</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM525</BillingCode>
            <Name>Proximal Ulna Plate</Name>
            <Description>Proximal Ulna Plate</Description>
            <Size>73 to 151 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO350</BillingCode>
            <Name>Acumed Tap Loc Elbow plates</Name>
            <Description>Variable angle locking plate system</Description>
            <Size>≥7 to ≤15 holes Olecranon</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK499</BillingCode>
            <Name>Stryker Locking Plate system</Name>
            <Description>Variable angle locking plate for olecranon fractures</Description>
            <Size>7-15 Hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL145</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Ulna</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY766</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Variable Angle Locking Perarticular Ulna Plates</Description>
            <Size>≥7 to ≤15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN010</BillingCode>
            <Name>Newclip Plating System</Name>
            <Description>Plates for fixation of fractures of the elbow and/or ulna</Description>
            <Size>Periarticular anatomic - Ulna ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5280</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1311</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW059</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Ulan Plating System</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5281</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY764</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Ulna Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5281</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO351</BillingCode>
            <Name>Acumed Tap Loc Elbow plates</Name>
            <Description>Variable angle locking plate system</Description>
            <Size>≥16 holes Olecranon</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5281</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1433</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY765</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Ulna Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5281</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1433</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM484</BillingCode>
            <Name>Periarticular Hand Plates</Name>
            <Description>Periarticular Hand Plates</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5282</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>337193</ARTG>
            </ARTGs>
            <MinimumBenefit>2371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY623</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Pelvic Locking Plates</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5283</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1108</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK577</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Matta Pelvic Plates</Description>
            <Size>2-6 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5283</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY725</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Non-Locking Anatomical Pelvic Plates</Description>
            <Size>≤6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5283</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK578</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Matta Pelvic Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5284</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>728</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY720</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Locking Pelvic Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5285</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW532</BillingCode>
            <Name>Pelvis II Plating System</Name>
            <Description>Quadrilateral Surface Plates</Description>
            <Size>Small/Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5285</SubGroupID>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK579</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>ocking Compression Anatomical Shape</Description>
            <Size>16-22 Hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5285</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY719</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomical Non Locking Pelvic Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5285</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW016</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Femur Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX045</BillingCode>
            <Name>ARMAR 4.5mm Meril Locking Plate System - Distal Femur Plate 5 Holes</Name>
            <Description>TAN Distal Femur Locking Plates</Description>
            <Size>5 Holes&#xD;
156mm Length&#xD;
Left and Right Variants</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL079</BillingCode>
            <Name>Conquest FN</Name>
            <Description>Anatomic Locking Femur Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL186</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Periarticular Anatomical Plate - Femur</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM180</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Proximal Femur Plates</Description>
            <Size>&lt; 6 holes</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN972</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Distal Femur Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ133</BillingCode>
            <Name>PediLoc - Plating System, ≤ 6 Holes, Periarticular Femoral Plates</Name>
            <Description>Periarticular Femoral Plates</Description>
            <Size>3.5mm-4.5mm, 4-6 Holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY711</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Femur Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL175</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large and Periprosthetic Femur Plate – Variable Angle Locking</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY712</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Antomic Locking Femur Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI746</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Variable Angle Locking Plate - Femur - Ti Alloy</Description>
            <Size>5 holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW305</BillingCode>
            <Name>Dall Miles Cable Grip System - Stainless Steel</Name>
            <Description>Stainless Steel Plate:5 hole -  Stainless Steel</Description>
            <Size>6 inches</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY682</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Non-Locking Femur Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5286</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW056</BillingCode>
            <Name>WEGO Trauma Systems </Name>
            <Description>Periarticular Femur Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX046</BillingCode>
            <Name>ARMAR 4.5mm Meril Locking Plate System - Distal Femur Plate ≥ 7 to ≤ 15 holes LK</Name>
            <Description>TAN Distal Femur Locking Plates</Description>
            <Size>7-13 Holes&#xD;
196-316 mm Length&#xD;
Left and Right variants</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ023</BillingCode>
            <Name>Femoral Closing Wedge Osteotomy</Name>
            <Description>Symmetric plate, with locking screw technology for femoral distal closing wedge Osteotomy.</Description>
            <Size>87.5mm x 27.5mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276245</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK557</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Femur Anatomical Locking Plates</Description>
            <Size>12-14 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL187</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Periarticular Anatomical Plate - Femur</Description>
            <Size> ≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM181</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Proximal Femur Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN973</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Distal Femur Plates</Description>
            <Size>≥7 to  ≤15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ134</BillingCode>
            <Name>PediLoc - Plating System, ≥ 7 to ≤ 15 holes, Periarticular Femoral Plates</Name>
            <Description>Periarticular Femoral Plates</Description>
            <Size>3.5mm-4.5mm, 8-14 Holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY709</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Femur Plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI749</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Variable Angle Locking Plate - Femur - Ti Alloy</Description>
            <Size>9 holes - 13 holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI845</BillingCode>
            <Name>Zimmer Periarticular Locking Plates</Name>
            <Description>5.5mm Periarticular Plates - Femur</Description>
            <Size>7 - 15 Holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD008</BillingCode>
            <Name>Distal Femur Plate</Name>
            <Description>Distal Femoral Locking Plates</Description>
            <Size>≥7 to  ≤15 holes</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN337</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Femur Plates Titanium</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV007</BillingCode>
            <Name>PS Distal Femoral Osteotomy Plate</Name>
            <Description>Distal Femoral Osteotomy Anatomic VAL Plate</Description>
            <Size>Medial - Left     Medial - Right    Lateral - Left    Lateral - Right</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>330187</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL173</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large and Periprosthetic Femur Plate – Variable Angle Locking</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY710</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Femur Plates</Description>
            <Size>7-15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI747</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Periprosthetic Variable Angle Locking Plate - Femur - Ti Alloy</Description>
            <Size>7 holes - 15 holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU197</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE078</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteotomy Plates</Name>
            <Description>Osteotomy, Femoral - Stainless Steel</Description>
            <Size>7.5mm - 17.5 mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1002</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW307</BillingCode>
            <Name>Dall Miles Cable Grip System - Stainless Steel</Name>
            <Description>Stainless Steel Plate:9 hole -  Stainless Steel</Description>
            <Size>10 inches</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>1002</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW308</BillingCode>
            <Name>Dall Miles Cable Grip System - Stainless Steel</Name>
            <Description>Stainless Steel Plate:11 hole -  Stainless Steel</Description>
            <Size>12 inches</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>1002</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY671</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Distal Femoral</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5287</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1002</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW057</BillingCode>
            <Name>WEGO Trauma Systems </Name>
            <Description>Periarticular Femur Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK558</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Femur Anatomical Locking Plates</Description>
            <Size>16-24 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>1751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL188</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Periarticular Anatomical Plate - Femur</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM182</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Proximal Femur Plates</Description>
            <Size>&gt;16 holes</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN974</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Distal Femur Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ135</BillingCode>
            <Name>PediLoc - Plating System ≥ 16 holes, Periarticular Femoral Plates</Name>
            <Description>Periarticular Femoral Plates</Description>
            <Size>3.5mm-4.5mm, 16-20 Holes</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191586</ARTG>
            </ARTGs>
            <MinimumBenefit>1751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY768</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Femur Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD009</BillingCode>
            <Name>Distal Femur Plate</Name>
            <Description>Distal Femoral Locking Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>2127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN338</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Femur Plates Titanium</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>2127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL174</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large and Periprosthetic Femur Plate – Variable Angle Locking</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>2127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY769</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Femur Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>2127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI748</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Periprosthetic Variable Angle Locking Plate - Femur - Ti Alloy</Description>
            <Size>Over 16 holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>2127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY672</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Non Locking Femur Plates</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5288</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ029</BillingCode>
            <Name>Valetis Ankle - Fibular</Name>
            <Description>Distal Fibula Anatomical Locking Plates</Description>
            <Size>3 to 6 hole, left and right</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>1241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU129</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE556</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Posterolateral Anatomic Distal Fibula Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>4-6 Holes Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM135</BillingCode>
            <Name>TriMed Hook Plate</Name>
            <Description>Hook Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY686</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Fibula</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI847</BillingCode>
            <Name>Zimmer Periarticular Locking Plates</Name>
            <Description>2.7mm Periarticular Locking Plates - Fibula</Description>
            <Size>2 - 6 Holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH307</BillingCode>
            <Name>ALPS Fibula Plating System</Name>
            <Description>Anatomic Fibular Plating System</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>275084</ARTG>
            </ARTGs>
            <MinimumBenefit>1495</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER421</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, fibular (≤ 6 holes)</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, fibular, tubular,anatomic, titanium</Description>
            <Size>thickness 1.5mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1495</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW813</BillingCode>
            <Name>Ortholoc Fracture System - Plates</Name>
            <Description>Syndesmosis</Description>
            <Size>4 Holes, Right and Left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1495</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK580</BillingCode>
            <Name>Stryker Locked Plate system</Name>
            <Description>Periarticular variable angle locking plate - fibula</Description>
            <Size>1-6 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>1495</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL129</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Fibula</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5289</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1495</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW060</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Fibula Plating System</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU130</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE578</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Posterolateral Anatomic Distal Fibula Plate</Name>
            <Description>Plate for fracture fixation</Description>
            <Size>8-10 holes Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU189</BillingCode>
            <Name>Locking Distal Fibula Plate</Name>
            <Description>Locking Distal Fibula Plate for Fracture Fixation</Description>
            <Size>8 -14 Holes ( Left and Right Specific)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU190</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE421</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking distal Fibula plate</Name>
            <Description>Locking Distal Fibula Plate For Fracture Fixation</Description>
            <Size>4-6 Holes ( Left and Right Specific)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW898</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR374</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - Distal Fibula Plate</Name>
            <Description>Distal Fibula variable angle locking plate, Titanium</Description>
            <Size>Long, Medium, Short, Right and Left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM136</BillingCode>
            <Name>TriMed Periarticular Ankle Plates</Name>
            <Description>TriMed Periarticular Ankle Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY811</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Distal fibula; lateral, posterolateral locking plates</Description>
            <Size>7 to 15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI848</BillingCode>
            <Name>Zimmer Periarticular Locking Plates</Name>
            <Description>2.7 mm Periarticular Locking Plates - Fibula</Description>
            <Size>8 - 14 Holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1244</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH308</BillingCode>
            <Name>ALPS Fibula Plating System</Name>
            <Description>Anatomic Fibular Locking Plate</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>275084</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ030</BillingCode>
            <Name>Valetis Ankle - Fibular</Name>
            <Description>Distal Fibular Anatomical Locking Plates</Description>
            <Size>7 to 9 hole, left and right</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO102</BillingCode>
            <Name>APTUS Foot &amp; Ankle</Name>
            <Description>Fibula Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER422</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, fibular (≥ 7 to ≤ 15 holes)</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, fibular, tubular, anatomic, titanium</Description>
            <Size>thickness 1.5mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW812</BillingCode>
            <Name>Ortholoc Fracture System - Plates</Name>
            <Description>Lateral Fibula, Posterior Fibula</Description>
            <Size>8-15 Holes, Right and Left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD004</BillingCode>
            <Name>CarboFix Piccolo Distal Fibula Plate System – Plate component</Name>
            <Description>CFR-PEEK distal fibula plate</Description>
            <Size>Left 72mm, 83mm, 96mm, 112mm, 153mm, 182mm&#xD;
Right 72mm, 83mm, 96mm, 112mm, 153mm, 182mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM308</BillingCode>
            <Name>Osteomed FPS</Name>
            <Description>Fibular Fracture Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO443</BillingCode>
            <Name>Acumed Ankle 3 Plating System</Name>
            <Description>Periarticular variable angle locking plate fibula</Description>
            <Size>7-15 holes, left and right</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK581</BillingCode>
            <Name>Stryker Locked Plate System</Name>
            <Description>Periartiicular variable angle locking plate - fibula</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL146</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Fibula</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY815</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Lateral Distal Fibula</Description>
            <Size>7 to 15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN006</BillingCode>
            <Name>Newclip Activ Ankle Plate</Name>
            <Description>Variable Angle Locking Fibular Plate</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5290</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1435</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW061</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Fibula Plating Systems</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1107</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM375</BillingCode>
            <Name>Cluster Plates</Name>
            <Description>Cluster Plates</Description>
            <Size>18 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>1107</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY812</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Distal fibula; lateral, posterolateral locking plates</Description>
            <Size>&gt;16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1107</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO104</BillingCode>
            <Name>APTUS Foot &amp; Ankle</Name>
            <Description>Fibula Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER423</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, fibular (≥ 16 holes)</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, fibular, tubular, anatomic, titanium</Description>
            <Size>thickness 1.5mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO449</BillingCode>
            <Name>Acumed Ankle 3 Plating System</Name>
            <Description>Periarticular variable angle locking plate fibula</Description>
            <Size>16-18 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL134</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Fibula</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY816</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>LCP Lateral Distal Fibula</Description>
            <Size>&gt;16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN037</BillingCode>
            <Name>Newclip Activ Ankle Plate</Name>
            <Description>Periarticular distal fibular VAL Plate</Description>
            <Size>L75-187mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5291</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260232</ARTG>
                <ARTG>260229</ARTG>
            </ARTGs>
            <MinimumBenefit>1368</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ027</BillingCode>
            <Name>Valetis Ankle - Tibial</Name>
            <Description>Distal Tibial Anatomical Locking Plates</Description>
            <Size>3 to 6 hole, left and right</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW018</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Tibia Plating Systems</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU131</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE529</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anterior Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>3-5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU132</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE549</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Posterior Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>3-5 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU133</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE552</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anterolateral Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>4-6 Holes Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU134</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE557</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medial Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>4-6 Holes Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX042</BillingCode>
            <Name>ARMAR 3.5 LPS Tibial Plates</Name>
            <Description>3.5 mm anatomical tibial plates</Description>
            <Size>4 - 6 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX047</BillingCode>
            <Name>ARMAR 4.5mm Meril Locking Plate System - Proximal Tibial Plates ≤ 6 holes</Name>
            <Description>TAN Proximal Tibial Locking Plates</Description>
            <Size>5 Holes&#xD;
140mm Length&#xD;
Left and Right</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB024</BillingCode>
            <Name>Low Profile Distal Medial Tibial Locking Plate - ≤ 6 Holes</Name>
            <Description>Low Profile Distal Medial Tibial Locking Plate</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ022</BillingCode>
            <Name>Lateral closing wedge Tibial</Name>
            <Description>Shifting the mechanical axis from the lateral to the medial compartment in patients with lateral Osteoarthritis in combination with Valgus deformity</Description>
            <Size>61mm-24mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276245</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL101</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SN985</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Peri-Loc</Name>
            <Description>Tibia Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY732</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Tibial Plates</Description>
            <Size>≤ 6 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN031</BillingCode>
            <Name>Newclip Activ Ankle Plate</Name>
            <Description>Locking Tibial Plate</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI850</BillingCode>
            <Name>Zimmer Periarticular Locking Plates</Name>
            <Description>3.5mm Periarticular Locking Plates - Tibia</Description>
            <Size>2 - 6 holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1366</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO105</BillingCode>
            <Name>APTUS Foot &amp; Ankle</Name>
            <Description>Tibia Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW809</BillingCode>
            <Name>Ortholoc Ankle Plating</Name>
            <Description>Anterior, Posterior, Lateral or Medial</Description>
            <Size>4-6 holes  50-155mm Length</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM305</BillingCode>
            <Name>Extremilock FPS</Name>
            <Description>Ankle Plating System</Description>
            <Size>3.5mm and 4mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO442</BillingCode>
            <Name>Acumed Ankle 3 Plating System</Name>
            <Description>Periarticular Anatomic variable angle locking tibial plates</Description>
            <Size>2 to 6 Holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL132</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Tibia</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL230</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large and Periprosthetic Tibia Plate – Variable Angle Locking</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>368492</ARTG>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN975</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Tibia Plates</Description>
            <Size>≤6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN052</BillingCode>
            <Name>Periarticular anatomic tibia VAL ≤ 6 holes</Name>
            <Description>Periarticular anatomic tibia VAL ≤ 6 holes</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI750</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Variable Angle Locking Plate - Tibia - Ti Alloy</Description>
            <Size>5 holes Left &amp; Right</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>274566</ARTG>
            </ARTGs>
            <MinimumBenefit>1588</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH197</BillingCode>
            <Name>Periarticular Plating System</Name>
            <Description>Meta Plate - Titanium</Description>
            <Size>Sm - Lge  3 to 6 Holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH445</BillingCode>
            <Name>Hinge Pediatric Plating System - Hinge Plate</Name>
            <Description>Articulated growth-correction fixation plate</Description>
            <Size>12mm, 16mm, 20mm (distance between anchoring points)</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <ARTGs>
                <ARTG>161505</ARTG>
            </ARTGs>
            <MinimumBenefit>1039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK530</BillingCode>
            <Name>Stryker Plating System.</Name>
            <Description>T-Plate, pre-shaped</Description>
            <Size>5-6 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>1039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN581</BillingCode>
            <Name>TC-100</Name>
            <Description>Tibia Plates, L:/E 6 Holes</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY729</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Tibial Plates</Description>
            <Size>≤ 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI823</BillingCode>
            <Name>Periarticular Plates</Name>
            <Description>Periarticular Tibial Plateau Plates - Stainless Steel</Description>
            <Size>2 holes - 6 holes Left and Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5292</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW062</BillingCode>
            <Name>WEGO Trauma Systems </Name>
            <Description>Periarticular Tibia Plating Systems</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU135</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE547</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medial Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>8-14 Holes Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU136</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE562</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anterolateral Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>8-14 Holes Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU137</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE569</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Posterior Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>7-9 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU138</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE571</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anterior Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>7-9 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW897</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR373</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - Medial Distal Tibia Plate</Name>
            <Description>Medial distal tibia variable angle locking plate, Titanium</Description>
            <Size>Short, Medium, Long, Left and Right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX043</BillingCode>
            <Name>ARMAR 3.5 LPS Tibial Plates</Name>
            <Description>3.5mm anatomical tibial plates</Description>
            <Size>7-15 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX048</BillingCode>
            <Name>ARMAR 4.5mm Meril Locking Plate System - Proximal Tibial Plates ≥ 7 to ≤ 15 holes</Name>
            <Description>TAN Proximal Tibial Locking Plates</Description>
            <Size>7-13 Holes&#xD;
180-300 Length&#xD;
Left and Right</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB025</BillingCode>
            <Name>Low Profile Distal Medial Tibial Locking Plate - 7 to 15 Holes</Name>
            <Description>Low Profile Distal Medial Tibial Locking Plate</Description>
            <Size>7 to 15 Holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK559</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Distal Tibia Anatomical Locking Plates</Description>
            <Size>10-15 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK561</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Tibial Anatomical Locking Plates</Description>
            <Size>7-15 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL102</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SN985</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Peri-Loc</Name>
            <Description>Tibia Plates</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY758</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Tibial Plates</Description>
            <Size>7 to 15 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286609</ARTG>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI851</BillingCode>
            <Name>Zimmer Periarticular Locking Plates</Name>
            <Description>3.5mm Periarticular Locking Plates - Tibia</Description>
            <Size>8 - 14 holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>1182</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH287</BillingCode>
            <Name>ALPS Anatomic Locked plating system</Name>
            <Description>Distal and Proximal Tibial Plates, Titanium</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
                <ARTG>97981</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ028</BillingCode>
            <Name>Valetis Ankle - Tibial</Name>
            <Description>Distal Tibial Anatomical Locking Plates</Description>
            <Size>7 to 14 hole, left and right</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO106</BillingCode>
            <Name>APTUS Foot &amp; Ankle</Name>
            <Description>Tibia Plates</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER502</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes)</Name>
            <Description>Paragon 28 Gorilla Silverback tibiotalar (TT) anterior or lateral ankle fusion plate, left or right</Description>
            <Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW810</BillingCode>
            <Name>Ortholoc Fracture System - Plates</Name>
            <Description>Anterolateral Tibia, Medial Tibia Plates or 1/3 Tubular</Description>
            <Size>7-13 Holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM307</BillingCode>
            <Name>Osteomed FPS</Name>
            <Description>Anterior Lateral Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO444</BillingCode>
            <Name>Acumed Ankle 3 Plating System</Name>
            <Description>Periarticular Anatomic variable angle locking tibial plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB081</BillingCode>
            <Name>Marathon VAL Tibia Plates</Name>
            <Description>Variable angle periarticular tibia plates </Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV006</BillingCode>
            <Name>PS High Tibial Osteotomy Plate</Name>
            <Description>High Tibial Osteotomy Anatomic VAL Plate </Description>
            <Size>Left - Medial  Right - Medial</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>330187</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL154</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Tibia</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL231</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large and Periprosthetic Tibia Plate – Variable Angle Locking</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>368492</ARTG>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN986</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Tibia Plates</Description>
            <Size>&gt;7 to &lt;15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY759</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Variable Angle Locking Tibial Plates</Description>
            <Size>7 to 15 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>286609</ARTG>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY770</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Variable Angle Locking Tibial Plates</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN040</BillingCode>
            <Name>Newclip Activ Ankle Plate</Name>
            <Description>Locking Tibial Plate</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN053</BillingCode>
            <Name>Periarticular anatomic tibia VAL ≥ 7 to ≤ 15 holes</Name>
            <Description>Periarticular anatomic tibia VAL ≥ 7 to ≤ 15 holes</Description>
            <Size>≥ 7 to ≤ 15 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN054</BillingCode>
            <Name>Periarticular anatomic tibia VAL ≥ 16 holes</Name>
            <Description>Periarticular anatomic tibia VAL ≥ 16 holes</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>260229</ARTG>
                <ARTG>260232</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI751</BillingCode>
            <Name>NCB Polyaxial Locking Plate System</Name>
            <Description>NCB Variable Angle Locking Plate - Tibia - Ti Alloy</Description>
            <Size>9 holes - 13 holes Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
                <ARTG>100349</ARTG>
            </ARTGs>
            <MinimumBenefit>1490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK531</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>T-Plate, pre-shaped</Description>
            <Size>7-13 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>925</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN582</BillingCode>
            <Name>TC-100</Name>
            <Description>Tibia Plates</Description>
            <Size>7 to ≤ 15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>925</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY730</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Tibial Plates</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>925</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI824</BillingCode>
            <Name>Periarticular Plates</Name>
            <Description>Periarticular Tibial Plateau Plates - Stainless Steel</Description>
            <Size>7 holes - 15 holes, Left and Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5293</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>925</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW063</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Periarticular Tibia Plating Systems</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>1349</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU139</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE534</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anterolateral Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>16-18 Holes Left and Right Side Specific</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1349</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU140</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE566</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medial Distal Tibia Plate</Name>
            <Description>Plate for Fracture Fixation</Description>
            <Size>16 Holes</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>1349</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX044</BillingCode>
            <Name>ARMAR 3.5 LPS Tibial Plates</Name>
            <Description>3.5mm tibial anatomical plates</Description>
            <Size>16-21 holes</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1349</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK562</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Tibial Anatomical Locking Plates</Description>
            <Size>16-31 hole</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>1349</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN976</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Tibia Plates</Description>
            <Size>≥ 16 Holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1349</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY756</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Locking Tibial Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286609</ARTG>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1349</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH288</BillingCode>
            <Name>ALPS-Anatomic Locked Plating system</Name>
            <Description>Distal and Proximal Tibial Plates, Titanium</Description>
            <Size>16 - 25 holes</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
                <ARTG>97981</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO103</BillingCode>
            <Name>APTUS Foot &amp; Ankle</Name>
            <Description>Tibia Plates</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER503</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, tibial (≥ 16 holes)</Name>
            <Description>Paragon 28 Gorilla Silverback Plating System-Plate, tibial, lateral TTC, left or right</Description>
            <Size>≥ 16 holes, 113-154 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK560</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Distal Tibia Anatomical Locking Plates</Description>
            <Size>16-23 hole</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>119848</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL147</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>VAL Periarticular Anatomical Small Fragment plate - Tibia</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL232</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Large and Periprosthetic Tibia Plate – Variable Angle Locking</Description>
            <Size>≥ 16 holes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY757</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Variable Locking Tibial Plates</Description>
            <Size>≥16 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY771</BillingCode>
            <Name>AO/ASIF</Name>
            <Description>Anatomic Variable Angle Locking Tibial Plates</Description>
            <Size>&gt; 16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY731</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Tibial Plates</Description>
            <Size>≥16 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5294</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO405</BillingCode>
            <Name>Acumed Locking Calcaneal Plates</Name>
            <Description>Locking Calcaneal Plates</Description>
            <Size>&lt;6 Hole LK</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5295</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB018</BillingCode>
            <Name>Calcaneal Locking Plate MIPO System - Locking Plates</Name>
            <Description>Posterior Tuberosity Calcaneal Locking Plate II, Anterior Process Calcaneal Locking Plate, Posterior Tuberosity Calcaneal Locking Plate</Description>
            <Size>5 &amp; 6 Holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5295</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW895</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR369</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - CalcLock Extreme Plate</Name>
            <Description>Calcaneal variable angle locking plate, Titanium</Description>
            <Size>Standard, Large, Extra Large, Right and Left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO404</BillingCode>
            <Name>Acumed Locking Calcaneal Plates</Name>
            <Description>Locking Calcaneal Plates</Description>
            <Size>≥ 7 to ≤ 15 LK</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX013</BillingCode>
            <Name>ARMAR 3.5mm Meril Locking Plate System - Calcaneal Plate</Name>
            <Description>TiCP calcaneal locking plates</Description>
            <Size>15 Holes&#xD;
64-81mm Length&#xD;
Left and Right</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286842</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB019</BillingCode>
            <Name>Calcaneal Locking Plate -  Locking Plates</Name>
            <Description>Calcaneal Locking Plate I, Calcaneal Locking Plate II, Compound Calcaneal Locking Plate II, Anterior Process Calcaneal Locking Plate II, Anatomical Calcaneal Locking Plate II, Anterior Process and Posterior Tuberosity Calcaneal Locking Plate</Description>
            <Size>≥ 7 to ≤ 15 holes, &#xD;
Large, medium and small</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF121</BillingCode>
            <Name>Islay Calaneal Locking Plate</Name>
            <Description>Islay Calaneal Locking Plate 3.5</Description>
            <Size>Islay Calaneal Locking Plate 3.5, large&#xD;
Islay Calaneal Locking Plate 3.5, medium&#xD;
Islay Calaneal Locking Plate 3.5, small</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN983</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Calcaneal Plates</Description>
            <Size>&gt;7 to &lt;15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY188</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Calcaneal, Locking</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1149</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH243</BillingCode>
            <Name>ALPS Foot System</Name>
            <Description>Calcaneal foot plate</Description>
            <Size>small to large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>153056</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO056</BillingCode>
            <Name>Aptus Foot</Name>
            <Description>Calcaneus Plates</Description>
            <Size>Left and right plates, small, medium and large</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER424</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Plate, Calcaneal ( ≥ 7 to ≤ 15 holes)</Name>
            <Description>Paragon 28 Gorilla Plating System-Plate, Calcaneus fracture, MTP various shapes, Titanium,</Description>
            <Size>thickness 1.1mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>289248</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU202</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE464</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Calcaneal Fracture Plate</Name>
            <Description>Calcaneal Fracture Plate for fixation of Calcaneal fractures</Description>
            <Size>X-small, small, Medium, Large - LEFT and RIGHT side specific plates</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW807</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR231</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Calcaneus Plate</Name>
            <Description>Titanium locking plate, Tab &amp; Perimeter</Description>
            <Size>14 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM306</BillingCode>
            <Name>Osteomed FPS</Name>
            <Description>Calcaneal Plates</Description>
            <Size>7 to 15 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB080</BillingCode>
            <Name>Marathon VAL Calcaneal Plate</Name>
            <Description>Variable Angle Calcaneal Plates</Description>
            <Size>7 - 15 Holes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>261562</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN984</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Calcaneal Plates</Description>
            <Size>&gt;7 to &lt;15 holes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR092</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Calcaneus Locking Plates</Description>
            <Size>12 Hole</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>1390</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK094</BillingCode>
            <Name>Stryker Plating System Small Fragment Set</Name>
            <Description>Calcaneal Plate</Description>
            <Size>70-80mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY017</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Calcaneal Plates</Description>
            <Size>7 - 15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5296</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW808</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR232</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Calcaneus Plate</Name>
            <Description>Titanium locking plate, Tab &amp; Perimeter</Description>
            <Size>16 &amp; 17 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5297</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1213</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR093</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Calcaneus Locking Plates</Description>
            <Size>16 Hole</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5297</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>1213</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU014</BillingCode>
            <Name>Airlock Bone plate System</Name>
            <Description>Osteosynthesis bone plate system</Description>
            <Size>Left and right thickness 1.3mm to 1.35 mm, Length from 16mm to 55mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>235766</ARTG>
            </ARTGs>
            <MinimumBenefit>693</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW709</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR052</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte MTP Fusion System</Name>
            <Description>MTP plate, stainless steel, SLIM LINE</Description>
            <Size>Left &amp; right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>693</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW714</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR065</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Rearfoot Plate - RPS</Name>
            <Description>Unique extended plate geometry for plating complex rearfoot reconstructions, uses 3.5mm locked screws for optimal bone purchase.</Description>
            <Size>6 hole - 37mm, 8 hole - 50mm, 14 hole - 66mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>693</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO380</BillingCode>
            <Name>Acumed Congruent Plate System</Name>
            <Description>Foot and Ankle Plate Titanium</Description>
            <Size>≤ 6 hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>693</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO381</BillingCode>
            <Name>Acumed Congruent Plate system</Name>
            <Description>Foort and Ankle Plate titanium</Description>
            <Size>≥7 to ≤15 hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99824</ARTG>
            </ARTGs>
            <MinimumBenefit>693</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW459</BillingCode>
            <Name>Variax 2 Foot Plates</Name>
            <Description>Polyaxial Locking plates with compressions holes</Description>
            <Size>Broad Straight – 2-7 Hole  Slim Straight – 2-7 Hole  Broad Y-Plate – 2-7 Shaft Holes  Slim Y-Plate – 2-7 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>162776</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW796</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR082</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ortholoc 3Di Plates</Name>
            <Description>Osteosynthesis Bone Plate System</Description>
            <Size>2-7 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW816</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR244</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Claw Locking Plate</Name>
            <Description>Straight, U, T Plates - 2, 3, &amp; 4 Hole</Description>
            <Size>15, 20, 25, 30mm, Sm, Med, Lge</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW834</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR292</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION 3Di Plating System - Plates</Name>
            <Description>Bridge plates and recon plates</Description>
            <Size>Small, medium and large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM339</BillingCode>
            <Name>Orthopaedic Fixation Plate</Name>
            <Description>Orthopaedic Fixation Plates</Description>
            <Size>2 - 8 holes and/or Small, Medium, Large</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>338649</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY715</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Anatomic Variable Angle Locking Foot Plate</Description>
            <Size>2-20 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <Suffix>VAL</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO379</BillingCode>
            <Name>Acumed Congruent Plate System</Name>
            <Description>Foot and Ankle Plate itianium</Description>
            <Size>≤ 6 hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <ARTGs>
                <ARTG>98244</ARTG>
            </ARTGs>
            <MinimumBenefit>428</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL197</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG081</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hallu-Fix Plates</Name>
            <Description>Hallu-C and Hallu-S titanium plates for first MTP arthrodesis </Description>
            <Size>Length: 40 - 55mm 3 sizes: 1, 2, 3 for left or right </Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5298</SubGroupID>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>428</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN731</BillingCode>
            <Name>Accord</Name>
            <Description>Orthopaedic Cable System, Sm Cable Grip</Description>
            <Size>75-255mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5299</SubGroupID>
            <ARTGs>
                <ARTG>140705</ARTG>
            </ARTGs>
            <MinimumBenefit>637</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY378</BillingCode>
            <Name>Trochanteric Reattachment Device</Name>
            <Description>Titanium alloy reattachment device with cables</Description>
            <Size>Standard and Long</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5299</SubGroupID>
            <ARTGs>
                <ARTG>139010</ARTG>
            </ARTGs>
            <MinimumBenefit>637</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI167</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cable System</Name>
            <Description>Cable-Ready 6 Hole Plate - Stainless Steel</Description>
            <Size>187mm long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5299</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>637</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN735</BillingCode>
            <Name>Accord</Name>
            <Description>Orthopaedic Cable System, Std Cable Grip</Description>
            <Size>85-265mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5300</SubGroupID>
            <ARTGs>
                <ARTG>140705</ARTG>
            </ARTGs>
            <MinimumBenefit>751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI169</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cable System</Name>
            <Description>Cable-Ready 10 Hole Plate - Stainless Steel</Description>
            <Size>305mm long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5300</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW896</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR372</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - Medial Malleolous Plate</Name>
            <Description>Medial malleolous variable angle locking plate, Titanium</Description>
            <Size>5 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5302</SubGroupID>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>1649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK403</BillingCode>
            <Name>Trochanteric Grip</Name>
            <Description>Trochanteric Grip Plate with 2 cables</Description>
            <Size>Large, 110 - 210mm, 2 -6 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5302</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>1649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI290</BillingCode>
            <Name>Cable Ready Cable Grip System</Name>
            <Description>Titanium - comes with two cables (Co Cr), Integral Crimps</Description>
            <Size>23 x 53mm, 1.8 x 635mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5302</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>1649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ114</BillingCode>
            <Name>SuperCable Trochanteric Grips and Cable Plate System</Name>
            <Description>Trochanteric Grips - Titanium</Description>
            <Size>Short 50mm, 2 Hole Plate 135mm, 4 Hole Plate 190mm, 6 Hole Plate Straight, Right, Left 245mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5303</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>133719</ARTG>
            </ARTGs>
            <MinimumBenefit>2727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW306</BillingCode>
            <Name>Dall Miles Cable Grip System - Stainless Steel</Name>
            <Description>Stainless Steel Plate:7 hole -  Stainless Steel</Description>
            <Size>8 inches</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5303</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>2470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK402</BillingCode>
            <Name>Trochanteric Grip</Name>
            <Description>Trochanteric Grip Plate with 2 cables</Description>
            <Size>Medium 100 - 200mm, 2 -6 Holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5303</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>2470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN730</BillingCode>
            <Name>Accord</Name>
            <Description>Orthopaedic Cable System, Titanium Plate</Description>
            <Size>150-250mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5303</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
            </ARTGs>
            <MinimumBenefit>2470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI297</BillingCode>
            <Name>Cable Ready Cable Grip System</Name>
            <Description>Titanium</Description>
            <Size>5 hole GTR with 4 cables</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5303</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>2470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI298</BillingCode>
            <Name>Cable Ready Cable Grip System</Name>
            <Description>Titanium</Description>
            <Size>2 hole GTR with 4 cables</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5303</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>2470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI299</BillingCode>
            <Name>Cable Ready Cable Grip System</Name>
            <Description>Titanium</Description>
            <Size>4 hole GTR with 4 cables</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5303</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>2470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA100</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tritium SCP (Sternal Cable Plate)</Name>
            <Description>BOX Plate (4 Holes, 1 Integrated Cable)</Description>
            <Size>One Size</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5994</SubGroupID>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>982</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA101</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tritium SCP (Sternal Cable Plate)  Double Cable Plate (6 Holes, 2 Integrated Cables)</Name>
            <Description>Periarticular Titanium Sternal Double Cable Plate, 6 Holes, 2 Integrated Cables, Locking Plate</Description>
            <Size>One Size</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5994</SubGroupID>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>982</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI926</BillingCode>
            <Name>Sternalock 360</Name>
            <Description>Sternal Closure System</Description>
            <Size>Box Plate (4 Holes, 1 Integrated Cable)</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5994</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>982</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA102</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tritium SCP (Sternal Cable Plate)</Name>
            <Description>Periarticular Titanium Sternal X Plate, 8 holes, 1 Integrated Cable, Locking Screws</Description>
            <Size>One Size</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5996</SubGroupID>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI927</BillingCode>
            <Name>Sternalock 360</Name>
            <Description>Sternal Closure System</Description>
            <Size>X-Plate 8 Holes, 1 Integrated Cable</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1694</GroupID>
            <SubGroupID>5996</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>1048</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH184</BillingCode>
            <Name>Small / Large  Fragment Set</Name>
            <Description>Cannulated Bone Screw Titanium</Description>
            <Size>4.5 - 8mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP031</BillingCode>
            <Name>Tyber Medical Trauma headed screw</Name>
            <Description>Trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>4.5mm-7.5mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ036</BillingCode>
            <Name>Austofix Cannulated Screws</Name>
            <Description>Cannulated Compression Screw</Description>
            <Size>4.5mm, 6.5mm, 7.3mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO117</BillingCode>
            <Name>APTUS headedCCS</Name>
            <Description>Headed Cannulated screws</Description>
            <Size>≥4.50mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER392</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, Standard ( ≥4.5mm), cannulated</Name>
            <Description>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), cannulated, headed, with and without blunt tip</Description>
            <Size>diameter (4.5-7.0 mm) x length (18-200 mm) x length of thread (6-200 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW053</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Standard Cannulated Screw Systems</Description>
            <Size>Standard ( ≥4.5mm) 20-120mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU204</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE371</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cannulated Titanium Low Profile Screws, Large</Name>
            <Description>Cannulated titanium Low Profile Screws, Large</Description>
            <Size>4.5-6.7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW820</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR248</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Darco Headed Compression Screw System 4.5, 6.5, 7.5</Name>
            <Description>Cannulated titanium compression screws</Description>
            <Size>4.5mm x 8-60mm; 6.5mm x 35-120mm; 7.5mm x 35-120mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW910</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR387</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxTorque Cannulated Screw System - Standard screws</Name>
            <Description>Bone screws, Titanium, Cannulated, Short or Long Thread</Description>
            <Size>Ø5.5mm Short Thread, Length 26-70mm  Ø5.5mm Long Thread, Length 45-70mm  Ø7.0mm Short thread, Length 40-130mm  Ø7.0mm long Thread, Length 45-130mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT010</BillingCode>
            <Name>Hawk 6.5mm Cannulated Screw System</Name>
            <Description>6.5mm Cannulated Screw</Description>
            <Size>6.5mm in diameter 45 to 115mm in length</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>230954</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ557</BillingCode>
            <Name>DELTA Xtend</Name>
            <Description>Non Locking Canulated Metaglene Screw </Description>
            <Size>4.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>150913</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates - Fracture; Screws - Cannulated Lag</Description>
            <Size>6 Hole Fracture Plate 47 - 52mm; 2 x 2 Hole Angled Fracture Plate; 3 x 3 Hole Angled Fracture Plate; 6.5mm x (30 -150)mm; 7.3mm x (30 - 150)mm</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM288</BillingCode>
            <Name>Bone Screw</Name>
            <Description>Bone Screw</Description>
            <Size>4.5mm diameter and larger</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM395</BillingCode>
            <Name>Cannulated Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>4.50 mm or larger diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM507</BillingCode>
            <Name>Partially threaded cannulated screw</Name>
            <Description>Partially threaded cannulated screw</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX041</BillingCode>
            <Name>ARMAR Meril Locking Plate System Self Drilling Cannulated Screw</Name>
            <Description>TAN Cannulated Bone Screws</Description>
            <Size>4.5-6.5mm Diameter&#xD;
20-150mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB044</BillingCode>
            <Name>Cannulated Screws 6.5 &amp; 7.3mm</Name>
            <Description>Cannulated Screws</Description>
            <Size>6.5mm &amp; 7.3mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF116</BillingCode>
            <Name>Speyside Superscrew - Standard</Name>
            <Description>Cannulated Cortical / Cancellous Lag Screw Partial or Full Thread</Description>
            <Size>Dia. 4.5 / 5.0 / 6.5 / 7.2 mm x 25-140mm Length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK529</BillingCode>
            <Name>Stryker Cannulated Screw System</Name>
            <Description>Asnis III Cannulated screws  Asnis JFX Cannulated Compression Screw</Description>
            <Size>5.0-8.0mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>340042</ARTG>
                <ARTG>352531</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL008</BillingCode>
            <Name>Cannulated Screw</Name>
            <Description>Partially &amp; Fully Threaded Titanium</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL009</BillingCode>
            <Name>Cannulated screws</Name>
            <Description>Partially &amp; Fully Threaded Stainless Steel</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
                <ARTG>99767</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL170</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS  </Name>
            <Description>Standard Screws - Cannulated</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>230143</ARTG>
                <ARTG>368491</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ144</BillingCode>
            <Name>Cannulated Screws</Name>
            <Description>Cannulated, Cancellous  Short, Medium, Partial, Full Thread  Locking, Non-locking</Description>
            <Size>4.5-7.0mm Diameter  14-120mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY630</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Cannulated Full, Partial Thread screw</Description>
            <Size>≥4.50mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN001</BillingCode>
            <Name>Newclip cannulated screws</Name>
            <Description>Cannulated screws</Description>
            <Size>Standard (≥4.5mm)</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK034</BillingCode>
            <Name>eight-Plate Plus Cannulated Screw</Name>
            <Description>The guided growth plate system plus consists of different sizes of plates and cannulated screws. The device is designed for the gradual correction of paediatric congenital as well as acquired deformities in both upper and lower extremities.</Description>
            <Size>4.5mm x 16mm  4.5mm x 24mm  4.5mm x 32mm  4.5mm x 36mm</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>289252</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI176</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cannulated Screw</Name>
            <Description>Magna-FX - Stainless Steel</Description>
            <Size>16 mm Thread - 30-30 mm; 32 mm Thread - 40-120 mm; Fully Threaded - 30-130 mm Long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI836</BillingCode>
            <Name>NCB Polyaxial Locking System</Name>
            <Description>4.5mm Cannulated Variable Angle Locking Screws - Ti Alloy</Description>
            <Size>14 - 100mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI872</BillingCode>
            <Name>Zimmer Cannulated Screw System</Name>
            <Description>7.0mm Cannulated Screw 32mm Thread&#xD;
7.0mm Cannulated Screw Full Thread</Description>
            <Size>7.0mm Cannulated Screw 32mm Thread. L=140&#xD;
7.0mm Cannulated Screw Full Thread. L=140&#xD;
7.0mm Cannulated Screw 32mm Thread. L=145&#xD;
7.0mm Cannulated Screw Full Thread. L=145&#xD;
7.0mm Cannulated Screw 32mm Thread. L=150&#xD;
7.0mm Cannulated Screw Full Thread. L=150&#xD;
7.0mm Cannulated Screw 32mm Thread. L=155&#xD;
7.0mm Cannulated Screw Full Thread. L=155&#xD;
7.0mm Cannulated Screw 32mm Thread. L=160&#xD;
7.0mm Cannulated Screw Full Thread. L=160&#xD;
7.0mm Cannulated Screw 32mm Thread. L=165&#xD;
7.0mm Cannulated Screw Full Thread. L=165&#xD;
7.0mm Cannulated Screw 32mm Thread. L=170&#xD;
7.0mm Cannulated Screw Full Thread. L=170&#xD;
7.0mm Cannulated Screw 32mm Thread. L=175&#xD;
7.0mm Cannulated Screw Full Thread. L=175&#xD;
7.0mm Cannulated Screw 32mm Thread. L=180&#xD;
7.0mm Cannulated Screw Full Thread. L=180</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>204658</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP026</BillingCode>
            <Name>Tyber Medical trauma headless screw</Name>
            <Description>Headless trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>4.5mm-9.0mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU012</BillingCode>
            <Name>Nexis osteosynthesis screws</Name>
            <Description>Bone screw titanium alloy (compressive)</Description>
            <Size>Diameter 5-7 mm, Length 26-120mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>235765</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU020</BillingCode>
            <Name>MAGNEZIX CS 4.8</Name>
            <Description>Compression screw for bone fixation.</Description>
            <Size>Diameter 4.8mm&#xD;
Length 24 - 70mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>283491</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ037</BillingCode>
            <Name>Valens - Cannulated Screws</Name>
            <Description>Countersunk Cannulated Partial-Thread Screw</Description>
            <Size>5.0mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ057</BillingCode>
            <Name>Valens Shoulder and Elbow - Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>4.5mm, 5.0mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EF004</BillingCode>
            <Name>Merete - Cannulated HCS (headless Compression Screws) 6.5mm</Name>
            <Description>Bone screws, Titanium, Cannulated Compression</Description>
            <Size>Diameter + 6.5mm, length 40-120mm (in 5mm increments)</Size>
            <SupplierCode>EF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>212520</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO093</BillingCode>
            <Name>APTUS SpeedTip CCS</Name>
            <Description>APTUS SpeedTip CCS 5.0/7.0</Description>
            <Size>5.0mm diameter and 7.0mm diameter. Short and long thread</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW065</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Self-tapping Cannulated Screw</Description>
            <Size>Standard ( ≥4.5mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU141</BillingCode>
            <Name>Compression FT</Name>
            <Description>Compression Screw</Description>
            <Size>5.0mm &amp; 7.0mm Diameters</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU154</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE481</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Headless Compression Screw System</Name>
            <Description>Headless Compression Screw for bone fixation</Description>
            <Size>6.5mm Diameter (30-120mm Diameter)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>350672</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW561</BillingCode>
            <Name>Stryker Fixos Screws</Name>
            <Description>Stryker Fixos Screws &gt;4.5mm</Description>
            <Size>5mm &amp; 7mm diameter</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW697</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cannulated Screw</Name>
            <Description>Multi use compression screw, cannulated, stainless steel or titanium</Description>
            <Size>6.5mm&amp; 7.0mm dia, 40-110mm lengths in 5mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW855</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR319</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Unima Screw</Name>
            <Description>Foot Screw</Description>
            <Size>4.5 x 26 - 70mm  7.3 x 40 - 120mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>295072</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW914</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR394</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix 4.5MM Compression Screw</Name>
            <Description>The NexFix Compression Screw is a stainless steel, cannulated, self tapping, and self drilling fixation device for osteotomies, fusions and fracture fixation of small bones</Description>
            <Size>4.5mm diameter x 14-40mm in 2mm increments, 40-65mm in 5mm increments, with short and long thread options</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW917</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR397</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix 6.5mm Compression Screw</Name>
            <Description>The NexFix Compression Screw is a stainless steel, cannulated, self tapping, and self drilling fixation device for osteotomies, fusions and fracture fixation of small bones</Description>
            <Size>6.5mm diameter x 40-120mm in 5mm increments with short and long thread options</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW982</BillingCode>
            <Name>SALVATION Limb Salvage System Intramedullary Fusion Beams</Name>
            <Description>Intramedullary Fusion Beams</Description>
            <Size>5 - 7mm x 50 - 170mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>198549</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT031</BillingCode>
            <Name>Integrant 6.5mm Screws</Name>
            <Description>6.5mm diameter screws with variable pitch/dynamic thread</Description>
            <Size>6.5mm diameter, 45mm-120mm length</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>230954</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM142</BillingCode>
            <Name>Extremity Medical Compression Screw System</Name>
            <Description>Compression Screws</Description>
            <Size>≥ 4.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>164980</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM287</BillingCode>
            <Name>IBS Screw</Name>
            <Description>Compression Screw</Description>
            <Size>4.5, 6.5 &amp; 8.0mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM350</BillingCode>
            <Name>Orthopaedic Fixation Screw</Name>
            <Description>Fixation Screw</Description>
            <Size>4.5mm and larger diameter, all lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM397</BillingCode>
            <Name>Headless Compression Screws</Name>
            <Description>Headless Compression Screws</Description>
            <Size>4.50mm or larger diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO357</BillingCode>
            <Name>Acutrak 2</Name>
            <Description>Headless compression screw</Description>
            <Size>&gt;4.5mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO383</BillingCode>
            <Name>Acumed Headless Compression Screw</Name>
            <Description>Acutrak 6/7 screw, Acutrak Plus</Description>
            <Size>&gt;4.5mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH547</BillingCode>
            <Name>Dynafit System</Name>
            <Description>Compressive Screws</Description>
            <Size>4.7-6.5mm x 18-120mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>216161</ARTG>
                <ARTG>216162</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB037</BillingCode>
            <Name>Headless Compression Screw System</Name>
            <Description>Headless Compression Screw</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF024</BillingCode>
            <Name>FH Screw Systems</Name>
            <Description>Large Compression Screw</Description>
            <Size>45mm - 110mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>141164</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF087</BillingCode>
            <Name>Speyside Double Threaded Cannulated Screw</Name>
            <Description>Speyside - Double threaded – Self tapping or self drilling cannulated screw</Description>
            <Size>Diameter 4.5 and 6.5mm x Length 30 to 100mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF094</BillingCode>
            <Name>Versa Screw</Name>
            <Description>Self Drilling self tapping Cannulated Compression Screw</Description>
            <Size>6.5 to 8mm Dia x 40 to 120mm length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL031</BillingCode>
            <Name>Headless Cannulated Screw</Name>
            <Description>Headless cannulated screw</Description>
            <Size>&gt;4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY645</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>HCS Countersinkable Compression Screw</Description>
            <Size>4.5mm-6.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY691</BillingCode>
            <Name>Midfoot Fusion Bolt</Name>
            <Description>Solid intramedullary arthodesis implant</Description>
            <Size>6.5mm diameter; 50-160mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>182343</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN002</BillingCode>
            <Name>Newclip cannulated DT screws</Name>
            <Description>Cannulated screws</Description>
            <Size>Standard (≥4.5mm)</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN073</BillingCode>
            <Name>Newclip Compression Screws</Name>
            <Description>Self-compressive cannulated screw</Description>
            <Size>≥4.5 mm diameter, length 20-70 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI180</BillingCode>
            <Name>Zimmer Large Herbert Bone Screw</Name>
            <Description>4.5mm Cannulated Double Threaded Compression Bone Screw - Ti Alloy</Description>
            <Size>30 - 70mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI181</BillingCode>
            <Name>Zimmer Large Herbert Bone Screw</Name>
            <Description>6.5mm Cannulated Double Threaded Compression Bone Screw - Ti Alloy</Description>
            <Size>25 mm - 100mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER393</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), cannulated, dual thread, locking</Name>
            <Description>Paragon 28 Monster Screw System-screws, cannulated, dual thread, locking, headless, partial thread, Titanium</Description>
            <Size>dia (4.5-7.2 mm) x length (50-200mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM134</BillingCode>
            <Name>TriMed Compression Screws</Name>
            <Description>Compression Screws</Description>
            <Size>4.5-7.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>229704</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM368</BillingCode>
            <Name>Intramedullary Beam</Name>
            <Description>Intramedullary Beam</Description>
            <Size>All sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>164980</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB062</BillingCode>
            <Name>MCS</Name>
            <Description>MCS System</Description>
            <Size>&gt; 4.5mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL080</BillingCode>
            <Name>Conquest FN</Name>
            <Description>Cannulated Screws</Description>
            <Size>≥4.50mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER523</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), cannulated, locking</Name>
            <Description>Paragon 28 Monster Screw System-Joust Beaming Screws, standard, cannulated, locking, headless, Titanium</Description>
            <Size>dia (5.0-7.2mm) x Length (50-185mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW877</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR347</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Humeral Nail Screws</Name>
            <Description>Screws for Aequalis Humeral Nail. Cannulated Proximal screws: 5mm Diameter cannulated Ti, PE insert with thread inside. Distal screws 4.5mm Diameter, Ti.  Sterile and non sterile.</Description>
            <Size>Proximal Screws length: From 36 to 60 every 4mm Distal Screws length: From 20 to 32 every 2mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ558</BillingCode>
            <Name>DELTA Xtend</Name>
            <Description>Locking Metaglene Screw Dia 4.5</Description>
            <Size>4.5mm; 24, 30, 36, 42, 48</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>150913</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM277</BillingCode>
            <Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Post with Cross Element</Name>
            <Description>Threaded Locking Screw</Description>
            <Size>5.2mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>182168</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN200</BillingCode>
            <Name>Bristow-Latarjet Instability Shoulder Set - Screw</Name>
            <Description>Cannulated locking screw</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK564</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>SPS Locking Plate System</Description>
            <Size>Locking Screws - 5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK593</BillingCode>
            <Name> Total Wrist Implant System</Name>
            <Description>Carpal Screws</Description>
            <Size>15, 18, 22, 26, 30mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>237794</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL171</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System- EVOS</Name>
            <Description>Standard Screws - Cannulated Locking  </Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>230143</ARTG>
                <ARTG>368491</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN769</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Locking Cannulated Screws</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY631</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Cannulated Locking Screws</Description>
            <Size>≥4.50mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW930</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR412</PriorBillingCode>
            </PriorBillingCodes>
            <Name>611 Ankle Fusion Nail -Component : LOCKING SCREWS</Name>
            <Description>The 611 ankle arthrodesis nail, self locking screws are made out of titanium alloy (Ti6AI4V) and incorporate a unique anti-backout design feature to ensure optimal fixation</Description>
            <Size>5mm x100mm, 5mmx95mm, 5mmx90mm, 5mmx85mm, 5mmx80mm, 5mmx75mm, 5mmx70mm, 5mmx65mm, 5mmx60mm, 5mmx55mm, 5mmx50mm, 5mmx45mm, 5mmx40mm, 5mmx35mm, 5mmx32mm, 5mmx29mm, 5mmx26mm, 5mmx23mm, 5mmx20mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>291613</ARTG>
            </ARTGs>
            <MinimumBenefit>229</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV008</BillingCode>
            <Name>PS Non-locking Dual Thread Screw</Name>
            <Description>Non Locking Screw ø4.5mm, self-tapping, Dual Thread</Description>
            <Size>4.5mm, 29-50mm Length</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>330190</ARTG>
            </ARTGs>
            <MinimumBenefit>229</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER522</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), dual thread, locking</Name>
            <Description>Paragon 28 Monster Screw System-Joust Beaming Screws, ( ≥4.5mm), headless, dual thread, locking, Ti</Description>
            <Size>dia (5.0-7.2mm) x length (50-185mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>289</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV009</BillingCode>
            <Name>PS Locking Dual Thread Screw</Name>
            <Description>Locking Screw ø4.5mm, self-tapping, VAL, Dual Thread</Description>
            <Size>4.5mm, 29-90mm Length</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>330190</ARTG>
            </ARTGs>
            <MinimumBenefit>289</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH166</BillingCode>
            <Name>Comprehensive Shoulder Screws</Name>
            <Description>Screw, Locking, Ti</Description>
            <Size>4.75 dia x (15-45)mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>144584</ARTG>
                <ARTG>210290</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH284</BillingCode>
            <Name>ALPS Plating System</Name>
            <Description>Locking screws</Description>
            <Size>4.5 to 6.5mm diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD056</BillingCode>
            <Name>Glenoid Baseplate Locking Bone Screws</Name>
            <Description>Glenoid Baseplate Locking Bone Screws</Description>
            <Size>5.0mm diameter, length 14-38mm in 4mm increments</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>212469</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ048</BillingCode>
            <Name>Valetis Screws</Name>
            <Description>Titanium Locking Screws</Description>
            <Size>5.0mm width, 10-100mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ056</BillingCode>
            <Name>Valens Shoulder and Elbow - Screws</Name>
            <Description>Cortex/Cancellous Screws</Description>
            <Size>4.5mm, 6.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER504</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm), locking</Name>
            <Description>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm), locking, recon/Tuffneck</Description>
            <Size>dia (4.5-5.2 mm) x length (14-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER530</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, standard ( ≥ 4.5mm), locking</Name>
            <Description>Paragon 28 Monster Screw System-Joust Beaming Screws, standard, locking, headless, Titanium</Description>
            <Size>dia (5.0-7.2mm) x Length (50-185mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX047</BillingCode>
            <Name>Equinoxe Glenosphere Locking Screw</Name>
            <Description>The Locking Screw locks compression screws to the glenoid plate at a variable angle</Description>
            <Size>one size</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>159797</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW005</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Standard Locking Screw Systems</Description>
            <Size>Standard ( ≥4.5mm) 10-120mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU115</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE343</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PEEKPower HTO Plate</Name>
            <Description>Medial High Tibial Osteotomy Implant Device System</Description>
            <Size>5.0mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU116</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE344</PriorBillingCode>
            </PriorBillingCodes>
            <Name>iBalance HTO System</Name>
            <Description>PEEK Screws for iBalance HTO Implant</Description>
            <Size>4.5mm Cortical and 6.5mm Cancellous</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU208</BillingCode>
            <Name>Titanium Locking Cortical and Cancellous Screws, Large</Name>
            <Description>Titanium Locking Cortical and Cancellous Screws, Large</Description>
            <Size>4.5-6.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW531</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Screw</Description>
            <Size>5.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
                <ARTG>352530</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW791</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR074</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Screws</Name>
            <Description>Stainless Steel or Titanium Locking Screws</Description>
            <Size>4.5-5.5mm diameter, 8 - 100m length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW836</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR294</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION 3Di Plating System - OP Locking Screws</Name>
            <Description>Osteopenic locking screws</Description>
            <Size>Diameter: 5.5mm  Length: 16, 18, 20, 22, 25, 30, 35, 40, 45, 50, 55, 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW872</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR342</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aequalis Reversed Shoulder - Fixation Screw for Articular Implant</Name>
            <Description>Titanium, sterile and non-sterile</Description>
            <Size>D4.5mm, L20 to 50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>291613</ARTG>
                <ARTG>214803</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT015</BillingCode>
            <Name>Superior Fusion Plate System - Locking screws</Name>
            <Description>4.5mm locking screw set with lengths ranging from 35mm to 110mm.Locking screws to hold and aid an anatomical contoured locking plate used for primary, revision and pantalar anterior ankle fusions.</Description>
            <Size>4.5mm in diameter with lengths of 35mm,37mm, 39mm, 41mm, 43mm, 45mm, 47mm, 49mm,&#xD;
50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm,&#xD;
110mm each</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191738</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD014</BillingCode>
            <Name>Screws - Locking</Name>
            <Description>Locking</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV011</BillingCode>
            <Name>Perform Reverse Central Locking Screw</Name>
            <Description>Titanium Locking Screw</Description>
            <Size>6.5mm, 9.5mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>386960</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM506</BillingCode>
            <Name>Locking Screw (Standard)</Name>
            <Description>Locking Screw (Standard)</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA530</BillingCode>
            <Name>Affinis Inverse locking screw</Name>
            <Description>Locking Metaglene screw</Description>
            <Size>24x4.0mm to 48x4.0mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>241996</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO414</BillingCode>
            <Name>Acumed Screws</Name>
            <Description>Locking Screws</Description>
            <Size>&gt;4.5mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX018</BillingCode>
            <Name>ARMAR Meril Locking Plate System Self tapping Locking Screws</Name>
            <Description>TiCP Self Tapping Locking Screws</Description>
            <Size>5mm Diameter&#xD;
14-90mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ003</BillingCode>
            <Name>FlexiSystem, Flexit Cortical and Cancellous locking screws and duel threaded screws</Name>
            <Description>Cortical and Cancellous locking Duel threaded screws</Description>
            <Size>30,35,40,45,50,55,60,6,70,75mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>206423</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV005</BillingCode>
            <Name>PS  Locking Screw</Name>
            <Description> Locking screw</Description>
            <Size>4.5mm Diameter, 24-90mm Length</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>330190</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL151</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Standard screws - Locking</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>230143</ARTG>
                <ARTG>368491</ARTG>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN768</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Fixation Device, Internal, Locking, Stainless Steel, Cortical &amp; Cancellous Screw</Description>
            <Size>4.5mm -5.0mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ091</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Cortical, Locking, Self-tapping, Standard, T20, Fully Threaded</Description>
            <Size>4.5 - 5.0mm Diameter  10-90mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191587</ARTG>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ116</BillingCode>
            <Name>SuperCable Trochanteric Grips and Cable Plate System</Name>
            <Description>Locking Screw Titanium</Description>
            <Size>5.0mm diameter 10mm to 50mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>133719</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY653</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Locking Screws</Description>
            <Size>≥ 4.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY693</BillingCode>
            <Name>Dynamic Locking Screw</Name>
            <Description>Pin-sleeve locking screw</Description>
            <Size>5.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN007</BillingCode>
            <Name>Newclip Locking Bone Screws</Name>
            <Description>Locking Bone Screws</Description>
            <Size>Diam ≥4.5mm, length 15 - 110mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI534</BillingCode>
            <Name>Zimmer Trabecular Metal Reverse Shoulder System</Name>
            <Description>Inverse/Reverse Screw 4.5mm</Description>
            <Size>18mm, 24mm, 27mm, 30mm, 33mm, 36mm, 42mm, 48mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>94829</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI548</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>2.7mm Universal Locking Screw</Description>
            <Size>Length:8mm; 10mm; 12mm; 14mm; 16mm; 18mm; 20mm; 22mm; 24mm; 26mm; 28mm; 30mm; 32mm; 34mm; 36mm; 38mm; 40mm; 42mm; 44mm; 46mm; 48mm; 50mm; 55mm; 60mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH167</BillingCode>
            <Name>Comprehensive Shoulder Screws</Name>
            <Description>Screw, Non-Locking</Description>
            <Size>(4.75 or 6.5)mm x 15-50mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH283</BillingCode>
            <Name>ALPS Plating System</Name>
            <Description>Non-locking bone screws</Description>
            <Size>4.5 - 6.5mm diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH317</BillingCode>
            <Name>Affixus Hip Fracture Nail System</Name>
            <Description>Distal screw</Description>
            <Size>20-80mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>177876</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH318</BillingCode>
            <Name>Affixus Hip Fracture Nail System</Name>
            <Description>Anti- rotational screw</Description>
            <Size>5mm diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>177876</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH331</BillingCode>
            <Name>Small / Large  Fragment Set</Name>
            <Description>Bone Screw Titanium</Description>
            <Size>4.5 to 6.5mm diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>153087</ARTG>
                <ARTG>203607</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD054</BillingCode>
            <Name>Replacement retaining screw for glenoid head</Name>
            <Description>Replacement retaining screw for glenoid head</Description>
            <Size>6.5mm x 30mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>212521</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ051</BillingCode>
            <Name>Valetis Screws</Name>
            <Description>Titanium Cortical Screws</Description>
            <Size>4.5mm width, 10-80mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ052</BillingCode>
            <Name>Valetis Screws</Name>
            <Description>Titanium Cancellous Screws</Description>
            <Size>4.5mm width, 10-80mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ098</BillingCode>
            <Name>Austofix L&amp;C Large Fragment Plate and Screw System</Name>
            <Description>Cortex, Cancellous Screws</Description>
            <Size>4.5mm, 6.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER391</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm)</Name>
            <Description>Paragon 28 Monster Screw System-Screws, headed, blunt tip, solid, various thread lengths</Description>
            <Size>dia (4.5-7.0 mm) x length (18-200 mm) x thread length (6-200 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER510</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm)</Name>
            <Description>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm)</Description>
            <Size>dia (4.5-5.2 mm) x length (14-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX046</BillingCode>
            <Name>Equinoxe Compression Screw</Name>
            <Description>The compression screw compresses the glenoid plate to the bone while providing 30 degrees of angular variability</Description>
            <Size>4.5x18mm white, 4.5x22mm black, 4.5x26mm orange, 4.5x30mm blue, 4.5x34mm red, 4.5x38mm green, 4.5x42mm yellow, 4.5x46mm purple</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>252473</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG002</BillingCode>
            <Name>Contile Fin II</Name>
            <Description>Bone Screw</Description>
            <Size>20 to 50mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>246519</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW007</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Standard Bone Screw Systems</Description>
            <Size>Standard ( ≥4.5mm) 10-130mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU155</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE537</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arthrex Jones Fracture Screw</Name>
            <Description>Partially Threaded Screw to fixate fractures of the 5th Metatarsal</Description>
            <Size>4.5mm (40-65mm Lengths)  5.5mm (40-65mm Lengths)  6.0mm (40-65mm Lengths)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>350672</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU156</BillingCode>
            <Name>PEEKPower HTO Plate</Name>
            <Description>Medial High Tibial Osteotomy Implant Device System</Description>
            <Size>4.5mm Titanium compression Screws</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU210</BillingCode>
            <Name>Low Profile Screw</Name>
            <Description>Low Profile Screw</Description>
            <Size>4.5mm - 5.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU268</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE367</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cancellous Bone Screws</Name>
            <Description>Cancellous Bone Screws</Description>
            <Size>25-50mm x 6.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW337</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Screws Ti or StST</Description>
            <Size>4.5-6.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>340042</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW699</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Carolina Jones Fracture System</Name>
            <Description>Low profile, solid-core, surgical grade stainless steel screw, partially threatded with thread length varying anthropometrically relative to overall screw length, utilising specialised instruments for IM placement in the 5th metatarsal</Description>
            <Size>4.5mm, 4.5mm, 6.5mm, 40mm-70mm overall screw lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW799</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR209</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Non-Locking Screws</Name>
            <Description>Titanium or Stailess Steel Alloy Non-Locking Screws</Description>
            <Size>20-100mm, 4.5-5.5mm Diameter</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
                <ARTG>198549</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW838</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR296</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION 3Di Plating System - Osteopenic Screws</Name>
            <Description>Osteopenic screws</Description>
            <Size>Diameter: 5.5mm  Length: 16, 18, 20, 22, 25, 30, 35, 40, 45, 50, 55, 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW873</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR343</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fixation Screw for Articular Implant</Name>
            <Description>Titanium, sterile and non-sterile</Description>
            <Size>D 4.5mm, L 18mm to 50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>291613</ARTG>
                <ARTG>214803</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT007</BillingCode>
            <Name>Hawk Anterior Ankle Fusion Set</Name>
            <Description>4.5mm screw set with lengths ranging from 35mm to 110mm.</Description>
            <Size>4.5mm x length (35mm to 110mm)</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>191738</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT009</BillingCode>
            <Name>Hawk Anterior Ankle Fusion Set</Name>
            <Description>6.5mm screw set with lengths ranging from 35mm to 110 mm.</Description>
            <Size>6.5mm length 35mm to 110mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>191738</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD013</BillingCode>
            <Name>Screws - Non Locking</Name>
            <Description>≥4.5mm)</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV013</BillingCode>
            <Name>Perform Reverse Peripheral Fixation Screw</Name>
            <Description>Locking Fixation Screw</Description>
            <Size>5.0mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>314266</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH444</BillingCode>
            <Name>Hinge Pediatric Plating System - Screws</Name>
            <Description>2 screws for articulated growth-correction fixation plate</Description>
            <Size>4.5 x 35mm, 4.5 x 30mm, 4.5 x 25mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>161505</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH675</BillingCode>
            <Name>MUTARS Cancellous Screws</Name>
            <Description>MUTARS Cancellous Screws</Description>
            <Size>20-40mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>237075</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM374</BillingCode>
            <Name>Plate Screw</Name>
            <Description>Plate Screw</Description>
            <Size>4.5mm diameter and greater</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM381</BillingCode>
            <Name>Screw and Locking Cap</Name>
            <Description>Screw and Locking Cap</Description>
            <Size>4.5 mm and larger diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM505</BillingCode>
            <Name>Non-Locking Screw (Standard)</Name>
            <Description>Non-Locking Screw (Standard)</Description>
            <Size> ≥4.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA539</BillingCode>
            <Name>Affinis Inverse Lag Screw</Name>
            <Description>Metaglene Lag screw</Description>
            <Size>18x4.5mm to 38 x 4.5 mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>241996</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA553</BillingCode>
            <Name>Affinis Inverse Screw with Locking Cap</Name>
            <Description>Titanium Screw with Locking Cap</Description>
            <Size>Length 15mm to 51mm  Diameter 4.5mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>241996</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO413</BillingCode>
            <Name>Acumed Screws</Name>
            <Description>Screws</Description>
            <Size>&gt;4.5mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU186</BillingCode>
            <Name>PAO Cortical Screw Ø4.5</Name>
            <Description>Peri-Acetabular Osteotomy Cortical Screw</Description>
            <Size>Ø4.5 L 50-140 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>219907</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX017</BillingCode>
            <Name>ARMAR Meril Locking Plate System Self Tapping Cortex Screws</Name>
            <Description>TiCP and Stainless Steel Self Tapping Cortex Screws</Description>
            <Size>4.5mm Diameter&#xD;
14-145mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX019</BillingCode>
            <Name>ARMAR Meril Locking Plate System Cancellous Screw</Name>
            <Description>TiCP and Stainless Steel Cancellous Bone Screws</Description>
            <Size>6.5mm Diameter&#xD;
20-150mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL013</BillingCode>
            <Name>TC-100</Name>
            <Description>Cortical &amp; Cancellous Screws</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL014</BillingCode>
            <Name>Peri-Loc &amp; Peri-Loc VLP</Name>
            <Description>Cortical &amp; Osteopenia Screws</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL152</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Standard screws</Description>
            <Size>≥4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>230143</ARTG>
                <ARTG>368491</ARTG>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL214</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG113</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screws</Name>
            <Description>Titanium screws (2) for use with the Universal2 Total Wrist System only</Description>
            <Size>4.5mm x (15, 20, 25, 30, 35mm)</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>177632</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ113</BillingCode>
            <Name>SuperCable Trochanteric Grips and Cable Plate System</Name>
            <Description>Compression Screws Titanium</Description>
            <Size>4.5mm Diameter 10mm to 50 mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>133719</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ121</BillingCode>
            <Name>Verso Shoulder System - Baseplate Fixation Screw</Name>
            <Description>Verso Shoulder Base Plate Fixation Screw</Description>
            <Size>5mm diameter, 15mm-50mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>262473</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ143</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Self-tapping, Cortical, Solid, Cancellous Thread, T20, Partially Threaded, Recon</Description>
            <Size>4.5-5.0mm Diameter  10-100mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>191587</ARTG>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST004</BillingCode>
            <Name>Stryker Plating System Screws - Cortical 4.5mm</Name>
            <Description>Titanium or Stainless Steel</Description>
            <Size>10-20mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>25735</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST005</BillingCode>
            <Name>Stryker Plating System Screws - Cancellous</Name>
            <Description>6.5mm Stainless Steel or Titanium</Description>
            <Size>20-50mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>25735</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY596</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Cortex,Cancellous, Compression Screws</Description>
            <Size>≥ 4.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN030</BillingCode>
            <Name>Newclip Non Locking Bone Screw</Name>
            <Description>Non Locking Bone Screw</Description>
            <Size>≥4.5mm diameter, Length 20 - 110mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI149</BillingCode>
            <Name>Periarticular Plates</Name>
            <Description>Periarticular 6.5mm Cancellous Screws - Stainless Steel</Description>
            <Size>16mm Thread - 35-90mm Long, 32mm Thread - 45-90mm Long, Fully Threaded - 25-90mm Long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI151</BillingCode>
            <Name>Periarticular Plates</Name>
            <Description>Periarticular 4.5mm Self Tapping Screws - Stainless Steel</Description>
            <Size>26 - 90mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI205</BillingCode>
            <Name>Zimmer Screws</Name>
            <Description>4.5mm Cortical Screws</Description>
            <Size>14 - 120mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI207</BillingCode>
            <Name>Zimmer Screws</Name>
            <Description>6.5mm Cancellous Screws</Description>
            <Size>25 - 120mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI831</BillingCode>
            <Name>NCB Polyaxial Locking System</Name>
            <Description>Variable Angle Locking Screw Cap - Ti Alloy</Description>
            <Size>8mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>100337</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI891</BillingCode>
            <Name>NCB System</Name>
            <Description>NCB Screws</Description>
            <Size>14- 100mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3369</SubGroupID>
            <ARTGs>
                <ARTG>100337</ARTG>
            </ARTGs>
            <MinimumBenefit>59</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU205</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE365</PriorBillingCode>
            </PriorBillingCodes>
            <Name>QuickFix Screw, Small</Name>
            <Description>Titanium Snapp-off Small Bone Screw, small</Description>
            <Size>3.0mm Diameter x 13-19mm Lengths</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL225</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG134</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Snap-Off screws</Name>
            <Description>Titanium break-off barrel screws for Hallu-Fix</Description>
            <Size>Diameter 3.0mm, Length 10 - 18mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF002</BillingCode>
            <Name>BePOD</Name>
            <Description>Self-Compressive Screw</Description>
            <Size>Lengths 10mm - 60mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>Breakoff, DT</Suffix>
            <ARTGs>
                <ARTG>141164</ARTG>
            </ARTGs>
            <MinimumBenefit>455</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF008</BillingCode>
            <Name>Arthrodesis Screws</Name>
            <Description>Titanium Alloy Compression Screws</Description>
            <Size>10mm - 60mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>Breakoff, DT</Suffix>
            <ARTGs>
                <ARTG>141164</ARTG>
            </ARTGs>
            <MinimumBenefit>455</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH186</BillingCode>
            <Name>Small / Large  Fragment Set</Name>
            <Description>Cannulated Titanium Bone Screw</Description>
            <Size>3.0mm - 4.0mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH277</BillingCode>
            <Name>ALPS Plating System &amp; Biodrive Screws</Name>
            <Description>Cannulated Bone Screws</Description>
            <Size>3.0 to 4.0mm diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP033</BillingCode>
            <Name>Tyber Medical Headed Trauma screw</Name>
            <Description>Headed trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>3.0mm - 4.0mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU003</BillingCode>
            <Name>Nexis osteosynthesis screws</Name>
            <Description>Bone screw titanium alloy (headed)</Description>
            <Size>Diameter 2.9-4mm, Length 10-60mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>235765</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ045</BillingCode>
            <Name>Valens Hand - Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>3.0mm, 3.5mm, 4.0mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO116</BillingCode>
            <Name>APTUS headedCCS</Name>
            <Description>Headed Cannulated screws</Description>
            <Size>&gt;2.7mm-4.49mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER395</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, small (2.71mm – 4.49mm), cannulated</Name>
            <Description>Paragon 28 Monster Screw System-Screws, small, cannulated, headed, partial or full thread</Description>
            <Size>dia (3.0-4.0) x length (10-150 mm) x thread length (3-150 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW006</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Cannulated Bone Screw Systems</Description>
            <Size>Small (2.71mm – 4.49mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU142</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE696</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Patella Fracture Screw</Name>
            <Description>4mm Blunt Tip Cannulated Lag Screw</Description>
            <Size>4mm x 24mm - 4mm x 60mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU218</BillingCode>
            <Name>Cannulated Low Profile Screws, Small</Name>
            <Description>Cannulated Low Profile Screws, Small</Description>
            <Size>3-4mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW717</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR068</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cannulated Screw</Name>
            <Description>Titanium cannulated screw intended for use in conjunction with a plate for fixation of midfoot fusion</Description>
            <Size>3.5mm diameter x 34, 36 &amp; 38mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW819</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR247</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Darco Headed Compression Screw System</Name>
            <Description>Cannulated titanium compression screws</Description>
            <Size>3.0-4.0mm x 16-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW909</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR386</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxTorque Cannulated Screw System - Small Screws</Name>
            <Description>Bone screws, Titanium, Cannulated, Short or Long Thread</Description>
            <Size>Ø3.2mm Short Thread, Length 12-30mm  Ø3.2mm Long Thread, Length 12-38mm  Ø3.8mm Short Thread,Length 16-50mm  Ø4.0mm Long Thread, Length 14-50mm  Ø4.0mm Long Thread, Length 24-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT011</BillingCode>
            <Name>Hawk 4.0mm Cannulated Screw System</Name>
            <Description>4.0mm Cannulated screw</Description>
            <Size>4.0mm in diameter with lengths of 26mm to 70mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>230954</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Screws - Cannulated Lag</Description>
            <Size>Diameter 2.71mm – 4.49mm</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM286</BillingCode>
            <Name>Bone Screw</Name>
            <Description>Bone Screw</Description>
            <Size>2.71 to 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM399</BillingCode>
            <Name>Cannulated Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>2.71mm – 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM523</BillingCode>
            <Name>OMNI Plating System</Name>
            <Description>Cannulated Screws</Description>
            <Size>2.71mm – 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO450</BillingCode>
            <Name>Cannulated Screw  New Information - Acumed Cannulated Screws</Name>
            <Description>4.0mm Cannulated Screw</Description>
            <Size>4.0mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB040</BillingCode>
            <Name>Cannulated Screws 4mm</Name>
            <Description>Cannulated 4mm</Description>
            <Size>4mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK528</BillingCode>
            <Name>'Stryker Cannulated Screw System</Name>
            <Description>Asnis III Cannulated screws</Description>
            <Size>4.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>155633</ARTG>
                <ARTG>340042</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN971</BillingCode>
            <Name>Cannulated Screw</Name>
            <Description>Stainless Steel</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ137</BillingCode>
            <Name>Cannulated Screws</Name>
            <Description>Cannulated, Cancellous  Short, Medium, Partial, Full Thread  Locking, Non-locking</Description>
            <Size>3.0-4.0mm Diameter  8-70mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR094</BillingCode>
            <Name>Stryker Cannulated Screw System</Name>
            <Description>Asnis Micro Cannulated screw</Description>
            <Size>2.71mm-3.0mm, Diameters, 8mm-40mm lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>155633</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY071</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Cannulated screws</Description>
            <Size>&gt;2.7mm-4.49mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN025</BillingCode>
            <Name>Newclip Cannulated Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>2.71 - 4.49mm diameter, lengths 10 - 70mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI177</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cannulated Screw</Name>
            <Description>Mini Magna-FX - Stainless Steel</Description>
            <Size>4 &amp; 5mm diameters</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI835</BillingCode>
            <Name>NCB Polyaxial Locking System</Name>
            <Description>4.0mm Cannulated Variable Angle Locking Screws - Ti Alloy</Description>
            <Size>14 - 65mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>100337</ARTG>
            </ARTGs>
            <MinimumBenefit>188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH190</BillingCode>
            <Name>Headless Compression Screws</Name>
            <Description>Headless Compression Screws</Description>
            <Size>3mm-4mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>210290</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP034</BillingCode>
            <Name>Tyber Medical Trauma headless screw</Name>
            <Description>Headless trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>3.0mm-4.0mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU009</BillingCode>
            <Name>Nexis osteosynthesis screws</Name>
            <Description>Bone screw titanium alloy (compressive)</Description>
            <Size>Diameter 2.9-4 mm, Length 10-60mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>235765</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU019</BillingCode>
            <Name>MAGNEZIX CS 3.2</Name>
            <Description>Compression screw for bone fixation.</Description>
            <Size>Diameter 3.2mm&#xD;
Length 10-40mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>283491</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ068</BillingCode>
            <Name>Austofix Cannulated Compression Screws</Name>
            <Description>Headless Cannulated Compression Screws</Description>
            <Size>3.0mm width, 10-48mm length;   3.8mm width, 10-60mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ090</BillingCode>
            <Name>Headless Compression Cannulated Screw System</Name>
            <Description>Fully-threaded headless cannulated screws</Description>
            <Size>3.0mm, 3.5mm, 4.0mm diameter   14-30mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO058</BillingCode>
            <Name>APTUS CCS</Name>
            <Description>Cannulated Screws</Description>
            <Size>2.71 – 4.49 mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW064</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Self-tapping Cannulated Screw</Description>
            <Size>Small (2.71mm – 4.49mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HJ003</BillingCode>
            <Name>HBS Self-Drilled High Compression Screw</Name>
            <Description>Headless compression screw, cannulated, dual thread, self-drilling, self-tapping, </Description>
            <Size>Distal thread Diameter 3mm, Length 12-40mm</Size>
            <SupplierCode>HJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>340314</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU151</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE480</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Headless Compression Screw System</Name>
            <Description>Headless Compression Screw for bone fixation</Description>
            <Size>3mm Diameter ( 10-36mm Lengths)  4.3mm Diameter (14-80mm Lengths)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>350672</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU158</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE466</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Compression FT</Name>
            <Description>Headless Compression Screw for bone fixation</Description>
            <Size>3.5mm/4.0mm x 12-60mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU296</BillingCode>
            <Name>Beveled FT Screw</Name>
            <Description>Screw for osteotomy</Description>
            <Size>3.5mm and 4.0mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW451</BillingCode>
            <Name>Stryker Cannulated Compression Screw Systems</Name>
            <Description>Double threaded compression screws</Description>
            <Size>2.71mm to 4.49mm diameter</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>149535</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW452</BillingCode>
            <Name>Fixos Screws</Name>
            <Description>Bone Fixation Srews, Cannulated, Double Threaded</Description>
            <Size>3.0mm-7.0mm diamter</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW824</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR264</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MICA Compression Screw</Name>
            <Description>Compression Screw for Minimally Invasive Surgery</Description>
            <Size>Sizes: 3mm - 4mm diameter,  14mm - 70mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>198485</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW915</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR395</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix 3.0mm Compression Screw</Name>
            <Description>The NexFix Compression Screw is a stainless steel, cannulated, self tapping, and self drilling fixation device for osteotomies, fusions and fracture fixation of small bones</Description>
            <Size>3.0mm diameter x 10 - 34mm length in 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW972</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Foot &amp; Ankle System</Name>
            <Description>Multi use compression screw, cannulated, stainless steel</Description>
            <Size>3.0 &amp; 4.3mm dia. 10-60mm in 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW974</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR062</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Headless Compression screws</Name>
            <Description>Compression screw cannulated, titanium, self tapping, self drilling.</Description>
            <Size>2.5-3.2mm diameter x 10-32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>198485</ARTG>
                <ARTG>326629</ARTG>
                <ARTG>291613</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG057</BillingCode>
            <Name>Kompressor</Name>
            <Description>Titanium compression screw</Description>
            <Size>10-34mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>160519</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT012</BillingCode>
            <Name>Hawk 3.0mm Cannulated Screw system</Name>
            <Description>3.0mm cannulated screw</Description>
            <Size>3.0mm in diameter with lengths of 14mm to 50mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>230954</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT032</BillingCode>
            <Name>Integrant 4.0mm Cannulated Screws</Name>
            <Description>Cannulated screws with variable pitch/dynamic thread screw heads</Description>
            <Size>4.0mm Diameter with lenghts from 26mm-70mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>230954</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ExtremiFix Screws</Name>
            <Description>Headless Cannulated Compression Screw</Description>
            <Size>Diameter 3.0mm, 4.0mm. Length 10mm to 52mm; Diameter 2.71mm - 4.49mm.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT073</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH480</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HBS 2 midi</Name>
            <Description>Self-compressive screws</Description>
            <Size>3.0mm x 10-40mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>276650</ARTG>
                <ARTG>276674</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM052</BillingCode>
            <Name>Ascension Compression Screw</Name>
            <Description>Titanium Compression Screw</Description>
            <Size>2-5mm diameter ; 12 - 40mm length</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>118626</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM143</BillingCode>
            <Name>Extremity Medical Compression Screw System</Name>
            <Description>Compression Screws</Description>
            <Size>3.0-4.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>164980</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM285</BillingCode>
            <Name>IBS Screw</Name>
            <Description>Compression Screw</Description>
            <Size>3.00 &amp; 3.5mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM315</BillingCode>
            <Name>Headless Compression Screws</Name>
            <Description>Compression Screws</Description>
            <Size>3.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>279795</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM349</BillingCode>
            <Name>Orthopaedic Fixation Screw</Name>
            <Description>Fixation Screw</Description>
            <Size>2.71 to 4.49mm diameter all lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM394</BillingCode>
            <Name>Headless Compression Screw</Name>
            <Description>Headless Compression Screw</Description>
            <Size>2.71mm – 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO355</BillingCode>
            <Name>Acutrak 2</Name>
            <Description>Headless compression screw</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO368</BillingCode>
            <Name>Acumed Fixation Screw</Name>
            <Description>Acutrak Compression Screw Titanium</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO382</BillingCode>
            <Name>Acutrak Headless Compression Screw</Name>
            <Description>Acutrak 4/5 screw</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH546</BillingCode>
            <Name>Dynafit System</Name>
            <Description>Compressive Screws</Description>
            <Size>2.8-4mm x 10-70mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>216161</ARTG>
                <ARTG>216162</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB036</BillingCode>
            <Name>Headless Compression Screw System</Name>
            <Description>Headless Compression Screw</Description>
            <Size>2.71 - 4.49mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB043</BillingCode>
            <Name>Cannulated Screws 3mm</Name>
            <Description>Cannulated Screws</Description>
            <Size>3mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB051</BillingCode>
            <Name>HN Intramedullary Nail</Name>
            <Description>The HN Intramedullary Nail</Description>
            <Size>Length 10mm - 26mm, Diameter 5.5mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>229660</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB052</BillingCode>
            <Name>The HN Intramedullary Nail locking screw</Name>
            <Description>The HN Intramedullary Nail locking screw, cannulated, dual-threaded</Description>
            <Size>Length 16mm - 60mm, Diameter 3.0mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF001</BillingCode>
            <Name>FH Screw Systems</Name>
            <Description>Canulated Self-Compressive Screws</Description>
            <Size>lengths 10mm to 50mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>141164</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF092</BillingCode>
            <Name>Twinlock Screw - Standard</Name>
            <Description>Twinlock Screw - Standard</Description>
            <Size>5.2/5.5mm to 6.0/7.0mm Dia x 25 to 120 mm Length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF093</BillingCode>
            <Name>TwinLock Screw - Small</Name>
            <Description>TwinLock Screw - Small</Description>
            <Size>3.5/3.6mm to 4.0/4.1mm Dia x 16 to 34 mm length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF114</BillingCode>
            <Name>Twinlock Screw - Standard</Name>
            <Description>Twinlock Screw - Standard</Description>
            <Size>5.2/5.5mm to 6.0/7.0mm Dia x 25 to 120 mm Length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF115</BillingCode>
            <Name>TwinLock Screw - Small</Name>
            <Description>TwinLock Screw - Small</Description>
            <Size>3.5/3.6mm to 4.0/4.1mm Dia x 16 to 34 mm length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK256</BillingCode>
            <Name>TwinFix Cannulated Compression Screw System</Name>
            <Description>The Stryker TwinFix Cannulated Compression Screw System is intended to be used for fractures or arthrodesis.</Description>
            <Size>Diameter 3.2mm, lengths 14-34mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>124318</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL193</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG069</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bold Compression Screw</Name>
            <Description>Cannulated titanium</Description>
            <Size>3mm diam 10-34mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL194</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG070</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ICOS Screw: Ideal Compression Screw</Name>
            <Description>Cannulated titanium</Description>
            <Size>4.0mm diam 26-60mm length, 6.5mm diam 40-150mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL208</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG107</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bold Compression Screw</Name>
            <Description>Cannulated Titanium</Description>
            <Size>Diameter 3.0-3.70mm, length 10-34mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL210</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG109</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Qwix Screw</Name>
            <Description>Self drilling, self tapping, cannulated, titanium screws.</Description>
            <Size>Diameter 3.0mm-7.5mm, length 10mm-120mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM173</BillingCode>
            <Name>Smith and Nephew Headless Compression Screw</Name>
            <Description>Headless Cannulated Screw</Description>
            <Size>2.71mm-4.49mm Headless Cannulated Screw 8mm - 40mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY644</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>HCS Countersinkable Compression Screw</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN016</BillingCode>
            <Name>Newclip Compression Screws</Name>
            <Description>Self-compressive cannulated screw</Description>
            <Size>2.71-4.49mm diameter, length 10-70mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>362</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER396</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, small (2.71mm – 4.49mm), cannulated, dual thread, locking</Name>
            <Description>Paragon 28 Monster Screw System-Screws, small, cannulated, dual thread, locking, headless, Titanium</Description>
            <Size>dia (3.0-4.0) x length (10-100 mm) x length of thread (3.5-100 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>429</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM133</BillingCode>
            <Name>TriMed Compression Screws</Name>
            <Description>'Compression Screws</Description>
            <Size>3.0-4.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>229704</ARTG>
            </ARTGs>
            <MinimumBenefit>429</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB063</BillingCode>
            <Name>MCS</Name>
            <Description>MCS System</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>429</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN199</BillingCode>
            <Name>Bristow-Latarjet Instability Shoulder Set - Screw</Name>
            <Description>Cannulated Locking Screw</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>136374</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL204</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG093</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal Screws/Lock Screws</Name>
            <Description>Screws - Cancellous, Cancellous cannulated, cortical, cortical cannulated plus Lock screws</Description>
            <Size>Cancellous/Cancellous cannulated - Diameter 6.5mm, Length 20mm - 100mm + Lock Screw, Cortical - Diameter 5.0mm, Length 25mm - 45mm + Lock Screw, Cortical - Diameter 4.5mm, Length 14mm - 65mm + Lock Screw, Cortical - Diameter 3.5mm, Length 14mm - 32mm + Lo</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL209</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG108</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal Surfix Style Screws</Name>
            <Description>Titanium bone screw +locking screw for the fixation of specific Newdeal bone plates</Description>
            <Size>Diameter 3.5mm, Length 10-50mm; Diameter 4.5mm, length 14-65mm; Diameter 6.5, length 20-100mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY797</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Philos Cannulated locking screw</Description>
            <Size>3.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN069</BillingCode>
            <Name>Small cannulated Locking screws </Name>
            <Description>Small cannulated Locking screws </Description>
            <Size>2.8 mm diameter ; 14-30 mm length</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI853</BillingCode>
            <Name>Zimmer Periarticular Plating System</Name>
            <Description>5.5mm Cannulated Periarticular Locking Screws</Description>
            <Size>30 - 150mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI855</BillingCode>
            <Name>Zimmer Periarticular Locking System</Name>
            <Description>3.5mm Cannulated Periarticular Locking Screws</Description>
            <Size>30 - 90mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO092</BillingCode>
            <Name>APTUS SpeedTip C System</Name>
            <Description>APTUS SpeedTip C Screws</Description>
            <Size>2.8mm diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>245</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU254</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE272</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bio-Compression Screw System</Name>
            <Description>Fixation Device</Description>
            <Size>16mm, 18mm, 20mm, 22mm, 24mm, 26mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>360378</ARTG>
                <ARTG>140794</ARTG>
            </ARTGs>
            <MinimumBenefit>245</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO374</BillingCode>
            <Name>Acutrak Fusion Screws</Name>
            <Description>Fusion Screws Titanium</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>245</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH477</BillingCode>
            <Name>DynafitSystem</Name>
            <Description>Self-compressive screws</Description>
            <Size>3.2 x 10-40mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>216161</ARTG>
                <ARTG>216162</ARTG>
            </ARTGs>
            <MinimumBenefit>245</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN017</BillingCode>
            <Name>Newclip Compression Screws</Name>
            <Description>Self-Compressive Screws</Description>
            <Size>2.71-4.49mm diameter, Length 10-30mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>245</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO074</BillingCode>
            <Name>APTUS Screws</Name>
            <Description>Aptus Locking Screws</Description>
            <Size>2.8mm - 3.5mm Diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>141171</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER381</BillingCode>
            <Name>Paragon 28 Phantom Lapidus Nail-Screws, small (2.71mm – 4.49mm), dual thread, locking</Name>
            <Description>Paragon 28 Phantom Lapidus Nail-Screws, small (2.71mm – 4.49mm), dual thread, locking</Description>
            <Size>dia 3.5 mm x length (10-26 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>290443</ARTG>
            </ARTGs>
            <MinimumBenefit>222</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE155</BillingCode>
            <Name>ASDM Clavicle Plating System - Screws</Name>
            <Description>Fixation Device, Internal, Locking, Stainless Steel, Cortical Screw Size: 3.5mm</Description>
            <Size>3.5mm Locking Screws, 10-30mm (2mm increments)</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>137369</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU004</BillingCode>
            <Name>Airlock Bone screw</Name>
            <Description>Bone Screws Titanium Alloy (Locking screws)</Description>
            <Size>Diameter 3-3.5mm, Length 8-30mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>235767</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ008</BillingCode>
            <Name>Austofix Intramedullary Screws</Name>
            <Description>Humeral Head Screw, stainless steel</Description>
            <Size>4.3mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ014</BillingCode>
            <Name>Austofix Proximal Humeral Plating System - Austofix PHP Locking Screw</Name>
            <Description>Locking Screw Titanium</Description>
            <Size>3.5mm, 16-100mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ017</BillingCode>
            <Name>Austofix Proximal Humeral Plating System - Austofix VA Locking Screw</Name>
            <Description>Variable Angle Locking Screw, Cobalt Chrome</Description>
            <Size>3.5mm 20-100mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ047</BillingCode>
            <Name>Valetis Screws</Name>
            <Description>Titanium Locking Screws</Description>
            <Size>3.5mm width, 10-65mm length&#xD;
4.0mm width, 10-75mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ092</BillingCode>
            <Name>Foot &amp; Ankle VA Locking Screw</Name>
            <Description>3.5 Variable Angle Locking Screw</Description>
            <Size>3.5mm diameter, 12-50mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ095</BillingCode>
            <Name>Small Fragment Screws</Name>
            <Description>Locking Screws</Description>
            <Size>3.5mm diameter,   10mm-90mm length </Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EF006</BillingCode>
            <Name>Merete - MetaFix LS - Locking Screws</Name>
            <Description>Bone screws, Titanium, Locking</Description>
            <Size>2.71mm - 4.49mm diameter, lengths 12 - 48mm</Size>
            <SupplierCode>EF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>212520</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER425</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Screws, small</Name>
            <Description>Paragon 28 Gorilla Plating System-Screws, small, locking; recon/Tuffneck</Description>
            <Size>dia (3.5-4.2 mm) x length (8-70 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW037</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Small Bone Screw Systems</Description>
            <Size>Small (2.71mm – 4.49mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU143</BillingCode>
            <Name>Locking Cortical land Cancellous Screws, Small</Name>
            <Description>Locking Cortical and Cancellous Screws, Small</Description>
            <Size>3-3.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU297</BillingCode>
            <Name>KreuLock Locking Compression Screws, Ti</Name>
            <Description>Locking Compression Screws</Description>
            <Size>3.0mm-3.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU316</BillingCode>
            <Name>KrueLock Locking Compression Screws SS</Name>
            <Description>locking compression screw </Description>
            <Size>3.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW460</BillingCode>
            <Name>Memometal Anchorage Bone Screws</Name>
            <Description>Anchorage Bone Screws</Description>
            <Size>3.0-3.5mm diameter to 10 - 40mm in length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>149535</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW719</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR072</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ortholoc Fracture System Screws</Name>
            <Description>Titanium, variable angle locking screws</Description>
            <Size>2.7, 3.5 &amp; 4.0mm diameter, 8-100mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW793</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR078</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Lisfranc Recontruction System - Screw.</Name>
            <Description>Solid core stainless steel screw.</Description>
            <Size>3.7mm diameter, 8-100mm length.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW805</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR228</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Titanium Screw</Name>
            <Description>Locking, non-locking or cannulated, for use only with Darco titanium plates, self-tapping</Description>
            <Size>8-40mm, 3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW817</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR245</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Claw Locking Screws</Name>
            <Description>3.5mm stainless steel locking screws for use with Claw Plate</Description>
            <Size>3.5mm: 12-40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW835</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR293</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION 3Di Plating System - OP Locking Screws</Name>
            <Description>Osteopenic locking screws</Description>
            <Size>Diameter: 4.0mm  Length: 16mm to 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW905</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR382</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - 3.5mm locking screws</Name>
            <Description>Bone screws, titanium, fixed or variable angle locking</Description>
            <Size>Ø 3.5mm Fixed angle, Length 8-45mm  Ø 3.5mm Variable angle, Length 10-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW932</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR416</PriorBillingCode>
            </PriorBillingCodes>
            <Name>WAVE Calcaneal Fracture System - Locking Screw</Name>
            <Description>The WAVE Calcaneal Fracture System is a low profile, anatomical plate and screw system designed for the minimally invasive fixation of the calcaneal fractures. The plate and associated locking and non-locking screws facilitate the reconstruction of the height and width of the calcaneus, and remodelling of the lateral calcaneal wall. The WAVE calcaneal System is provided non-sterile. The Locking Screw is used with the WAVE Calcaneal Fracture Plate</Description>
            <Size>Screws: Diameter = 4.0mm, Length - 14-44 in 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>168890</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW954</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR444</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC SPS Locking Screws</Name>
            <Description>Stainless steel locking head screws: cortical or cancellous</Description>
            <Size>Dia 3.5mm  Length: 10mm - 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW966</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR457</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC SPS Blunt-tipped Locking Screws </Name>
            <Description>Stainless steel locking head screws, blunt tipped</Description>
            <Size>Dia 3.5mm   Length: 18mm - 54mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW976</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR218</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Ortholoc EPS System 3.5 locking</Name>
            <Description>Stainless Steel, Variable Angle Locking, Cortical &amp; Cancellous Screws</Description>
            <Size>3.5mm Diameter, 10-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD001</BillingCode>
            <Name>CarboFix Piccolo Plate Systems – Locking Screws: Small</Name>
            <Description>Titanium alloy screws (locking) for fixation of CarboFix plate shaft and head.</Description>
            <Size>Locking Proximal Screw 4.0mm x 25.0mm, 30.0mm, 32.5mm, 35.0mm, 37.5mm, 40.0mm, 42.5mm, 45.0mm, 47.5mm, 50.0mm, 55.0mm, 60.0mm&#xD;
Locking Distal Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 22.5mm, 25.0mm, 27.5mm, 30.0mm, 32.5mm, 35.0mm, 40.0mm, 45.0mm&#xD;
Locking Screw 3.5mm x 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM145</BillingCode>
            <Name>TriMed Bone Screw</Name>
            <Description>Locking Cortical Bone Screw</Description>
            <Size>3.2mm x 10-40mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM147</BillingCode>
            <Name>TriMed Bone Screw</Name>
            <Description>Locking Compression Bone Screw</Description>
            <Size>4mm x 35-60mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM252</BillingCode>
            <Name>OsteoMed FPS</Name>
            <Description>Bone screws</Description>
            <Size>3.5/4mm x 10-70mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM278</BillingCode>
            <Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Locking Cortical Screw</Name>
            <Description>Locking Cortical Screw</Description>
            <Size>3.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182168</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM280</BillingCode>
            <Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Post Cap Screw</Name>
            <Description>Post Cap Screw</Description>
            <Size>2.7 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182168</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM310</BillingCode>
            <Name>Skeletal Dynamics Bone Screw Locking</Name>
            <Description>Bone Screw Locking</Description>
            <Size>3.0m and 3.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM351</BillingCode>
            <Name>Orthopaedic locking Screws</Name>
            <Description>Orthopaedic locking Screws</Description>
            <Size>2.71 to 4.49 mm diameter, all lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>338649</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM359</BillingCode>
            <Name>Hex Locking Screws</Name>
            <Description>Hex plate fixation locking screws</Description>
            <Size>2.71 to 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>178232</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM477</BillingCode>
            <Name>TriMed ASET Foot Plating System</Name>
            <Description>VA Locking Screws (small) </Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM504</BillingCode>
            <Name>Locking Screws (Small)</Name>
            <Description>Locking Screws (Small)</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM521</BillingCode>
            <Name>OMNI Plating System</Name>
            <Description>Locking Screws</Description>
            <Size>2.71mm – 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO322</BillingCode>
            <Name>Acumed Hexalobe Locking Screws</Name>
            <Description>Acumed Hexalobe Locking Screws</Description>
            <Size>Small (2.71mm-4.49mm)</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO370</BillingCode>
            <Name>Acumed Tap-Loc</Name>
            <Description>Tap screws, Tap-Loc Screws</Description>
            <Size>3.6mm -60 mm Length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO377</BillingCode>
            <Name>Acu-Loc Distal Radius Plate System</Name>
            <Description>Cortical Screw</Description>
            <Size>3.5mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO415</BillingCode>
            <Name>Acumed Screws</Name>
            <Description>Screws</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO426</BillingCode>
            <Name>ACUMED Hexalobe Low Profile 4.3mm screws</Name>
            <Description>ACUMED Hexalobe low profile 4.3mm locking screws, Titanium, fully threaded</Description>
            <Size>4.3mm in diameter, 18mm to 64mm in length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX011</BillingCode>
            <Name>MBOSS 3.5mm Locking Screw</Name>
            <Description>3.5mm Locking Screw, Self Tapping</Description>
            <Size>Diameter: 3.5mm&#xD;
Length: 10-95mm</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB022</BillingCode>
            <Name>Calcaneal Locking Plate MIPO System - Locking Screw</Name>
            <Description>Locking Screws</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF084</BillingCode>
            <Name>Signature FAA Screw</Name>
            <Description>Titanium Locking Screw.</Description>
            <Size>2.7mm diameter from 8-30mm in length.</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF124</BillingCode>
            <Name>Islay non-LOCKING SCREW</Name>
            <Description>2.7mm non locking screw&#xD;
GENII 2.7mm non-locking screw&#xD;
3.5mm non-locking screw&#xD;
GENII 3.5mm non-locking screw</Description>
            <Size>8-30mm (FPS 2.7mm non locking)&#xD;
10-50mm (FPS 3.5mm non-locking)</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK563</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>SPS Locking Plate System</Description>
            <Size>Locking screws 3-4mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK630</BillingCode>
            <Name>SBi Locking Screws</Name>
            <Description>Titanium Cortical Locking Self-tapping screws</Description>
            <Size>2.7mm Cortical Locking, Self-tapping 10 - 30mm&#xD;
3.5mm Cortical, Locking, Self tapping 8 -20mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>167057</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL090</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Bone Screws</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL191</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG067</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surfix screw plus Surfix Lock-Screw</Name>
            <Description>Locking screws with an independent lock-screw head</Description>
            <Size>2.7mm: 10-32mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL192</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG068</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surfix Screw plus Surfix Lock-Screw</Name>
            <Description>Locking screws with an independent lock-screw head that screw into fixation plates. This combination effects dynamic compression.</Description>
            <Size>3.5mm: 10-28mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL203</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG092</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Newdeal Lock Screws</Name>
            <Description>For use with Newdeal bone screws and plates</Description>
            <Size>Diameter 2.7mm - 6.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL220</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG120</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surfix Locking Screws</Name>
            <Description>Locking screws with an independent lock-screw head</Description>
            <Size>3mm; 10-24mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN944</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Locking Screws</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ132</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Cortical, Locking, Self-tapping, Standard, T15, trans-physeal</Description>
            <Size>3.5-4.0mm   10-70mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ181</BillingCode>
            <Name>PediFoot Deformity Correction System  </Name>
            <Description>3.5mm Variable Angle Locking Screws</Description>
            <Size>8-60mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR073</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Locking Screws</Description>
            <Size>Diameter 2.7 to 3.5mm</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>124318</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY652</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Locking Head Screws</Description>
            <Size>&gt;2.7mm to &amp;lt; 4.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY692</BillingCode>
            <Name>Dynamic Locking Screw</Name>
            <Description>Pin-sleeve locking screw</Description>
            <Size>3.7mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN023</BillingCode>
            <Name>Newclip Locking Bone Screws</Name>
            <Description>Locking Bone Screws</Description>
            <Size>2.71-4.49mm diameter, length 10-95 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA005</BillingCode>
            <Name>ALPS Plating System &amp; DVR Plating System</Name>
            <Description>Locking screws and pegs</Description>
            <Size>2.7-4.0mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>209305</ARTG>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA103</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tritum SCP (Sternal Cable Plate), Rescue Screw</Name>
            <Description>Cannullous Locking Rescue Screw for use with Pioneer Tritium SCP (Sternal Cable Plate), 3.0mm</Description>
            <Size>Diameter: 3.0mm  Lengths: 8mm, 10mm, 12mm, 14mm, 16mm,18mm,20mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI852</BillingCode>
            <Name>Zimmer Periarticular Plating System</Name>
            <Description>4.5mm Periarticular Locking Screws</Description>
            <Size>12 - 110mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI854</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>3.5mm Universal Locking Screws</Description>
            <Size>12 - 90mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI856</BillingCode>
            <Name>Zimmer Universal Locking System</Name>
            <Description>3.5mm Universal Locking Screws - Ti Alloy</Description>
            <Size>12 - 60mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI947</BillingCode>
            <Name>Screws -Locking</Name>
            <Description>Locking Screw</Description>
            <Size>10 - 70mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>140687</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ071</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screw</Name>
            <Description>Locking Screw</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>239817</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE154</BillingCode>
            <Name>ASDM Clavicle Plating System - Screws</Name>
            <Description>Fixation Device, Internal, Non-locking, Stainless Steel, Cortical Screw Size: 3.5mm &amp; Cancellous Screw sizes 4.0mm</Description>
            <Size>3.5mm Low-profile Cortex Screws, 10-30mm (2mm increments)&#xD;
4.0mm Low-profile Cortex Screws, 10-30mm (2mm increments)</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>137369</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH185</BillingCode>
            <Name>Small / Large  Fragment Set</Name>
            <Description>Bone Screw, Titanium</Description>
            <Size>3.5 - 4.0mm diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU007</BillingCode>
            <Name>Airlock Bone screw</Name>
            <Description>Bone Screws Titanium Alloy (non locking screws)</Description>
            <Size>Diameter 3-3.5mm, Length 8-30mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>235767</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD055</BillingCode>
            <Name>Glenoid Baseplate Non Locking Bone Screw</Name>
            <Description>Glenoid Baseplate Non Locking Bone Screw</Description>
            <Size>3.5mm diameter, length 14-34mm in 2mm increments</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>212470</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ013</BillingCode>
            <Name>Austofix Proximal Humeral Plating System - Austofix PHP Cancellous Screw</Name>
            <Description>Cancellous Screw, Titanium</Description>
            <Size>4mm 20-40mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ015</BillingCode>
            <Name>Austofix Proximal Humeral Plating System - Austofix Cortical Screw</Name>
            <Description>Cortical Screw, Titanium</Description>
            <Size>3.5mm, 20-40mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ020</BillingCode>
            <Name>VRP Distal Radius Fixation System, 3.5mm Cortical Screw, Titanium</Name>
            <Description>3.5mm Cortical Screw, Titanium</Description>
            <Size>3.5mm diameter, 10mm-20mm lengths</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>149433</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ049</BillingCode>
            <Name>Valetis Screws</Name>
            <Description>Titanium Cortical Screws</Description>
            <Size>3.5mm width, 10-80mm length&#xD;
4.0mm width, 10-80mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ050</BillingCode>
            <Name>Valetis Screws</Name>
            <Description>Titanium Cancellous Screws</Description>
            <Size>3.5mm width, 10-80mm length&#xD;
4.0mm width, 10-80mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ055</BillingCode>
            <Name>Valens Shoulder and Elbow - Screws</Name>
            <Description>Cortex/Cancellous Screws</Description>
            <Size>3.5mm, 4.0mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ076</BillingCode>
            <Name>Cannulated Humeral Nail</Name>
            <Description>Nail Locking Screw</Description>
            <Size>3.5mm Width  20mm-30mm Length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ077</BillingCode>
            <Name>Cannulated Humeral Nail</Name>
            <Description>Nail Locking Screw</Description>
            <Size>4.0mm diameter  20mm to 50mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ078</BillingCode>
            <Name>Cannulated Humeral Nail</Name>
            <Description>Humeral Head Screw</Description>
            <Size>4.3mm diameter  25mm to 45mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ094</BillingCode>
            <Name>Foot &amp; Ankle Cortex Screw</Name>
            <Description>3.5 Cortex Screw</Description>
            <Size>3.5mm diameter, 12-50mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO077</BillingCode>
            <Name>APTUS Screws</Name>
            <Description>Cortical Screws</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER386</BillingCode>
            <Name>Hintermann Series H3™ Total Ankle Prosthesis-Screw</Name>
            <Description>Hintermann Series H3™ Total Ankle Prosthesis-Screw, cortical, stainless steel</Description>
            <Size>dia 3.5 mm x length (12-42 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>289320</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER394</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, small (2.71mm – 4.49mm)</Name>
            <Description>Paragon 28 Monster Screw System-Screws, small, headed, with and without blunt tip, solid, recon/Tuffneck</Description>
            <Size>dia (3.0-4.2 mm) x length (10-150 mm) x thread length (3-150 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW054</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Small Bone Screw Systems</Description>
            <Size>Small (2.71mm – 4.49mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU144</BillingCode>
            <Name>Non-Locking Cortical and Cancellous Screws, Small</Name>
            <Description>Non-Locking Cortical and Cancellous Screws, Small</Description>
            <Size>3-3.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>355042</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU206</BillingCode>
            <Name>Low Profile Cancellous Bone Screws</Name>
            <Description>Low Profile Cancellous Bone Screws</Description>
            <Size>4mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU313</BillingCode>
            <Name>Low Profile Cancellous Screws, SS</Name>
            <Description>Cancellous Screws</Description>
            <Size>2.71mm-4.49mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW461</BillingCode>
            <Name>Memometal Anchorage Bone Screws</Name>
            <Description>Anchorage Locking Bone Screws</Description>
            <Size>3.0 - 3.5mm diameter to 10 - 40mm in length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW801</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR219</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve Ortholoc EPS System 3.5 NL Screws</Name>
            <Description>Stainless Steel, Cortical &amp; Cancellous Screws</Description>
            <Size>3.5mm diameter 10-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW814</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR241</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stainless Steel Screw</Name>
            <Description>Stainless steel plate screw, non locking</Description>
            <Size>2.7 &amp; 3.2 dia. 8-50mm length in 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW837</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR295</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION 3Di Plating System - Osteopenic Screws</Name>
            <Description>Osteopenic screws</Description>
            <Size>Diameter: 4.0mm  Length: 16, 18, 20, 22, 25, 30, 35, 40, 45, 50, 55, 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW904</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR381</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - 3.5/4mm Non Locking Screws</Name>
            <Description>Bone screws, Titanium, non locking</Description>
            <Size>Ø 3.5mm, length 8-50mm  Ø 4mm, length 8-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW955</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR445</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ORTHOLOC SPS Non-Locking Screws</Name>
            <Description>Stainless steel, cortical, non-locking screws</Description>
            <Size>Dia. 3.5mm  Length: 10mm - 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG066</BillingCode>
            <Name>Integra Total Wrist Fusion System</Name>
            <Description>Cortical Screw for use with the Integra Total Wrist Fusion Plates</Description>
            <Size>3.5mm diameter: 10-32mm length</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>176758</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG130</BillingCode>
            <Name>Spider Limited Wrist Fusion System - 2.8mm bone screws</Name>
            <Description>Stainless steel screws for Spider Plate</Description>
            <Size>Diameter 2.8mm, length 10-18mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>177622</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT008</BillingCode>
            <Name>Hawk Anterior Ankle Fusion Set</Name>
            <Description>3.5mm diameter screw set lengths 35mm to 110mm</Description>
            <Size>3.5mm x length 35mm to 110mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>191738</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD003</BillingCode>
            <Name>CarboFix Piccolo Plate Systems – Non-Locking Screws: Small</Name>
            <Description>Titanium alloy screws (non-locking) for fixation of CarboFix plate shaft and head.</Description>
            <Size>Non-Locking Distal Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 22.5mm, 25.0mm, 27.5mm, 30.0mm, 32.5mm, 35.0mm, 40.0mm, 45.0mm&#xD;
Non-Locking Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Lag Screws - Maxi, MMF, 3.0mm</Description>
            <Size>2.4mm x (8 - 42)mm; 2.4 x (12 - 18)mm; 3.0mm x (12 - 36)mm;</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT091</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH642</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin - Radial Plating System</Name>
            <Description>smartDrive Screw</Description>
            <Size>3.0 x 8-30mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>276650</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM146</BillingCode>
            <Name>TriMed Bone Screws</Name>
            <Description>Non-Locking Cortical Bone Screw</Description>
            <Size>3.2/3.8/4.0 x 10-60mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM279</BillingCode>
            <Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Cortical Screw</Name>
            <Description>Cortical Screw</Description>
            <Size>3.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>182168</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM290</BillingCode>
            <Name>NEOFIT - Screws</Name>
            <Description>NEOFIT screws</Description>
            <Size>2.7 &amp; 3.0mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM317</BillingCode>
            <Name>Skeletal Dynamics Bone Screw Non-Locking</Name>
            <Description>Non-Locking Cortical Bone Screws</Description>
            <Size>3.0mm, 3.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM326</BillingCode>
            <Name>Extremilock Screws</Name>
            <Description>Screws</Description>
            <Size>2.7mm - 4.49mm x 8-70mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>149435</ARTG>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM340</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Plate Fixation Bone Screws</Description>
            <Size>2.71 to 4.49mm diameter  All lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>338649</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM341</BillingCode>
            <Name>Bone Screws - Locking</Name>
            <Description>Locking</Description>
            <Size>2.71mm - 4.49mm diameter&#xD;
All lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM358</BillingCode>
            <Name>Hex Screw</Name>
            <Description>Hex plate fixation screw</Description>
            <Size>2.71 to 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>178232</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM380</BillingCode>
            <Name>Screw and Locking Cap</Name>
            <Description>Screw and Locking Cap</Description>
            <Size>2.71 to 4.49 mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM475</BillingCode>
            <Name>TriMed ASET Foot Plating System</Name>
            <Description>Non-Locking Cortical Bone Screws (Small)</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM503</BillingCode>
            <Name>Non-Locking Screws (Small)</Name>
            <Description>Non-Locking Screws (Small)</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM520</BillingCode>
            <Name>OMNI Plating System</Name>
            <Description>Non-Locking Screws</Description>
            <Size>2.71 - 4.49mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO321</BillingCode>
            <Name>Acumed Hexalobe Non Locking Screws</Name>
            <Description>Acumed Hexalobe Non Locking Screws</Description>
            <Size>3.0mm,3.5mm and 4.0mm diameter, 8-65mm length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO378</BillingCode>
            <Name>Acu-Loc Distal Radius Plate System</Name>
            <Description>Cortical Screw Locking</Description>
            <Size>3.5mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU185</BillingCode>
            <Name>PAO Cortical Screw Ø3.5</Name>
            <Description>Peri-Acetabular Osteotomy Cortical Screw</Description>
            <Size>Ø3.5 L 20-140 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>219907</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX010</BillingCode>
            <Name>MBOSS 3.5 mm Cortex Screw</Name>
            <Description>3.5 mm Cortex Screw, Self Tapping</Description>
            <Size>Diameter: 3.5mm&#xD;
Length: 10-150mm</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX012</BillingCode>
            <Name>MBOSS 4.0 mm Cancellous Screw</Name>
            <Description>4.0 mm Cancellous screw with short or long thread</Description>
            <Size>Diameter: 4mm&#xD;
Length: 10-100mm</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB021</BillingCode>
            <Name>Calcaneal Locking Plate MIPO System - Cortex, Cancellous and Non Locking Screw</Name>
            <Description>Cortex, Cancellous, Non locking Screws</Description>
            <Size>2.71mm - 4.49mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF120</BillingCode>
            <Name>Islay Locking screw</Name>
            <Description>FPS 3.5mm locking screw&#xD;
FPS GENII 3.5mm locking screw&#xD;
FPS 2.7mm locking screw&#xD;
FPS GENII 2.7mm locking screw</Description>
            <Size>10-50MM(FPS 3.5MM locking) &#xD;
8-30MM (FPS 2.7MM locking)</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK229</BillingCode>
            <Name>Omega Plus Compression Hip Screw System</Name>
            <Description>Cephalic Implants</Description>
            <Size>Hansson Twin Hook Compression Screw 25mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>94876</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK452</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Non-Locking Bone Screws (Small)</Description>
            <Size>2.7mm - 4.5mm Diameter 8mm - 150mm Length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>340042</ARTG>
                <ARTG>352530</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK631</BillingCode>
            <Name>Sbi Non-Locking Screws</Name>
            <Description>Titanium Cortical Non-Locking Self tapping screws</Description>
            <Size>2.7mm Cortical, Non Locking, Self-tapping 10 -30mm&#xD;
2.7mm Lag, Non Locking, self tapping 10 -30mm&#xD;
3.5mm Cortical, Non Locking,Self tapping 8 -20mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>167057</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL011</BillingCode>
            <Name>TC-100</Name>
            <Description>Cortical and Cancellous Screws</Description>
            <Size>2.71mm-4.49mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL012</BillingCode>
            <Name>Peri-Loc and Peri-Loc VLP</Name>
            <Description>Cortical and Osteopenia Screws</Description>
            <Size>2.71mm-4.49mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL091</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Bone Screws</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL190</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG063</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tibiaxys Distal tibia system</Name>
            <Description>Titanium screw for use with Tibiaxys distal tibia system</Description>
            <Size>4mm diameter with 6mm head; 40mm - 100mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ145</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Cortical, Cancellous, Self-tapping, Full Thread, Partial Thread, Standard, T15</Description>
            <Size>3.5-4.0mm Diameter&#xD;
10-70mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ176</BillingCode>
            <Name>PediFoot Deformity Correction System  </Name>
            <Description>3.5mm Cortical Screws</Description>
            <Size>8-60mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST006</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Cancelleous screws</Description>
            <Size>2.7-4.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY068</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Cortex, Conical, Cancellous, Compression Screws</Description>
            <Size>2.71mm-4.49mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN022</BillingCode>
            <Name>Newclip Bone Screws</Name>
            <Description>Non-Locking Bone Screws</Description>
            <Size>2.71mm – 4.49mm diameter, length 08-150 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA004</BillingCode>
            <Name>ALPS Plating System &amp; DVR Plating System</Name>
            <Description>Non-locking bone screw</Description>
            <Size>2.7-4.0mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>209305</ARTG>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI150</BillingCode>
            <Name>Periarticular Plates</Name>
            <Description>Periarticular 4.0mm Cancellous Screws - Stainless Steel</Description>
            <Size>Part thread - 30-60 mm, Full thread 30-110 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI152</BillingCode>
            <Name>Periarticular Plates</Name>
            <Description>3.5mm screws</Description>
            <Size>lengths up to 130mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI202</BillingCode>
            <Name>Zimmer ECT Screws</Name>
            <Description>3.5mm Cortical Screws</Description>
            <Size>10 - 130 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI203</BillingCode>
            <Name>Zimmer ECT Screws</Name>
            <Description>4.0mm Cancellous Screws</Description>
            <Size>10 - 60 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI892</BillingCode>
            <Name>NCB System</Name>
            <Description>NCB Screws</Description>
            <Size>4mm x 14-90mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>100337</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI940</BillingCode>
            <Name>Screws - Standard</Name>
            <Description>Standard Screws</Description>
            <Size>10 - 70mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>140687</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ070</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screw</Name>
            <Description>Cortical Bone Screw</Description>
            <Size>2.71mm – 4.49mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3370</SubGroupID>
            <ARTGs>
                <ARTG>239817</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER398</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screw, mini (2.01 – 2.7 mm), breakoff</Name>
            <Description>Paragon 28 Monster Bite screw, mini, snap-off, 1/2 threaded, Titanium</Description>
            <Size>dia 2.7mm x length (8-24 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW453</BillingCode>
            <Name>Fixos Screws</Name>
            <Description>Bone Fixation Screws, Double Threaded</Description>
            <Size>2.2mm diameter, 11 to 16mm (each 1mm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>149535</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW698</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Foot &amp; Ankle System</Name>
            <Description>Snap-off screws, titanium alloy</Description>
            <Size>2.0 dia 11, 12, 14mm. 2.7 dia 13, 15, 17mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
                <ARTG>198485</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW830</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR284</PriorBillingCode>
            </PriorBillingCodes>
            <Name>EOS Footset - Entos</Name>
            <Description>Footscrew</Description>
            <Size>11-14mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>214803</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW922</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR402</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix Snap-Off Screw</Name>
            <Description>The NexFix Snap-Off Screw System is a self-drilling and self-tapping screw system for fixation of fractures, fusions and osteotomies. The design allows the holding device to break off once the screw head is in contact with the distal cortex.</Description>
            <Size>2.0mm x 11mm, 2.0mm x 12mm, 2.0mm x 13mm, 2.7mm x 13mm, 2.7mm x 15mm, 2.7mm x 17 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>148960</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG105</BillingCode>
            <Name>Hallu Break-off screw</Name>
            <Description>Titanium with break-off barrel</Description>
            <Size>Diameter 2.7mm, Length 11-14mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM352</BillingCode>
            <Name>Snap Off Screws</Name>
            <Description>Snap Off Screws</Description>
            <Size>2.01 to 2.7mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB049</BillingCode>
            <Name>Break-Off Screws</Name>
            <Description>A self-breaking, self-drilling screw used for the fixation of small bone osteotomies and fractures</Description>
            <Size>Diameter 2.0mm, Length 10-20mm&#xD;
Diameter 2.7mm, Length 10-20mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF007</BillingCode>
            <Name>Forefoot Snap off Screws</Name>
            <Description>Titanium Alloy Screws with Snap-off Grip</Description>
            <Size>Weil self tapping L9 - L15</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>141164</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF117</BillingCode>
            <Name>Speyside TWIST-OFF SCREW</Name>
            <Description>11 mm TWIST-OFF SCREW2.5MM Cancellous thread&#xD;
12 mm TWIST-OFF SCREW2.5MM Cancellous thread&#xD;
13 mm TWIST-OFF SCREW2.5MM Cancellous thread&#xD;
14 mm TWIST-OFF SCREW2.5MM Cancellous thread&#xD;
15 mm TWIST-OFF SCREW2.5MM Cancellous thread&#xD;
17 mm TWIST-OFF SCREW2.5MM Cancellous thread&#xD;
TWIST-OFF SCREWS10mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS11mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS12mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS13mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS14mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS15mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS16mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS17mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS18mm (1.5mm Shank)&#xD;
TWIST-OFF SCREWS10, 11, 12, 13, 14, 15, 16, 17, 18mm</Description>
            <Size>10-18mm (1.5mm shank) 10-18mm, 11-17mm (cancellous thread)</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL224</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG133</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Snap-Off screws</Name>
            <Description>Titanium break-off barrel screws for Hallu-Fix</Description>
            <Size>Diameter 2.7mm; length 10-34mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>173932</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN039</BillingCode>
            <Name>Newclip Snap-off Screws</Name>
            <Description>Snap-off screws</Description>
            <Size>2.01 – 2.7 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI921</BillingCode>
            <Name>Twistoff Screws</Name>
            <Description>Twistoff Screws</Description>
            <Size>2.7mm x 8mm-24mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>295</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW457</BillingCode>
            <Name>Fixos Screws</Name>
            <Description>Bone Fixation Screws</Description>
            <Size>2mm diam. X11mm lenth to 2mm x 16mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>Breakoff, CN</Suffix>
            <ARTGs>
                <ARTG>149535</ARTG>
            </ARTGs>
            <MinimumBenefit>393</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP027</BillingCode>
            <Name>Tyber Medical Trauma headed screw</Name>
            <Description>Headed trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>2.5mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ044</BillingCode>
            <Name>Valens Hand - Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>2.7mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO115</BillingCode>
            <Name>APTUS headedCCS</Name>
            <Description>Headed Cannulated screws</Description>
            <Size>&gt;2.01mm-2.7mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER399</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, mini (2.01 – 2.7 mm), cannulated</Name>
            <Description>Paragon 28 Monster Screw System-Screws, mini, cannulated, partially or fully threaded</Description>
            <Size>dia 2.5mm x length (10-100 mm) x length of thread (3-100 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW818</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR246</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Headed Compression Screw System</Name>
            <Description>Cannulated compression screws - titanium or stainless steel</Description>
            <Size>2.0-2.7mm x 10-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW831</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR285</PriorBillingCode>
            </PriorBillingCodes>
            <Name>EOS Footset-Pyxis</Name>
            <Description>Footscrew</Description>
            <Size>11-28mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>291613</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW908</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR385</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxTorque Cannulated Screw System - Mini Cannulated Screws</Name>
            <Description>Bone screws, Titanium, Cannulated, Short or Long Thread</Description>
            <Size>Ø2.5mm Short Thread, Length 18-30mm  Ø2.5mm Long Thread, Length 10-30mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Screws - Cannulated Lag</Description>
            <Size>Diameter 2.01 – 2.7 mm</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM284</BillingCode>
            <Name>Bone Screw</Name>
            <Description>Bone Screw</Description>
            <Size>2.01-2.7mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM392</BillingCode>
            <Name>Cannulated Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>2.01 mm – 2.70 mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN970</BillingCode>
            <Name>Cannulated Screw</Name>
            <Description>Stainless Steel</Description>
            <Size>2.01mm - 2.7mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ175</BillingCode>
            <Name>Cannulated Screws</Name>
            <Description>Cannulated, Short, Medium, Full Thread</Description>
            <Size>2.5mm Diameter 8-30mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR095</BillingCode>
            <Name>Stryker Cannulated Screw System</Name>
            <Description>Asnis Micro Cannulated Screw</Description>
            <Size>2.01mm-2.7mm, Diameters, 8mm-40mm lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>155633</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY321</BillingCode>
            <Name>AO/ASIF Screw</Name>
            <Description>Cannulated screw</Description>
            <Size>2.4mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN049</BillingCode>
            <Name>Screws 2.01 - 2.7 CN</Name>
            <Description>Mini screws 2.01-2.7  CN</Description>
            <Size>2.01mm – 2.7mm diameter, length 14-50 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>179</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH241</BillingCode>
            <Name>Headless Compression Screws</Name>
            <Description>Headless Compression Screws</Description>
            <Size>2.5mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>209305</ARTG>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP028</BillingCode>
            <Name>Tyber Medical Trauma headless screw</Name>
            <Description>Headless trauma screw for compression and fixation of bone Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>2.5mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU010</BillingCode>
            <Name>Nexis osteosynthesis screws</Name>
            <Description>Bone screw titanium alloy (compressive)</Description>
            <Size>Diameter 2.3mm, Length 10-30mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>235765</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU018</BillingCode>
            <Name>MAGNEZIX CS 2.7</Name>
            <Description>Compression screw for bone fixation.</Description>
            <Size>Diameter 2.7mm&#xD;
Length 10 - 34mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>283491</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ070</BillingCode>
            <Name>Austofix Cannulated Compression Screws</Name>
            <Description>2.4mm Headless Cannulated Compression Screws</Description>
            <Size>2.4mm diameter&#xD;
10-30mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO057</BillingCode>
            <Name>Aptus CCS</Name>
            <Description>2.01 - 2.7 Cannulated Compression Screw</Description>
            <Size>(2.01 – 2.7 mm) diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HJ002</BillingCode>
            <Name>Surgifeet Cannulated Compression Screw</Name>
            <Description>Compression screw. Cannulated, Dual thread, self drilling/tapping, Headless</Description>
            <Size>Diameter 2.55mm. Length 10-34mm, Left or Right thread.</Size>
            <SupplierCode>HJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>336654</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HJ005</BillingCode>
            <Name>MICRO HBS Self-Drilled High Compression Screw</Name>
            <Description>Micro headless compression screw, cannulated, dual threads, self-drilling, self- tapping, </Description>
            <Size>Distal thread Diameter 2.5mm, Length 10-30mm</Size>
            <SupplierCode>HJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>340314</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU152</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE479</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Headless Compression Screw System</Name>
            <Description>Headless Compression Screw for bone fixation</Description>
            <Size>2.5mm Diameter x (8-34mm Length)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>350672</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU159</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE465</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Compression FT</Name>
            <Description>Headless Compression Screw for bone fixation</Description>
            <Size>2.5mm x 8-50mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW454</BillingCode>
            <Name>Fixos Screws, Cannulated, Double Threaded, 2.5mm</Name>
            <Description>Done Fixation Screws, Cannulated Threaded, 2.5mm</Description>
            <Size>2.5mm  diameter, 10 to 30 (each 2mm)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>149535</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW916</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR396</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix 2.5mm Compression Screw</Name>
            <Description>The NexFix Compression Screw is a stainless steel, cannulated, self tapping, and self drilling fixation device for osteotomies, fusions and fracture fixation of small bones</Description>
            <Size>2.5mm diameter x 10 - 34mm length in 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>291613</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG121</BillingCode>
            <Name>BOLD 2.5mm Compression Screw</Name>
            <Description>Cannulated, double threaded compression screw</Description>
            <Size>Diameter 2.5mm, length 10-30mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT036</BillingCode>
            <Name>Integrant 2.5 mm Screw</Name>
            <Description>2.5 mm Cannulated Screw</Description>
            <Size>8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36 mm lengths</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>230954</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ExtremiFix Screws</Name>
            <Description>Headless Cannulated Compression Screw</Description>
            <Size>Diameter 2.0mm, 2.4mm. Length 10mm to 52mm; Diameter 2.01mm - 2.7mm</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC062</BillingCode>
            <Name>HVS BONE SCREW</Name>
            <Description>Self drilling, self threading double threaded cannulated screw</Description>
            <Size>Length 10-34mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>173930</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM283</BillingCode>
            <Name>IBS Screw</Name>
            <Description>Compression Screw</Description>
            <Size>2.5mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM314</BillingCode>
            <Name>Headless Compression Screws</Name>
            <Description>Compression Screws</Description>
            <Size>2.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>279795</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM327</BillingCode>
            <Name>Osteomed Screws</Name>
            <Description>Cannulated Compression Screws</Description>
            <Size>Diameter 2.0mm, 2.4mm and 2.7mm. Length 6mm to 52mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM348</BillingCode>
            <Name>Orthopaedic Fixation Screw</Name>
            <Description>Fixation Screw</Description>
            <Size>2.01 to 2.7mm all lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM396</BillingCode>
            <Name>Headless Compression Screw</Name>
            <Description>Headless Compression Screw</Description>
            <Size>2.01 – 2.7 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO356</BillingCode>
            <Name>Acutrak 2</Name>
            <Description>Headless compression screw</Description>
            <Size>2.5mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH475</BillingCode>
            <Name>DynafitSystem</Name>
            <Description>Self-compressive screws</Description>
            <Size>2.6mm x 10-40mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>216161</ARTG>
                <ARTG>216162</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB042</BillingCode>
            <Name>Compression Screws</Name>
            <Description>Headless Compression Screws</Description>
            <Size>2.4mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF088</BillingCode>
            <Name>Speyside HVS Bone Screw</Name>
            <Description>Self drilling, self threading double threaded cannulated screw</Description>
            <Size>Length 10-34mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF122</BillingCode>
            <Name>2.5 mm Speyside B Screw</Name>
            <Description>Speyside B Screw</Description>
            <Size>2.5mm length 10 up to 2.5mm length 26mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK620</BillingCode>
            <Name>AutoFIX</Name>
            <Description>The SBi AutoFIX Twin Pitch Cannulated Compression Screw System implants are indicated in the treatment of fractures, nonunions, pseudarthrosis and degenerative changes, as well as corrective osteotomies geared towards a functionally stable osteosynthesis</Description>
            <Size>2.0mm and 2.5mm Cannulated Compression Screw</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>119660</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY646</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>HCS Countersinkable Compression Screw</Description>
            <Size>2.01mm-2.7mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN018</BillingCode>
            <Name>Newclip Compression Screws</Name>
            <Description>Self-Compressive Cannulated Screws</Description>
            <Size>2.01mm - 2.7mm diameter, length 10 - 38mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER400</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, mini (2.01 – 2.7 mm), cannulated, dual thread, locking</Name>
            <Description>Paragon 28 Monster Screw System-screws, mini, cannulated, dual thread, locking, headless, partially threaded, Titanium</Description>
            <Size>dia 2.5 mm x length (8-100 mm) x length of thread (3-32 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER547</BillingCode>
            <Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), variable angle locking, cannulated, dual thread</Name>
            <Description>variable angle locking screw, cannulated, dual thread</Description>
            <Size>dia 2.4 mm x lenght (12-40 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>337240</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM132</BillingCode>
            <Name>TriMed Compression Screws</Name>
            <Description>Compression Screws</Description>
            <Size>2.0mm – 2.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>229704</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM312</BillingCode>
            <Name>Skeletal Dynamics Peg High Compression Locking</Name>
            <Description>High Compression Locking Peg</Description>
            <Size>2.7mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO437</BillingCode>
            <Name>Acu-Loc Distal Radius Plating System</Name>
            <Description>Frag-Loc Cannulated Compression Screw with Compression Sleeve</Description>
            <Size>Standard 16mm to 24mm,Long 20mm to 28mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN068</BillingCode>
            <Name>Cannulated Locking Screws</Name>
            <Description>Cannulated Locking Screws</Description>
            <Size>2.01 – 2.7 mm diameter</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>CN,LK</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO373</BillingCode>
            <Name>Acutrak fusion Screws</Name>
            <Description>Fusion Screws Titanium</Description>
            <Size>2.01mm - 2.7mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>247</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH476</BillingCode>
            <Name>DynafitSystem</Name>
            <Description>Compressive Screws</Description>
            <Size>2.4/2.6mm - 10x40mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>216161</ARTG>
                <ARTG>216162</ARTG>
            </ARTGs>
            <MinimumBenefit>247</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI179</BillingCode>
            <Name>Zimmer Herbert/Whipple Bone Screw</Name>
            <Description>Cannulated Double Threaded Compression Bone Screw</Description>
            <Size>12 mm - 30 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>247</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO073</BillingCode>
            <Name>APTUS Screws</Name>
            <Description>Aptus Locking Screws</Description>
            <Size>2.5mm Diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>141171</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT080</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH515</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand fracture system - multidirectional screw</Name>
            <Description>Multidirectional screw</Description>
            <Size>2.3mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>276650</ARTG>
            </ARTGs>
            <MinimumBenefit>223</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI929</BillingCode>
            <Name>RibFix/Sternalock</Name>
            <Description>Screws Ti</Description>
            <Size>2.4-2.7mm x 7-20mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU029</BillingCode>
            <Name>CentroLock Screws</Name>
            <Description>CentroLock Screw System</Description>
            <Size>smaller than 2.7mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>235767</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ010</BillingCode>
            <Name>VRP Distal Radius Fixation System</Name>
            <Description>VRP Distal Radius Fixation System, Variable Angle, Threaded, non-threaded, partially threaded locking, non-locking screw, peg, titanium</Description>
            <Size>2.5-2.7mm diameter, 10-34mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>149433</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ026</BillingCode>
            <Name>VRP Distal Radius Fixation System - VRP VA locking Screw</Name>
            <Description>Variable Angle Locking Screw, Cobalt Chrome</Description>
            <Size>2.5mm, 10-30mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>149433</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ043</BillingCode>
            <Name>Mini Fragment - Screws</Name>
            <Description>Locking Screws</Description>
            <Size>2.4mm, 2.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ046</BillingCode>
            <Name>Valetis Screws</Name>
            <Description>Titanium Locking Screws</Description>
            <Size>2.7mm width, 6-28mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ054</BillingCode>
            <Name>Valens Shoulder and Elbow - Screws</Name>
            <Description>Self-Tapping Locking Screws</Description>
            <Size>2.4mm, 2.7mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ074</BillingCode>
            <Name>Austofix PHP - Proximal Humeral Plating System</Name>
            <Description>Locking Screws</Description>
            <Size>2.7mm diameter, 16-70mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ091</BillingCode>
            <Name>Foot &amp; Ankle VA Locking Screw</Name>
            <Description>2.7 Variable Angle Locking Screw</Description>
            <Size>2.7mm diameter, 10-50mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER426</BillingCode>
            <Name>Paragon 28 Gorilla Plating System-Screws, mini</Name>
            <Description>Paragon 28 Gorilla Plating System-Screws, mini, locking; recon/Tuffneck/baby</Description>
            <Size>dia (2.5-2.7 mm) x length (8-50 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER560</BillingCode>
            <Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), variable angle locking</Name>
            <Description>Variable angle locking screws, fully or partially threaded</Description>
            <Size>dia (2.4-2.7 mm) x length (8-40 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>337240</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW039</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Mini Bone Screw Systems</Description>
            <Size>Mini (2.01 – 2.7 mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU145</BillingCode>
            <Name>Low Profile Locking Screws</Name>
            <Description>Locking screws for Arthrex Fracture Plate Fixation</Description>
            <Size>2.01mm to 2.7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU298</BillingCode>
            <Name>KreuLock Locking Compression Screws, Ti</Name>
            <Description>Locking Compression Screws</Description>
            <Size>2.4mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU315</BillingCode>
            <Name>KreuLock Locking Compression Screws SS</Name>
            <Description>Locking Compression Screw</Description>
            <Size>2.7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW795</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR081</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ortholoc Fracture System</Name>
            <Description>Titanium, variable angle locking screws</Description>
            <Size>2.4, 2.7mm diameter, 8-100mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW815</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR243</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Claw Locking Screws</Name>
            <Description>2.7mm stainless steel locking screws for use with Claw Plate</Description>
            <Size>2.7mm, 12-36mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW901</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR377</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mini MaxLock Extreme System - 2.4/2.7mm Locking Screws</Name>
            <Description>Bone screws, Titanium, fixed or variable angle locking</Description>
            <Size>Ø2.4/2.7mm Fixed angle locking, Length 6-40mm  Ø2.4mm Variable angle locking, Length 6-30mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW977</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR227</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Titanium Screw</Name>
            <Description>Locking, non-locking or cannulated, for use only with Darco titanium plates, self-tapping</Description>
            <Size>8-40mm, 2.7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD007</BillingCode>
            <Name>CarboFix Piccolo Plate Systems – Locking Screws: Mini</Name>
            <Description>Titanium alloy screws (locking) for fixation of CarboFix plate shaft and head.</Description>
            <Size>Locking Proximal Screw 2.5mm x 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm&#xD;&#xD;
Locking Screw 2.7mm x 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV008</BillingCode>
            <Name>SternalPlate Closure System - Screws   </Name>
            <Description>Titanium Sternal Fixation System</Description>
            <Size>2.3mm  2.7mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>386783</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT088</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH639</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin - Radial Plating Sysem</Name>
            <Description>smartDrive Locking Screw</Description>
            <Size>2.5 x 8-30mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>276650</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT089</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH640</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin - Radial Plating Sysem</Name>
            <Description>smartDrive Locking Screws</Description>
            <Size>3.0 x 8-30mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276650</ARTG>
                <ARTG>276674</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM061</BillingCode>
            <Name>Xpode Screws</Name>
            <Description>Xpode screws</Description>
            <Size>2.4mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM112</BillingCode>
            <Name>Ascension Radial Head Plate Screws</Name>
            <Description>Ascension Radial Head Plate Locking Screws</Description>
            <Size>2.7mm x 10mm - 40mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>118625</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM185</BillingCode>
            <Name>Trimed Locking Cortical Screws</Name>
            <Description>Locking cortical screw</Description>
            <Size>2.01 to 2.7mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM313</BillingCode>
            <Name>Volar Bearing Plate Screws</Name>
            <Description>Volar Bearing Plate Screws</Description>
            <Size>2.5mm x 10mm-30mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM320</BillingCode>
            <Name>Screws</Name>
            <Description>Screws, Locking</Description>
            <Size>2.01 to 2.7mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM324</BillingCode>
            <Name>Osteomed Screws</Name>
            <Description>Bone Screws</Description>
            <Size>2- 2.7m x 6-38mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM345</BillingCode>
            <Name>Orthopaedic Plate Fixation Screw</Name>
            <Description>Orthopaedic Plate Fixation Screw</Description>
            <Size>2.01 to 2.7 mm diameter&#xD;
all lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM353</BillingCode>
            <Name>Locking Screws</Name>
            <Description>Locking Screws</Description>
            <Size>2.7mm diameter, multiple lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM476</BillingCode>
            <Name>TriMed ASET Foot Plating System </Name>
            <Description>VA Locking Screw (Mini)</Description>
            <Size>2.01 – 2.7 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO320</BillingCode>
            <Name>Acumed Hexalobe Locking Screws</Name>
            <Description>Acumed Hexalobe Locking Screws</Description>
            <Size>2.7mm diameter, 8-65mm length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO369</BillingCode>
            <Name>Acumed Tap-Loc</Name>
            <Description>Tap screws, Tap-Loc Screws</Description>
            <Size>2.7mm 36mm-60mm length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO376</BillingCode>
            <Name>Acu-Loc Distal Radius Plate System</Name>
            <Description>Locking screws</Description>
            <Size>2.01-2.7mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO394</BillingCode>
            <Name>RibLoc rib fracture plating system screws</Name>
            <Description>RibLoc Screws</Description>
            <Size>Mini 2.01-2.7mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>158694</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO421</BillingCode>
            <Name>ACUMED Hexalobe 2.3mm Multiscrews</Name>
            <Description>ACUMED Hexalobe 2.3 Multiscrew</Description>
            <Size>2.3mm in diameter, 5mm to 20mm in length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO435</BillingCode>
            <Name>RibLoc Dual Locking Screw</Name>
            <Description>Locking Screws</Description>
            <Size>2.7mm diameter,6mm to 14mm length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>158694</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX028</BillingCode>
            <Name>ARMAR 2.4 Locking Distal Radial Plate System - Self Tapping Locking Screws</Name>
            <Description>TAN Self Tapping Locking Screws</Description>
            <Size>2.4-2.7mm Diameter&#xD;
6-60mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB020</BillingCode>
            <Name>Calcaneal Locking Plate MIPO System - Locking Screw</Name>
            <Description>Locking Screws</Description>
            <Size>Mini (2.01mm-2.7mm)</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK527</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Locking Screws</Description>
            <Size>2.01-2.7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
                <ARTG>340043</ARTG>
                <ARTG>340044</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL030</BillingCode>
            <Name>D-RAD SMART PACK</Name>
            <Description>VAL Locking screws 2.01mm - 2.7mm</Description>
            <Size>2.01mm - 2.7mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL042</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>VAL Locking Screws</Description>
            <Size>Mini Screws (2.01 – 2.7 mm)</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL221</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG126</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Surfix Locking Screws</Name>
            <Description>Locking screws with an independent lock-screw head</Description>
            <Size>2.7mm, 10 - 24mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN968</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Locking screws</Description>
            <Size>2.01mm - 2.7mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN969</BillingCode>
            <Name>Peri-Loc VLP</Name>
            <Description>VAL Locking Screws 2.01mm - 2.7mm</Description>
            <Size>2.01mm - 2.7mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ147</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Cortical, Locking, Self-tapping, Standard, T10,</Description>
            <Size>2.7mm Diameter&#xD;
5-60mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ179</BillingCode>
            <Name>PediFoot Deformity Correction System</Name>
            <Description>2.7mm Variable Angle Locking Screws</Description>
            <Size>6-60mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY651</BillingCode>
            <Name>AO/ASIF Cortex Screws</Name>
            <Description>Locking Head Screws</Description>
            <Size>2.4mm-2.7mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN041</BillingCode>
            <Name>Newclip Locking Bone Screws</Name>
            <Description>Locking Bone Screw</Description>
            <Size>2.01 - 2.7mm diameter, lengths 8 - 34mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA007</BillingCode>
            <Name>ALPS Plating System, DVR Plating System &amp; F3 Plating System</Name>
            <Description>Locking titanium and multidirectional bone screws</Description>
            <Size>2.2-2.7mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>209305</ARTG>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA105</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tritium SCP (Sternao Cable Plate), Standard Screw</Name>
            <Description>Cannullous Locking Screw for use with Pioneer Tritium SCP (Sternal Cable Plate), 2.7mm</Description>
            <Size>"Diamter: 2.7mm  Lengths: 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm"</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI201</BillingCode>
            <Name>Zimmer Cortical Screws</Name>
            <Description>Cortical Screws</Description>
            <Size>6 - 50mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ077</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arix Locking Screw</Name>
            <Description>Locking Screw</Description>
            <Size>2.01 – 2.7 mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>239817</ARTG>
            </ARTGs>
            <MinimumBenefit>120</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE149</BillingCode>
            <Name>ASDM Clavicle Plating System - Screws</Name>
            <Description>Fixation Device, Internal, Non-locking, Stainless Steel, Cortical Screw Size: 2.7mm</Description>
            <Size>2.7mm Low-profile cortex screws, 10-30mm (2mm increments)</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>134456</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI768</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>Screw, IMF 2./2.4 Mandibular Fracture, Titanium</Description>
            <Size>2.0 x(5 - 13)mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ093</BillingCode>
            <Name>Foot &amp; Ankle Cortex Screw</Name>
            <Description>2.7 Cortex Screw</Description>
            <Size>2.7mm diameter, 10-30mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>284755</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ096</BillingCode>
            <Name>Mini Fragment Screws</Name>
            <Description>Cortex/Cancellous Screws</Description>
            <Size>2.4mm diameter,   6mm-60mm length </Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO076</BillingCode>
            <Name>APTUS Screws</Name>
            <Description>Cortical Screws</Description>
            <Size>2.3mm - 2.5mm Diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>141171</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER397</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, mini (2.01 – 2.7 mm)</Name>
            <Description>Paragon 28 Monster Screw System-Screws, mini, headed, with or without a blunt tip, recon/Tuffneck, Titanium</Description>
            <Size>dia (2.5-2.7 mm) x length (10-100 mm) x length of thread (3-100 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER559</BillingCode>
            <Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), standard </Name>
            <Description>Cortex screw</Description>
            <Size>dia (2.4-2.7 mm) x lenth (8-40 mm) </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>337240</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW008</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Mini Bone Screw Systems</Description>
            <Size>Mini (2.01 – 2.7 mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU146</BillingCode>
            <Name>Cortical Screw</Name>
            <Description>Screw for Bone fixation</Description>
            <Size>2.01-2.7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU147</BillingCode>
            <Name>Cortex Screw</Name>
            <Description>Cortical Screw</Description>
            <Size>2.4mm x (08-34mm)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW822</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR255</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve EPS System Non-Locking</Name>
            <Description>Stainless Steel Cortical Screws</Description>
            <Size>2.5 - 2.7mm Diameter, 10-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW903</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR380</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System - 2.4/2.7mm Non locking screws</Name>
            <Description>Bone screws, Titanium, Non locking</Description>
            <Size>Ø 2.4/2.7mm, length 6-40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG065</BillingCode>
            <Name> Integra Total Wrist Fusion System - Cortical Screw</Name>
            <Description>Cortical screw for use with the integra Total Wrist Fusion Plates</Description>
            <Size>2.7mm diameter: 10-32mm length</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>176758</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG129</BillingCode>
            <Name>Spider Limited Wrist Fusion System - 2.4mm bone screws</Name>
            <Description>Stainless steel screws for Spider plate</Description>
            <Size>Diameter 2.4mm, length 8-14mm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>177622</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JD002</BillingCode>
            <Name>CarboFix Piccolo Plate Systems – Non-Locking Screws: Mini</Name>
            <Description>Titanium alloy screws (non-locking) for fixation of CarboFix plate shaft and head.</Description>
            <Size>Non-Locking Proximal Screw 2.5mm x 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm&#xD;&#xD;
Non-Locking Screw 2.7mm x 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm</Size>
            <SupplierCode>JD</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>222648</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT082</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH518</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand fracture system - standard screw</Name>
            <Description>Standard screw</Description>
            <Size>2.3mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>276650</ARTG>
                <ARTG>276674</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT090</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH641</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin - Radial Plating System</Name>
            <Description>smartDrive Screw</Description>
            <Size>2.5 x 8-30mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>276650</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM111</BillingCode>
            <Name>Ascension Radial Head Plate Screws</Name>
            <Description>Ascension radial Head Plate Non-Locking Screws</Description>
            <Size>2.7mm x 10-26mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>118625</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM144</BillingCode>
            <Name>TriMed Bone Screw</Name>
            <Description>Non-Locking Cortical Bone Screws</Description>
            <Size>2.3mm x 7mm - 32mm&#xD;
2.7mm x 8mm - 28mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM319</BillingCode>
            <Name>Screws</Name>
            <Description>Non Locking</Description>
            <Size>2.01 - 2.7mm diameter&#xD;
all lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM325</BillingCode>
            <Name>Osteomed Screws</Name>
            <Description>Bone Screw standard and threaded/lag.</Description>
            <Size>2.01-2.7mm x 4-50mm.</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM344</BillingCode>
            <Name>Orthopaedic Plate Fixation Screw</Name>
            <Description>Orthopaedic Plate Fixation Screw</Description>
            <Size>2.01 to 2.7mm diameter&#xD;
All lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM354</BillingCode>
            <Name>Non-Locking Screws</Name>
            <Description>Non-Locking Screws</Description>
            <Size>2.7mm diameter, multiple lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM474</BillingCode>
            <Name>TriMed ASET Foot Plating System </Name>
            <Description>Cortical Bone Screws (mini)</Description>
            <Size>2.01 to 2.7mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO323</BillingCode>
            <Name>Acumed Hexalobe Non Locking Screws</Name>
            <Description>Acumed Hexalobe Non Locking Screws</Description>
            <Size>2.7mm diameter,8-65mm length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO375</BillingCode>
            <Name>Acu-Loc Distal Radius Plate System</Name>
            <Description>Threaded, non-threaded,locking, non-locking screw peg, titanium</Description>
            <Size>2.3 mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO423</BillingCode>
            <Name>ACUMED Hexalobe 2.3mm Lag screw</Name>
            <Description>ACUMED Hexalobe 2.3mm Lag screw</Description>
            <Size>2.3mm in diameter, 5mm to 20mm in length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX029</BillingCode>
            <Name>ARMAR 2.4 Locking Distal Radial Plate System - Cortex and Compression Screws</Name>
            <Description>TAN Cortex and Compression Screws</Description>
            <Size>2.4-2.7mm Diameter&#xD;
6-60mm Length</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>286843</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB033</BillingCode>
            <Name>Mini Locking System - Cortex Screw, Stardrive, Self-tapping</Name>
            <Description>Cortex Screws, Stardrive, Self-tapping</Description>
            <Size>6.-30mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK103</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Cortical bone screws</Description>
            <Size>2.01-2.7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>269713</ARTG>
                <ARTG>295226</ARTG>
                <ARTG>340043</ARTG>
                <ARTG>340044</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK599</BillingCode>
            <Name>Carpal Screw</Name>
            <Description>Titanium</Description>
            <Size>2.5mm diameter in sizes 12mm - 20mm length</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>167057</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK618</BillingCode>
            <Name>Percufix</Name>
            <Description>Titanium</Description>
            <Size>Diameter: 2-2.5mm, Length 22-40mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>252452</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL028</BillingCode>
            <Name>D-RAD SMART PACK</Name>
            <Description>Cortical screws</Description>
            <Size>2.01 mm - 2.7 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL045</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>VAL Cortical Screws</Description>
            <Size>Mini Screws (2.01 – 2.7 mm)</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN082</BillingCode>
            <Name>TC 100 </Name>
            <Description>Cortical Screws</Description>
            <Size>2.01mm - 2.7mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN833</BillingCode>
            <Name>Peri-Loc &amp; Peri-Loc VLP</Name>
            <Description>Cortical Screws</Description>
            <Size>2.01-2.7mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ148</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Cortical Screw, Self-tapping, Standard, T10</Description>
            <Size>2.7mm Diameter&#xD;
5-60mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ180</BillingCode>
            <Name>PediFoot Deformity Correction System  </Name>
            <Description>2.7mm Cortical Screw</Description>
            <Size>6-60mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY352</BillingCode>
            <Name>A/ASIF Screw</Name>
            <Description>Cortex, Cancellous, Compression Screws</Description>
            <Size>2.01mm-2.7mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN036</BillingCode>
            <Name>Newclip Bone Screws</Name>
            <Description>Non-locking Bone Screw</Description>
            <Size>2.01-2.7mm diameter, lengths 8 - 34mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA006</BillingCode>
            <Name>ALPS Plating System, DVR Plating System &amp; F3 Plating System</Name>
            <Description>Non-locking bone screw</Description>
            <Size>2.01-2.7mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>209305</ARTG>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ078</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screw</Name>
            <Description>Cortical Bone Screw</Description>
            <Size>2.01mm – 2.7mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3371</SubGroupID>
            <ARTGs>
                <ARTG>239817</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH193</BillingCode>
            <Name>Twistoff Screw</Name>
            <Description>TwistOff Screw Titanium</Description>
            <Size>8-15mm Long</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>210290</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU001</BillingCode>
            <Name>Nexis osteosynthesis screws</Name>
            <Description>Bone screw titanium alloy snap off</Description>
            <Size>Diameter 2mm, Length 11-16mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>235767</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER402</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm), breakoff</Name>
            <Description>Paragon 28 Monster Bite Screws, micro (≤ 2.0mm), snap-off, 1/2 or 3/4 threaded</Description>
            <Size>dia 2.0 mm x length (8-24 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HJ001</BillingCode>
            <Name>Surgifeet Weil Screw</Name>
            <Description>Snap off screw , self drilling, self tapping.</Description>
            <Size>Diameter 2mm  Length 11-15mm</Size>
            <SupplierCode>HJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>336654</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HJ004</BillingCode>
            <Name>Snap-off Type II Screw</Name>
            <Description>Snap-off screw, self-drilling, self-tapping, conical thread</Description>
            <Size>Diameter 2mm. Length 10-17mm</Size>
            <SupplierCode>HJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>340314</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU207</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE364</PriorBillingCode>
            </PriorBillingCodes>
            <Name>QuickFix Screw Micro</Name>
            <Description>Titanium Snap-off Small Bone Screw</Description>
            <Size>2.0mm Diameter x 10-14mm lengths</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>350871</ARTG>
                <ARTG>351000</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW806</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR229</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Twist-off Screw</Name>
            <Description>Unique feature of two thread diameters to suit variable bone quality, specifically designed for Weil-osteotomy, titanium, self drilling and self tapping, twist-off connector.</Description>
            <Size>2.0mm diameter x 11-15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>291613</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT013</BillingCode>
            <Name>Hawk 2.0mm Twist off Screw</Name>
            <Description>2.0mm Twist off Screw</Description>
            <Size>2.0mm in diameter with lengths of 11mm to 20mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>230954</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN262</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Quick Insertion Screws, Twist-Off</Description>
            <Size>2.0mm x 11-18mm lengths</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF091</BillingCode>
            <Name>Speyside Self Breaking Screw - Micro</Name>
            <Description>Speyside Self Breaking Screw - Micro</Description>
            <Size>Dia 2.0 mm x Length 7-24 mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL226</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG135</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spin screw: Snap-off screws</Name>
            <Description>Titanium break-off barrel screws</Description>
            <Size>Diameter 2.0 mm, Length 11 -14mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>173963</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM172</BillingCode>
            <Name>Smith and Nephew QFX Screw</Name>
            <Description>2.0mm Twist-Off Screw</Description>
            <Size>2.0mm Twist-Off Screw 8mm, 2.0mm Twist-Off Screw 10mm, 2.0mm Twist-Off Screw 12mm, 2.0mm Twist-Off Screw 14mm, 2.0mm Twist-Off Screw 16mm, 2.0mm Twist-Off Screw 18mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO090</BillingCode>
            <Name>APTUS SpeedTip C-Snap System</Name>
            <Description>APTUS SpeedTip C-Snap Screws</Description>
            <Size>2.0mm diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff, DT</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>414</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO367</BillingCode>
            <Name>Acumed Fixation Screw</Name>
            <Description>Acutrak Compression Screw Titanium</Description>
            <Size>≤2mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff, DT</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>414</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH545</BillingCode>
            <Name>Dynafit System</Name>
            <Description>Snap Off, Compressive Screws</Description>
            <Size>2.0mm x 10-14mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>Breakoff, DT</Suffix>
            <ARTGs>
                <ARTG>216161</ARTG>
                <ARTG>216162</ARTG>
            </ARTGs>
            <MinimumBenefit>414</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP036</BillingCode>
            <Name>Tyber Medical Trauma headed screw</Name>
            <Description>Trauma headed screw for compression and fixation of bone Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>2.00MM</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO113</BillingCode>
            <Name>APTUS CCS</Name>
            <Description>Cannulated Screws</Description>
            <Size>Diameter ≤ 2.0mm  Length 6.0mm to 20.0mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER403</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm), cannulated</Name>
            <Description>Paragon 28 Monster Screw System-screws, micro, cannulated, headed</Description>
            <Size>dia 2.0 mm x length (8-100mm) x length of thread (3-100 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM281</BillingCode>
            <Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Cross Element Screw</Name>
            <Description>Cross Element Screw</Description>
            <Size>1.9 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>182168</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM398</BillingCode>
            <Name>Cannulated Screws</Name>
            <Description>Cannulated Screws</Description>
            <Size>2.0mm diameter and smaller</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP035</BillingCode>
            <Name>Tyber Medical Trauma Headless screw</Name>
            <Description>Headless trauma screw for compression and fixation of bone Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>2.0mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU017</BillingCode>
            <Name>MAGNEZIX CS 2.0</Name>
            <Description>Absorbable compression screw.</Description>
            <Size>Diameter 2.0mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>283491</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ069</BillingCode>
            <Name>Austofix Cannulated Compression Screws</Name>
            <Description>1.7mm Cannulated Headless Compression Screws</Description>
            <Size>1.7mm diameter&#xD;
6mm to 14mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT074</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH481</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HBS 2 mini</Name>
            <Description>Self-compressive screws</Description>
            <Size>Diam: 1.7 - 2.0mm  Length: 10 - 40mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>276650</ARTG>
                <ARTG>276674</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM258</BillingCode>
            <Name>Bone Screws - cannulated</Name>
            <Description>Screws - cannulated</Description>
            <Size>2.0mm x 6.0-36.0mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>202320</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM282</BillingCode>
            <Name>IBS Screw</Name>
            <Description>Compression Screw</Description>
            <Size>2mm diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM371</BillingCode>
            <Name>Orthopaedic Fixation Screw</Name>
            <Description>Fixation Screw</Description>
            <Size>2.0mm or less diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>266217</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM393</BillingCode>
            <Name>Headless Compression Screws</Name>
            <Description>Headless Compression Screws</Description>
            <Size>2.0mm or smaller diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>329613</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB035</BillingCode>
            <Name>Mini Locking System - Headless Compression Screw</Name>
            <Description>Compression Screws</Description>
            <Size>1.5mm &amp; 2mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY647</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>HCS Countersinkable Compression Screw</Description>
            <Size>≤ 2.0mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN015</BillingCode>
            <Name>Foot Motion - weil screws</Name>
            <Description>Weil screw is a titanium self tapping, self-cutting screw</Description>
            <Size>2.0mm diameter, length 8mm - 15mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>346</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER404</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm), cannulated, dual thread, locking</Name>
            <Description>Paragon 28 Monster micro screws, cannulated, dual thread, locking, headless, partially threaded</Description>
            <Size>dia 2.0 mm x length (8-100 mm) x length of thread (3mm-32 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM131</BillingCode>
            <Name>TriMed Compression Screws</Name>
            <Description>Compression screws</Description>
            <Size>1.7mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>CN,DT,LK</Suffix>
            <ARTGs>
                <ARTG>229704</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO091</BillingCode>
            <Name>APTUS SpeedTip C System</Name>
            <Description>APTUS SpeedTip C Screws</Description>
            <Size>2.0mm diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW919</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR399</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix Compression Pin</Name>
            <Description>The NexFix Compression Pin is a tapered stainless steel compression pin for use in maintaining alignment and providing interfragmentary compression of small bones in osteotomies, fusions and fractures until a stable bony union occurs. It is self drilling </Description>
            <Size>2.0mm x 10mm, 2.0mm x 12mm, 2.0mm x 14mm, 2.0mm x 16mm, 2.7mm x 20mm, 2.7mm x 24mm, 3.5mm x 25mm, 3.5mm x 30mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>132072</ARTG>
            </ARTGs>
            <MinimumBenefit>209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH544</BillingCode>
            <Name>Dynafit System</Name>
            <Description>Compressive Screw</Description>
            <Size>2.0mm x 10-14mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>DT</Suffix>
            <ARTGs>
                <ARTG>216161</ARTG>
                <ARTG>216162</ARTG>
            </ARTGs>
            <MinimumBenefit>209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO072</BillingCode>
            <Name>APTUS Screws</Name>
            <Description>Aptus Locking Screws</Description>
            <Size>1.5mm - 2.0mm Diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>141171</ARTG>
            </ARTGs>
            <MinimumBenefit>209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT079</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH514</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand fracture system - multidirectional locking screw</Name>
            <Description>Multidirectional locking screw</Description>
            <Size>1.2 – 2.0mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>DT,LK</Suffix>
            <ARTGs>
                <ARTG>276650</ARTG>
                <ARTG>276674</ARTG>
            </ARTGs>
            <MinimumBenefit>209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH300</BillingCode>
            <Name>ALPS Hand Fracture System</Name>
            <Description>Locking Bone Screws</Description>
            <Size>1.0 - 2.0mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ042</BillingCode>
            <Name>Valens Hand - Screws</Name>
            <Description>Locking Screws</Description>
            <Size>1.5mm, 2.0mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ053</BillingCode>
            <Name>Valens Shoulder and Elbow - Screws</Name>
            <Description>Self-Tapping Locking Screws</Description>
            <Size>2.0mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ066</BillingCode>
            <Name>VRP Distal Radius Fixation System</Name>
            <Description>VRP Distal Radius Fixation System, Locking Peg</Description>
            <Size>2.0mm width, 14-30mm length</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>149433</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER427</BillingCode>
            <Name>Paragon 26 Gorilla Plating System-Screws, micro</Name>
            <Description>Paragon 26 Gorilla Plating System-Screws, locking, baby</Description>
            <Size>dia 2.0 mm x length (8-40 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW011</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Micro Bone Screw Systems</Description>
            <Size>Micro (≤ 2.0mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU279</BillingCode>
            <Name>Variable Angle Locking Screw</Name>
            <Description>VAL Screw</Description>
            <Size>1.4mm - 2.0mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW720</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR073</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ortholoc Fracture System</Name>
            <Description>Titanium, variable angle locking screws</Description>
            <Size>2.0mm diameter, 8 - 100mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM257</BillingCode>
            <Name>OsteoMed HPS</Name>
            <Description>Bone screws - angled locking</Description>
            <Size>1.6/2mm x 6-36mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>202230</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM478</BillingCode>
            <Name>Locking Screws</Name>
            <Description>Locking Screws</Description>
            <Size>≤ 2.0mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>337193</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO420</BillingCode>
            <Name>ACUMED Hexalobe 1.5mm Multiscrews</Name>
            <Description>ACUMED Hexalobe 1.5mm locking Multiscrew</Description>
            <Size>1.5mm in diameter, 5mm to 20mm in length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB034</BillingCode>
            <Name>Mini Locking System - Locking Screw, Stardrive, Self Tapping</Name>
            <Description>Locking Screws</Description>
            <Size>1.5mm &amp; 2mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK526</BillingCode>
            <Name>Stryker Locking Plate System</Name>
            <Description>Locking Screws</Description>
            <Size>1.2-2.0mm diameter</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>340044</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL037</BillingCode>
            <Name>VLP</Name>
            <Description>VAL Locking screws</Description>
            <Size>Micro Screws ≤ 2.0mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL044</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>VAL Locking Screws</Description>
            <Size>Micro Screws (≤ 2.0mm)</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY650</BillingCode>
            <Name>AO/ASIF Cortex Screws</Name>
            <Description>Locking head screws</Description>
            <Size>1.3-2.0mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN064</BillingCode>
            <Name>Newclip Locking Screws</Name>
            <Description>VAL Locking screws</Description>
            <Size>≤2.0 mm diameter, length 08-30 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ079</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screw</Name>
            <Description>Locking Screw</Description>
            <Size>≤ 2.0mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <Suffix>LK</Suffix>
            <ARTGs>
                <ARTG>239817</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH299</BillingCode>
            <Name>ALPS Plating System</Name>
            <Description>Bone Screws</Description>
            <Size>1.0 - 2.0mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>210296</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP030</BillingCode>
            <Name>Tyber Medical Trauma headed screw</Name>
            <Description>Trauma headed screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>1.5mm-2.0mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP032</BillingCode>
            <Name>Tyber Medical Trauma Headless screw</Name>
            <Description>Headless trauma screw for compression and fixation of bone Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>2.0mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>324189</ARTG>
                <ARTG>324190</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ041</BillingCode>
            <Name>Valens Hand - Screws</Name>
            <Description>Cortical Screws</Description>
            <Size>1.5mm, 2.0mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO075</BillingCode>
            <Name>APTUS Screws</Name>
            <Description>Cortical Screws</Description>
            <Size>1.5mm - 2.0mm Diameter</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>141171</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER401</BillingCode>
            <Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm)</Name>
            <Description>Paragon 28 Monster Screw System-Screws, micro, headed, blunt tip, solid, partially or fully threaded</Description>
            <Size>dia 2.0 mm x length (8-100 mm) x length of thread (3-100 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>289308</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW010</BillingCode>
            <Name>WEGO Trauma Systems</Name>
            <Description>Micro Bone Screw Systems</Description>
            <Size>Micro (≤ 2.0mm)</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>324381</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU278</BillingCode>
            <Name>Low Profile Screws, Cortical</Name>
            <Description>Cortical Screws</Description>
            <Size>1.0mm - 2.0mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>350999</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW661</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Cortical Bone Screws</Description>
            <Size>0.5-2.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>269713</ARTG>
                <ARTG>340044</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW823</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR256</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolve EPS System Non-Locking</Name>
            <Description>Stainless Steel Cortical Screws</Description>
            <Size>1.5 - 2.0mm Diameter, 10-40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT081</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH517</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand fracture system, standard screw</Name>
            <Description>Bone screw</Description>
            <Size>1.2 – 2.0mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>276650</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM256</BillingCode>
            <Name>Osteomed Screws</Name>
            <Description>Bone Screws - threaded/lag</Description>
            <Size>1.2/1.6/2.0mm x 4-36mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO422</BillingCode>
            <Name>ACUMED Hexalobe 1.5mm Lag Screws</Name>
            <Description>ACUMED Hexalobe 1.5mm Lag Screw</Description>
            <Size>1.5mm in diameter, 5mm to 20mm in length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>99823</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB032</BillingCode>
            <Name>Mini Locking System - Cortex Screw</Name>
            <Description>Cortex Screws</Description>
            <Size>≤ 2.0mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL006</BillingCode>
            <Name>TC-100</Name>
            <Description>Cortical Screws</Description>
            <Size>≤2.0mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL036</BillingCode>
            <Name>VLP</Name>
            <Description>Cortical Screws</Description>
            <Size>Micro Screws ≤ 2.0mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL043</BillingCode>
            <Name>VLP EVOS</Name>
            <Description>Cortical Screws</Description>
            <Size>Micro (Screw size ≤ 2.0mm)</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY065</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Cortex Screw</Description>
            <Size>≤2.0mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN065</BillingCode>
            <Name>Newclip Cortical Screws</Name>
            <Description>Cortical screws</Description>
            <Size>≤2.0 mm diameter, length 08-30 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI742</BillingCode>
            <Name>Zimmer ECT Screws</Name>
            <Description>1.5mm Cortical Screws</Description>
            <Size>6 - 18mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ072</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EF015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screw</Name>
            <Description>Cortical Bone Screw</Description>
            <Size>≤ 2.0mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3372</SubGroupID>
            <ARTGs>
                <ARTG>239817</ARTG>
            </ARTGs>
            <MinimumBenefit>52</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW333</BillingCode>
            <Name>Omega Plus Compression Hip Screw System</Name>
            <Description>Lag Screw - Standard -  Stainless Steel</Description>
            <Size>50-130mm length </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW334</BillingCode>
            <Name>Omega Plus Compression Hip Screw System</Name>
            <Description>Lag Screw - Super -  Stainless Steel</Description>
            <Size>50-130mm length </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>76592</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN279</BillingCode>
            <Name>Femoral Neck System, Antirotation Screw</Name>
            <Description> Orthopaedic bone screw,  sterile  </Description>
            <Size>75 to 130 mm length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK228</BillingCode>
            <Name>Omega Plus Compression Hip Screw System</Name>
            <Description>Cephalic Implants</Description>
            <Size>Hansson Twin Hook 50-140mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>94876</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN489</BillingCode>
            <Name>Intermediate Osteotomy System</Name>
            <Description>Lag</Description>
            <Size>35 mm - 85mm, 1 1/2" - 3-3/4"</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN492</BillingCode>
            <Name>Paediatric Osteotomy System</Name>
            <Description>Lag Screw</Description>
            <Size>22mm- 40mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY054</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>DHS/DCS lag screw</Description>
            <Size>50-145mm L</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>183900</ARTG>
                <ARTG>297881</ARTG>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY690</BillingCode>
            <Name>MultiLoc Screw</Name>
            <Description>Conical, Locking "Screw-in-Screw"</Description>
            <Size>4.5mm; 20mm - 60mm Length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI158</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Compression Hip Screw</Name>
            <Description>Versa-FX Femoral Fixation Screw - Stainless Steel</Description>
            <Size>55 mm - 155 mm long</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3373</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
                <ARTG>169898</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH169</BillingCode>
            <Name>Washerloc Tibial Fixation Device</Name>
            <Description>Interference Anchor Plate</Description>
            <Size>(4.75 or 6.5)mm dia x 15-50mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>116765</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH189</BillingCode>
            <Name>Small / Large Fragment Set S/S</Name>
            <Description>Washer Spiked, Standard, Cancellous, Cortical &amp; Fastening Wire</Description>
            <Size>One size only</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>200720</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH332</BillingCode>
            <Name>Small / Large  Fragment Set</Name>
            <Description>Washer Titanium - Flat/Cup/Countersink</Description>
            <Size>One size only</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>200720</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP029</BillingCode>
            <Name>Tyber Medical Trauma screw washer</Name>
            <Description>Screw washer intended to be used with bone screws to improve fixation. Sterile or Non sterile, Titanium or stainless steel</Description>
            <Size>2.0mm -7.5mm</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>324373</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ023</BillingCode>
            <Name>Austofix Femoral &amp; Tibial Nailing System</Name>
            <Description>Washer for screws; s-s</Description>
            <Size>Dia 11mm &amp; 13mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>111818</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ038</BillingCode>
            <Name>Valens - Cannulated Screw Washer</Name>
            <Description>Washer</Description>
            <Size>8mm, 10mm, 12mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>276915</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO112</BillingCode>
            <Name>APTUS Washer</Name>
            <Description>Washers</Description>
            <Size>5.0mm - 13.0mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER405</BillingCode>
            <Name>Paragon 28 Monster Screw System-washer</Name>
            <Description>Paragon 28 Monster Screw System-washer, deep well, flat/dome</Description>
            <Size>dia 2-7 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>289309</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER561</BillingCode>
            <Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), screw washer</Name>
            <Description>Screw washer</Description>
            <Size>2.4/2.7 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>337240</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW009</BillingCode>
            <Name>WEGO Trauma Systems </Name>
            <Description>Washers</Description>
            <Size>10-13mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>324402</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU161</BillingCode>
            <Name>Washer</Name>
            <Description>Screw Washer</Description>
            <Size>6mm - 18mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>350851</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW298</BillingCode>
            <Name>Asnis Guided Screw System</Name>
            <Description>Washer, Stainless Steel</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>119849</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW299</BillingCode>
            <Name>Asnis Guided Screw System</Name>
            <Description>Washer -  Titanium</Description>
            <Size>4, 5, 6.5,8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>119849</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW712</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR060</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ring washer</Name>
            <Description>Screw Washers</Description>
            <Size>2.7/3.7/4.0/4.5</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>326629</ARTG>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW911</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR388</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxTorque Cannulated Screw System- Washers</Name>
            <Description>Screw washer, Titanium, Contoured or Flat</Description>
            <Size>Ø4.0 to 7.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW918</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR398</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix Washer</Name>
            <Description>The NexFix Washer is a threaded circular piece of stainless steel through which is inserted a NexFix Compression Screw. The Compression Screw is locked to the washer to form a headed screw that will increase bone coverage and prevent the screw from sinking</Description>
            <Size>9mm, 11mm, 13mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>163237</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT002</BillingCode>
            <Name>Hawk 6.5mm Cannulated Screw System - Washer</Name>
            <Description>Titanium Washer</Description>
            <Size>Internal diameter 6.6mm and external diameter 14mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>232499</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT003</BillingCode>
            <Name>Hawk 4.0mm Cannulated Screw System - Washer</Name>
            <Description>Titanium washer</Description>
            <Size>internal diameter of 4.13mm and external diameter of 10mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>232499</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT083</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH519</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Hand fracture system - washer</Name>
            <Description>Washer</Description>
            <Size>4.5 – 5mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>276674</ARTG>
                <ARTG>276650</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM081</BillingCode>
            <Name>Surgicraft Washers</Name>
            <Description>Fixation Washers</Description>
            <Size>All Sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>149434</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM255</BillingCode>
            <Name>OsteoMed FPS</Name>
            <Description>Screw Washers</Description>
            <Size>2/2.7/3.5/4.0mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>202319</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM316</BillingCode>
            <Name>Skeletal Dynamics Washer</Name>
            <Description>Washer</Description>
            <Size>One size</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM346</BillingCode>
            <Name>Screw Washer</Name>
            <Description>Screw Washer</Description>
            <Size>All sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>296619</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN352</BillingCode>
            <Name>Bristow-Latarjet Instability Shoulder Set - Top Hat Screw</Name>
            <Description>Cannulated titanium top hat screw</Description>
            <Size>One size only</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>136374</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO158</BillingCode>
            <Name>Polarus Humeral Fixation System</Name>
            <Description>Polarus Washer</Description>
            <Size>3.8mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>169180</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH489</BillingCode>
            <Name>DynafitSystem</Name>
            <Description>washer</Description>
            <Size>8-10mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>221403</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB041</BillingCode>
            <Name>Washers</Name>
            <Description>Washers</Description>
            <Size>Thickness 1- 5.5mm&#xD;
Width 7 - 13mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>223188</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF095</BillingCode>
            <Name>Versa Screw Washer</Name>
            <Description>Versa Screw Washer</Description>
            <Size>One Size</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK201</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>Proximal Humeral Nail</Description>
            <Size>Proximal Humerous Washer round/square</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>119849</ARTG>
                <ARTG>76714</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK565</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Washers</Description>
            <Size>7-13mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>119849</ARTG>
                <ARTG>269713</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL007</BillingCode>
            <Name>Universal Washers</Name>
            <Description>Screw Washers</Description>
            <Size>All sizes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>120321</ARTG>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ129</BillingCode>
            <Name>Screw Washer</Name>
            <Description>Stainless Steel</Description>
            <Size>Screw sizes 4.0mm - 7.0mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>191602</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY092</BillingCode>
            <Name>AO/ASIF Washers</Name>
            <Description>Washers</Description>
            <Size>1.0mm - 18mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>133919</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN003</BillingCode>
            <Name>Washers</Name>
            <Description>Washers</Description>
            <Size>4-8 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>260231</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA008</BillingCode>
            <Name>ALPS Plating System &amp; Biodrive Screws</Name>
            <Description>Flat and cupped Titanium washers</Description>
            <Size>3.0-6.5mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>213857</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI210</BillingCode>
            <Name>Zimmer Washers</Name>
            <Description>Washer</Description>
            <Size>Small &amp; Large</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3374</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>70</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO088</BillingCode>
            <Name>Aptus Shoulder (Spiral Blades )</Name>
            <Description>Spiral Blades Proximal Humerus</Description>
            <Size>3.5mm System</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>141170</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM041</BillingCode>
            <Name>Trimed Fixation Pegs</Name>
            <Description>Plate fixation pegs</Description>
            <Size>Various sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM311</BillingCode>
            <Name>Skeletal Dynamics Pegs</Name>
            <Description>Smooth Pegs:Locking, Threaded Pegs: Locking &amp; Non Locking</Description>
            <Size>2mm, 2.3mm &amp; 2.7mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM522</BillingCode>
            <Name>Omni Plating System</Name>
            <Description>Post</Description>
            <Size>12 &amp; 16 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>306780</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN278</BillingCode>
            <Name>Femoral Neck System, Bolt</Name>
            <Description>Orthopaedic bone bolt</Description>
            <Size>75 to 130 mm length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>183900</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK154</BillingCode>
            <Name>Stryker Cross-Screw</Name>
            <Description>HA/PLLA screw for ligament/tendon fixation</Description>
            <Size>Dia 6mm: Length 40-60mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>143030</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK155</BillingCode>
            <Name>Wedge Interference screw</Name>
            <Description>Threaded PLLA screw with cross pin for ligament/tendon fixation</Description>
            <Size>Dia 7-12mm, Length 20-40mm; pin length standard</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>139735</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL029</BillingCode>
            <Name>D-RAD SMART PACK</Name>
            <Description>Variable angle locking screw or peg</Description>
            <Size>1.0 - 2.0mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL150</BillingCode>
            <Name>Smith &amp; Nephew Plate and Screw System - EVOS</Name>
            <Description>Locking Peg</Description>
            <Size>Various length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>104369</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN422</BillingCode>
            <Name>Fixation Post</Name>
            <Description>Tibial fixation device</Description>
            <Size>25 -55mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY110</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Buttress Pin</Description>
            <Size>Various lengths</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>297881</ARTG>
                <ARTG>133927</ARTG>
                <ARTG>157068</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY435</BillingCode>
            <Name>Epoca Custom Offset Shoulder Prosthesis</Name>
            <Description>Epoca  Screw</Description>
            <Size>8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>214668</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY649</BillingCode>
            <Name>AO/ASIF Screws</Name>
            <Description>Self Drilling, self tapping, conical screws/pins/bar</Description>
            <Size>≥ 3.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>297881</ARTG>
                <ARTG>133927</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN048</BillingCode>
            <Name>Screws peg locking</Name>
            <Description>Locking screws peg</Description>
            <Size>&lt; 2.0 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4521</SubGroupID>
            <ARTGs>
                <ARTG>260233</ARTG>
                <ARTG>260234</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK204</BillingCode>
            <Name>Stryker Trauma Locking Nail System</Name>
            <Description>SCN</Description>
            <Size>Nut for Condyle Screws 5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4522</SubGroupID>
            <ARTGs>
                <ARTG>139632</ARTG>
            </ARTGs>
            <MinimumBenefit>35</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK566</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Nuts</Description>
            <Size>4.5-5.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4522</SubGroupID>
            <ARTGs>
                <ARTG>120234</ARTG>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>35</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW274</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Locking Insert/Plug Assembly</Description>
            <Size>4.0mm to 5 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>4523</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>295226</ARTG>
            </ARTGs>
            <MinimumBenefit>163</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW335</BillingCode>
            <Name>Omega Plus Compression Hip Screw System</Name>
            <Description>Compression Screw -  Stainless Steel</Description>
            <Size>25mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3732</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>76592</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW906</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR383</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxLock Extreme System  - PEEK ring</Name>
            <Description>Locking Ring, PEEK,Pre - assembled on inserter</Description>
            <Size>Ø 2.4/3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3732</SubGroupID>
            <ARTGs>
                <ARTG>214671</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM378</BillingCode>
            <Name>Orthopaedic screw cap</Name>
            <Description>Orthopaedic screw cap</Description>
            <Size>All sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3732</SubGroupID>
            <ARTGs>
                <ARTG>266216</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL241</BillingCode>
            <Name>EVOS</Name>
            <Description>Screw Accessories, Hole Filler</Description>
            <Size>3.5mm and 4.5mm  </Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3732</SubGroupID>
            <ARTGs>
                <ARTG>230143</ARTG>
                <ARTG>368491</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN945</BillingCode>
            <Name>Peri-Loc</Name>
            <Description>Screw Accessories, Hole Filler</Description>
            <Size>4.5mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3732</SubGroupID>
            <ARTGs>
                <ARTG>140705</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY195</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Protective caps for rods, protection caps</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3732</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI597</BillingCode>
            <Name>NCB Plating System</Name>
            <Description>NCB Spacers &amp; Screw Caps</Description>
            <Size>1, 2 and 3</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1231</GroupID>
            <SubGroupID>3732</SubGroupID>
            <ARTGs>
                <ARTG>100337</ARTG>
            </ARTGs>
            <MinimumBenefit>102</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH335</BillingCode>
            <Name>Small / Large Fragment Set S/S</Name>
            <Description>K/Wire Stainless Steel </Description>
            <Size>0.8 to 3.0 mm x 6-9" or 150-500mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5364</SubGroupID>
            <ARTGs>
                <ARTG>200700</ARTG>
                <ARTG>202246</ARTG>
                <ARTG>202248</ARTG>
                <ARTG>203768</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP045</BillingCode>
            <Name>Isola System (Stainless Steel)</Name>
            <Description>Double Wire</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5364</SubGroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC506</BillingCode>
            <Name>Orfil</Name>
            <Description>Double Pearl-Tipped Wires</Description>
            <Size>1 - 350mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5364</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN460</BillingCode>
            <Name>Wire</Name>
            <Description>Cerclage</Description>
            <Size>0.6mmx175mm - 0.8mmx200mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5364</SubGroupID>
            <ARTGs>
                <ARTG>108396</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ141</BillingCode>
            <Name>NEO Pedicle Screw System - K-wire</Name>
            <Description>Stainless steel</Description>
            <Size>1.5mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5364</SubGroupID>
            <ARTGs>
                <ARTG>289290</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU016</BillingCode>
            <Name>MAGNEZIX Pin and Screw</Name>
            <Description>Bioabsorbable bone pin and screw.</Description>
            <Size>Diameter 1.5, 2.0, 2.7 and 3.2mm&#xD;
Length 8 - 50mm&#xD;
Diameter 2.0, 2.7 and 3.5mm&#xD;
Length 6 - 40mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>283491</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU253</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE273</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Trim-IT Spin Pin</Name>
            <Description>Trim-IT  Pin Fixation</Description>
            <Size>1.5 - 2.0mm x 100mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>140553</ARTG>
                <ARTG>360375</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV050</BillingCode>
            <Name>Bionx Implants - Rods </Name>
            <Description>PGA, PLA or PLLA</Description>
            <Size>1.5mm x 10-70mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>139657</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV051</BillingCode>
            <Name>Bionx Implants - Rods </Name>
            <Description>PGA, PLA or PLLA</Description>
            <Size>2.0mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>139657</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV063</BillingCode>
            <Name>SmartNail</Name>
            <Description>Self-Reinforced 96L/4D PLA Bone Fixation Nail</Description>
            <Size>1.5mm O.D x 16, 20 &amp; 25mm L</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>139690</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV084</BillingCode>
            <Name>SmartNail</Name>
            <Description>Self-reinforced 96L / 4D PLA Bone Fixation Nail</Description>
            <Size>2.4mm O.D x 16, 25, 35 &amp; 45mm L</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>139690</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV088</BillingCode>
            <Name>SmartPin Resorbable Bone Fixation Pin, 1.1mm</Name>
            <Description>Self-Reinforced PLLA</Description>
            <Size>10, 20, 30 &amp; 40mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>139657</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK021</BillingCode>
            <Name>CPS Bioabsorbable Fixation System</Name>
            <Description>OTPS fixation system: PLGA/TMC copolymer</Description>
            <Size>Pin 1.5 &amp; 2 mm dia x 20-50 mm long</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>154545</ARTG>
            </ARTGs>
            <MinimumBenefit>257</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK230</BillingCode>
            <Name>Hansson Pin</Name>
            <Description>Cephalic Implants</Description>
            <Size>Hansson Pin 70-140mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>COM</Suffix>
            <ARTGs>
                <ARTG>94876</ARTG>
            </ARTGs>
            <MinimumBenefit>275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP480</BillingCode>
            <Name>DePuy Spinal Wire</Name>
            <Description>Wire with Button or Beaded Wire</Description>
            <Size>18 - 24 gauge wire</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>139772</ARTG>
                <ARTG>97391</ARTG>
                <ARTG>97395</ARTG>
                <ARTG>99178</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO100</BillingCode>
            <Name>APTUS K-wires</Name>
            <Description>Olive K-wires</Description>
            <Size>1.6mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>200263</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER478</BillingCode>
            <Name>Paragon 28 Olive Wires</Name>
            <Description>Paragon 28 Olive wire (Gorilla Plating System), smooth or threaded, standard or short tip</Description>
            <Size>dia 1.3-1.8 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>289488</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT030</BillingCode>
            <Name>Frame It Wires - Olives</Name>
            <Description>Wires with stopper</Description>
            <Size>Diameter 1mm-3mm&#xD;
Length 120mm-250mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO162</BillingCode>
            <Name>Tension Band Pin</Name>
            <Description>Stainless Steel</Description>
            <Size>50 to 90mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>99821</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV011</BillingCode>
            <Name>PS Olive Wires</Name>
            <Description>Olive Wires</Description>
            <Size>2-3.2mm diameter</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>330187</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV017</BillingCode>
            <Name>PS Olive Wires</Name>
            <Description>Olive Wires</Description>
            <Size>2-3.2mm diameter</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>202035</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK117</BillingCode>
            <Name>Stryker Kirschner Wires</Name>
            <Description>Olive Wires</Description>
            <Size>1.0- 2.0mm Diameter</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>139635</ARTG>
                <ARTG>143230</ARTG>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN441</BillingCode>
            <Name>Ilizarov</Name>
            <Description>Wires with stopper</Description>
            <Size>300-400 length x 1-1.8mm diameter</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>108396</ARTG>
                <ARTG>157918</ARTG>
                <ARTG>99767</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN459</BillingCode>
            <Name>Wire</Name>
            <Description>Suture</Description>
            <Size>18Ga - 28Ga</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>108396</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ191</BillingCode>
            <Name>Wires Olive</Name>
            <Description>Wire Olive, Bayonet, Drill Tip</Description>
            <Size>Diameter 1.5-1.8mm, Length 300-400mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>OL</Suffix>
            <ARTGs>
                <ARTG>345470</ARTG>
            </ARTGs>
            <MinimumBenefit>117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE069</BillingCode>
            <Name>Threaded wires &amp; pins</Name>
            <Description>Threaded wires &amp; pins</Description>
            <Size>1.0-5.0mm diameters
various threaded lengths</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>164927</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI232</BillingCode>
            <Name>Moore Pins</Name>
            <Description>Scan Pin, Stainless Steel</Description>
            <Size>16mm x 51-152mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>138206</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI271</BillingCode>
            <Name>EBI XFIX Dynafix System</Name>
            <Description>Wire Straight or Olive with Washer, Chrome Cobalt</Description>
            <Size>0.9-3.2mm, &lt;400mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>210294</ARTG>
                <ARTG>217978</ARTG>
                <ARTG>227787</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO209</BillingCode>
            <Name>Acumed Congruent Plate System</Name>
            <Description>Threaded K-Wire - Titanium</Description>
            <Size>WT-1606STT: Length 15cm x Diameter 0.62"; WT-0906STT: Length 15cm x Diameter 0.35"; WS-2408STT length 20.32cm x Diameter 0.24cm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>99820</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV012</BillingCode>
            <Name>PS Threaded K-Wire </Name>
            <Description>Threaded K-Wire</Description>
            <Size>2-3.0mm, Length 200 mm</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>330187</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV018</BillingCode>
            <Name>PS Threaded K-Wire</Name>
            <Description>Threaded K-Wire</Description>
            <Size>2-3.0mm, Length 200 mm</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>202035</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV019</BillingCode>
            <Name>PS K-Wire</Name>
            <Description>K-Wires</Description>
            <Size>Dia 1-3.0 mm, Length 150 mm</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>202035</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ076</BillingCode>
            <Name>K wires</Name>
            <Description>K wire threaded</Description>
            <Size>1.25mm - 4.5mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>191530</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST890</BillingCode>
            <Name>Steinmann Pins</Name>
            <Description>Stainless Steel</Description>
            <Size>7,9"</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>142054</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY249</BillingCode>
            <Name>AO/ASIF K Wires, Pins </Name>
            <Description>Hybrid Pins - Spade point wires/reduction wires</Description>
            <Size>1.5 - 3.2mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <Suffix>TH</Suffix>
            <ARTGs>
                <ARTG>133927</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE052</BillingCode>
            <Name>ASDM K-wire</Name>
            <Description>Stainless steel - sterile</Description>
            <Size>Dia 0.7 - 2.5mm, length 100 - 230mm</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>296136</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE070</BillingCode>
            <Name>ASDM Steinmann Pin</Name>
            <Description>Steinmann Pin</Description>
            <Size>2.8-5.0mm diameter</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>296136</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO089</BillingCode>
            <Name>Aptus K-wires</Name>
            <Description>K-wires</Description>
            <Size>0.8mm - 2.2mm Diameter, various lengths</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>200263</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER477</BillingCode>
            <Name>Paragon 28 K wires</Name>
            <Description>Paragon 28, K wire (for Phantom, Gorilla and Monster systems), smooth, grooved  or threaded, trocar/double trocar</Description>
            <Size>dia 0.9-3.0 mm, length (100-250 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>290442</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER545</BillingCode>
            <Name>Osteomed ExtremiLock K-Wire</Name>
            <Description>K-Wire</Description>
            <Size>0.9-1.6 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>337153</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FB001</BillingCode>
            <Name>K-Wire</Name>
            <Description>K-Wire, stainless steel, sterile</Description>
            <Size>0.6mm – 2.8mm   x   75mm – 230mm</Size>
            <SupplierCode>FB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>226653</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FB002</BillingCode>
            <Name>K-Wire</Name>
            <Description>K-Wire, threaded, stainless steel, sterile</Description>
            <Size>1.2mm – 2.8mm   x   100mm – 230mm</Size>
            <SupplierCode>FB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>226653</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HG001</BillingCode>
            <Name>HSP K - Wire</Name>
            <Description>Stainless Steel Wire with Trocar point, single, double.</Description>
            <Size>Diameter - 0.7mm - 2.0mm  Length - 80mm - 250mm</Size>
            <SupplierCode>HG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>295191</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW368</BillingCode>
            <Name>Osteo Kirschner Wire</Name>
            <Description>K wire -  Stainless Steel</Description>
            <Size>Diameter 1.0 - 2.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>143230</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW975</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR063</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K Wire</Name>
            <Description>Titanium or stainless steel, single or double trocar</Description>
            <Size>0.9 - 2.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>217014</ARTG>
                <ARTG>113920</ARTG>
                <ARTG>112287</ARTG>
                <ARTG>196920</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT004</BillingCode>
            <Name>Hawk 6.5mm Cannulated Screw System - Guide Pin</Name>
            <Description>Threaded, Stainless steel</Description>
            <Size>2.5mm in diameter and 200 in length</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>230955</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT005</BillingCode>
            <Name>Hawk 4.0mm Cannulated Screw system - Guide Pin</Name>
            <Description>Threaded, Stainless steel</Description>
            <Size>1.5mm in diameter and length of 200mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>230955</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT006</BillingCode>
            <Name>Hawk 3.0mm Cannulated Screw System - guide pin</Name>
            <Description>Threaded, stainless steel</Description>
            <Size>1.0mm in diameter with a length of 200mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>230955</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JC001</BillingCode>
            <Name>K-Wires</Name>
            <Description>K-Wires - stainless steel</Description>
            <Size>Diameter 0.8mm to 4mm&#xD;
Length 100mm to 350mm</Size>
            <SupplierCode>JC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>286985</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM014</BillingCode>
            <Name>Trimed Marked K-Wire</Name>
            <Description>Stainless Steel</Description>
            <Size>Diameter 0.9 - 1.1mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM383</BillingCode>
            <Name>K-Wire</Name>
            <Description>K-Wire</Description>
            <Size>Multiple sizes to suit patient and surgeon requirements</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>317003</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO177</BillingCode>
            <Name>Acumed Wires and Pins</Name>
            <Description>Wire Kirschner Stainless Steel</Description>
            <Size>0.70mm to 2.4mm diameter, 4 to 9.25in (10 to 24cm) length</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>99820</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB069</BillingCode>
            <Name>BFix Bone Pins</Name>
            <Description>Bone Pins </Description>
            <Size>0.6mm - 5.0mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>322423</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV010</BillingCode>
            <Name>PS K-Wires</Name>
            <Description>K-Wires</Description>
            <Size>Dia 1-3.0 mm, Length 150 mm</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>330187</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK213</BillingCode>
            <Name>Hoffmann II Micro</Name>
            <Description>K-wire, Steinmann Pins</Description>
            <Size>Diameter: 1.2-2.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>143230</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK622</BillingCode>
            <Name>SBi K-Wire</Name>
            <Description>K-Wire</Description>
            <Size>1.6mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>155633</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL195</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG073</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K-Wire (Kirschner)</Name>
            <Description>Stainless steel</Description>
            <Size>70mm, 100mm, 200mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>173964</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN451</BillingCode>
            <Name>Wire</Name>
            <Description>Kirschner</Description>
            <Size>Various 1.3 - 304.8mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>108396</ARTG>
                <ARTG>110986</ARTG>
                <ARTG>118355</ARTG>
                <ARTG>131082</ARTG>
                <ARTG>157918</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ190</BillingCode>
            <Name>Wires</Name>
            <Description>Wire, Bayonet, HA Coated, Pear Wire, Cone Shape, Drill Tip</Description>
            <Size>Diameter 1.2-2.0mm, Length 200-400mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>345470</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST007</BillingCode>
            <Name>Stryker Plating System - K Wires</Name>
            <Description>Stainless Steel or Titanium</Description>
            <Size>150mm length in 1.25, 1.6, 2.0mm diameter</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>139635</ARTG>
                <ARTG>143230</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST038</BillingCode>
            <Name>Stryker Plating System -  Reduction Pin</Name>
            <Description>4.5mm Diameter, Stainless Steel</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>139635</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY787</BillingCode>
            <Name>AO/ASIF K-Wires</Name>
            <Description>K-Wires</Description>
            <Size>0.25 - 3.2mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>139010</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN055</BillingCode>
            <Name>Pins</Name>
            <Description>Stainless steel pins</Description>
            <Size>1.1 to 1.4 mm</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>309175</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TS001</BillingCode>
            <Name>Trewavis Surgical Kirschner Wires</Name>
            <Description>Composition: Stainless Steel, Model Nos: 200-000-A to 200-930-T, 200-1110-A to 200-1210-Z, 200-370-X to 200-370-Y and TSS200 to TSS241</Description>
            <Size>Dia 0.7-2.8mm, Length 100-370mm</Size>
            <SupplierCode>TS</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>123770</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TS002</BillingCode>
            <Name>Trewavis Surgical Steinmann Pins</Name>
            <Description>Composition:  Stainless Steel, Model Nos: 200-950-L to 200-970-Q</Description>
            <Size>Dia 3.0 - 5.0mm</Size>
            <SupplierCode>TS</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>123771</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI293</BillingCode>
            <Name>Zimmer Wires</Name>
            <Description>Stainless Steel</Description>
            <Size>Length 23cm, Thickness 2mm, 0-4mm, 8mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI323</BillingCode>
            <Name>Zimmer Wires</Name>
            <Description>Stainless Steel Rushpins</Description>
            <Size>Diameter 2.4 - 6.4mm; Length 2.5 - 52.7cm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI895</BillingCode>
            <Name>Zimmer Pins</Name>
            <Description>Stainless steel, Threaded</Description>
            <Size>Length 230mm, Diameter 2.0mm - 4.8mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5365</SubGroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>24</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW309</BillingCode>
            <Name>Dall Miles Cable Grip System - Vitallium</Name>
            <Description>Vitallium: Cable -  Vitallium</Description>
            <Size>1.6 and 2mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5366</SubGroupID>
            <ARTGs>
                <ARTG>141273</ARTG>
                <ARTG>16234</ARTG>
            </ARTGs>
            <MinimumBenefit>331</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF014</BillingCode>
            <Name>TLS- Tendon Anchoring/Suspension Tape</Name>
            <Description>Suspension tape for anchoring tendon for ACL/PCL reconstruction</Description>
            <Size>One size - 6mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5366</SubGroupID>
            <ARTGs>
                <ARTG>181401</ARTG>
            </ARTGs>
            <MinimumBenefit>331</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF026</BillingCode>
            <Name>TLS Tape</Name>
            <Description>TLS Suspension Tape for use with TLS ACL reconstruction system</Description>
            <Size>6mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5366</SubGroupID>
            <ARTGs>
                <ARTG>181401</ARTG>
            </ARTGs>
            <MinimumBenefit>331</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY276</BillingCode>
            <Name>Spine Cable System</Name>
            <Description>Single Lead</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5366</SubGroupID>
            <ARTGs>
                <ARTG>157705</ARTG>
            </ARTGs>
            <MinimumBenefit>331</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI163</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cable System</Name>
            <Description>Cable-Ready Plate Cable Stainless Steel</Description>
            <Size>610 mm long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5366</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>331</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP364</BillingCode>
            <Name>Control Cable with Sleeve</Name>
            <Description>Control Cable with sleeve </Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>99178</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU267</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE649</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cerclage System</Name>
            <Description>Pre-tied Cerclage System</Description>
            <Size>One Size Only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>354057</ARTG>
                <ARTG>309161</ARTG>
            </ARTGs>
            <Note>The prosthesis is only to be used in a surgical procedure described in item 47450 or 47528 or 47565 in Group T8 of the Regulations.</Note>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW524</BillingCode>
            <Name>Dall Miles Cable Grip System</Name>
            <Description>Cable and sleeve</Description>
            <Size>1.6mm and 2.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI146</BillingCode>
            <Name>Atlas Cable System</Name>
            <Description>Single</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL181</BillingCode>
            <Name>EVOS Cabling System</Name>
            <Description>Orthopaedic Cable System, Cable w/Crimp</Description>
            <Size>2.0mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>140705</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN732</BillingCode>
            <Name>Accord</Name>
            <Description>Orthopaedic Cable System, Cable w/clamp</Description>
            <Size>2.0mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>140705</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ115</BillingCode>
            <Name>Iso-Elastic™ Cerclage System</Name>
            <Description>Iso-Elastic™ Cerclage Cable Assembly</Description>
            <Size>One Size Only</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>133719</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY377</BillingCode>
            <Name>Orthopaedic Cable System</Name>
            <Description>Cable with Crimp</Description>
            <Size>1.0mm - 1.7mm, 750mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>139010</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI164</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cable System</Name>
            <Description>Cable-Ready GTR Distal end Cable - Cobalt Chrome</Description>
            <Size>635 mm long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI173</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cable System</Name>
            <Description>Cable-Ready GTR Cable - Proximal </Description>
            <Size>635mm long</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI174</BillingCode>
            <Name>Zimmer Internal Fixation Systems: Cable System</Name>
            <Description>Cable-Ready Stainless Steel Cable</Description>
            <Size>1.8mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5367</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ923</BillingCode>
            <Name>Songer Cable System</Name>
            <Description>Double loop Cable with 2 crimps</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5368</SubGroupID>
            <ARTGs>
                <ARTG>144675</ARTG>
            </ARTGs>
            <MinimumBenefit>434</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI147</BillingCode>
            <Name>Atlas Cable System</Name>
            <Description>Double w/2 crimps</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5368</SubGroupID>
            <ARTGs>
                <ARTG>264077</ARTG>
            </ARTGs>
            <MinimumBenefit>434</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK401</BillingCode>
            <Name>Trochanteric Grip</Name>
            <Description>Dall-Miles Trochanteric Grip with 2 Chrome Cobalt Cables</Description>
            <Size>Small, Medium and Large</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5368</SubGroupID>
            <ARTGs>
                <ARTG>145550</ARTG>
                <ARTG>16232</ARTG>
            </ARTGs>
            <MinimumBenefit>434</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA097</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pioneer Cable System</Name>
            <Description>Pioneer Titanium Sternal Orthopaedic Cable and Crimp - Single</Description>
            <Size>One diameter size (1.10mm) Reverse cutting needle</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5368</SubGroupID>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>421</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA098</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pioneer Cable System</Name>
            <Description>Pioneer Stainless Steel Sternal Orthopaedic cable and crimp - Single</Description>
            <Size>One diameter size (1.10mm) There are 4 needle types on the cables. Cutting Edge, Blunt Tip, Tapered Tip, Reverse Cutting.</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5368</SubGroupID>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>421</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA099</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pioneer Cable System</Name>
            <Description>Pioneer Stainless Steel Sternal Orthopeadic Cable and Crimp - 4 Pack</Description>
            <Size>One diameter size (1.10mm)  There are four needle types on the cables. Cutting edge, Blunt Tip, Tapered Tip, reverse Cutting.</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5368</SubGroupID>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>421</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM001</BillingCode>
            <Name>TriMed Wrist Fixation System</Name>
            <Description>Washer</Description>
            <Size>One size</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5369</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM323</BillingCode>
            <Name>GEMINUS Hook Plate</Name>
            <Description>GEMINUS Hook Plate</Description>
            <Size>One size</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5369</SubGroupID>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY257</BillingCode>
            <Name>A/O/ASIF K-wires</Name>
            <Description>Cerclage Wire - coils with and without eye</Description>
            <Size>0.4-2.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5369</SubGroupID>
            <ARTGs>
                <ARTG>139010</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH630</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC Cerclage System</Name>
            <Description>IC Bone Cerclage System, pure titanium</Description>
            <Size>8mm wide</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5370</SubGroupID>
            <ARTGs>
                <ARTG>197728</ARTG>
            </ARTGs>
            <MinimumBenefit>434</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM005</BillingCode>
            <Name>TriMed Fixation Systems</Name>
            <Description>Multiple stainless steel wire forms</Description>
            <Size>various sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5370</SubGroupID>
            <ARTGs>
                <ARTG>182677</ARTG>
            </ARTGs>
            <MinimumBenefit>434</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP363</BillingCode>
            <Name>Control Cable</Name>
            <Description>Control Cable sleeve </Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>99178</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW310</BillingCode>
            <Name>Dall Miles Cable Grip System - Vitallium</Name>
            <Description>Vitallium: Sleeve -  Vitallium</Description>
            <Size>1.6 and 2mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ925</BillingCode>
            <Name>Songer Cable System</Name>
            <Description>Cable and Crimp</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>144675</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM243</BillingCode>
            <Name>HK2</Name>
            <Description>Finger Mini Fixator System</Description>
            <Size>1.2mm, 1.5mm, 1.8mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>235591</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI148</BillingCode>
            <Name>Atlas Cable System</Name>
            <Description>Crimp</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL179</BillingCode>
            <Name>EVOS Cabling System</Name>
            <Description>Cable Locking device – Cable Post</Description>
            <Size>3.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN733</BillingCode>
            <Name>Accord</Name>
            <Description>Orthopaedic Cable System, SS Button Plate Adapter</Description>
            <Size>One Size Only</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>140705</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY057</BillingCode>
            <Name>AO/ASIF K-Wires, Pins, Washers etc</Name>
            <Description>Wire mount &amp; spacer</Description>
            <Size>2mm - 6mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>133923</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA106</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MZ018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pioneer Cable System Crimps</Name>
            <Description>Crimps - two pack</Description>
            <Size>One size only</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5371</SubGroupID>
            <ARTGs>
                <ARTG>193369</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW302</BillingCode>
            <Name>Dall Miles Cable Grip System - Stainless Steel</Name>
            <Description>Stainless Steel: Trochanter Grip -  Stainless Steel</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5372</SubGroupID>
            <ARTGs>
                <ARTG>144003</ARTG>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>508</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW311</BillingCode>
            <Name>Dall Miles Cable Grip System - Vitallium</Name>
            <Description>Vitallium: Trochanter Grip -  Vitallium</Description>
            <Size>Small, Medium and Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5372</SubGroupID>
            <ARTGs>
                <ARTG>312160</ARTG>
            </ARTGs>
            <MinimumBenefit>508</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR072</BillingCode>
            <Name>Dall miles Trochanteric grip with divergent hooks</Name>
            <Description>stainless steel dall miles trochanteric grip with diverging proximal hooks</Description>
            <Size>small, medium, large  43-53mm</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5372</SubGroupID>
            <ARTGs>
                <ARTG>144002</ARTG>
                <ARTG>144003</ARTG>
                <ARTG>145550</ARTG>
            </ARTGs>
            <MinimumBenefit>508</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY805</BillingCode>
            <Name>AO/ASIF</Name>
            <Description>Humerus Block</Description>
            <Size>12 x 16mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5372</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>508</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW313</BillingCode>
            <Name>Stryker Plating System</Name>
            <Description>Cable Plug</Description>
            <Size>4.0mm to 5.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5373</SubGroupID>
            <ARTGs>
                <ARTG>119660</ARTG>
                <ARTG>139635</ARTG>
                <ARTG>143230</ARTG>
                <ARTG>308681</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL180</BillingCode>
            <Name>EVOS Cabling System</Name>
            <Description>Cable Saddle/Button</Description>
            <Size>3.5mm and 4.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5373</SubGroupID>
            <ARTGs>
                <ARTG>108428</ARTG>
                <ARTG>368492</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TN056</BillingCode>
            <Name>Grooved button</Name>
            <Description>Grooved button</Description>
            <Size>3 sizes</Size>
            <SupplierCode>TN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5373</SubGroupID>
            <ARTGs>
                <ARTG>309175</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI234</BillingCode>
            <Name>Cable System </Name>
            <Description>Cable Ready, Cable Button</Description>
            <Size>2,5mm - 5,0mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5373</SubGroupID>
            <ARTGs>
                <ARTG>108377</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER454</BillingCode>
            <Name>Paragon 28 Titan 3-D Wedge</Name>
            <Description>Paragon 28 Titan 3-D Cotton or Evans Wedge, Anatomical,  Titanium metal scaffold for angular correction,  Sterile</Description>
            <Size>5-8 mm (Cotton); 6-12 mm (Evans)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5457</SubGroupID>
            <ARTGs>
                <ARTG>290444</ARTG>
            </ARTGs>
            <MinimumBenefit>1468</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU209</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE345</PriorBillingCode>
            </PriorBillingCodes>
            <Name>iBalance HTO System</Name>
            <Description>Medial High Tibial Osteotomy Implant Device System</Description>
            <Size>Small (6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm)  Medium (5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm)  Large (5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5457</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>1468</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MZ020</BillingCode>
            <Name>Strasbourg Costal Osteosynthesis System (StraCos/StraTos) - Titanium 3D Rib Clips, Bar&#xD;
Mounting</Name>
            <Description>Titanium 3D Rib Clip, Bar Mounting, Straight and Angled 22.5 &amp; 45 degrees, Standard &amp; XL</Description>
            <Size>Two widths: Standard (19mm) &amp; XL (27.5mm)&#xD;
Three Angles: 0 (Straight), 22.5 &amp; 45 degrees</Size>
            <SupplierCode>MZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5938</SubGroupID>
            <Suffix>Modified</Suffix>
            <ARTGs>
                <ARTG>235762</ARTG>
            </ARTGs>
            <MinimumBenefit>1569</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN326</BillingCode>
            <Name>MatrixRIB Fixation System</Name>
            <Description>Pre-Contoured Plates; Straight Plates; Universal Plates</Description>
            <Size>7 - 30 holes </Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5938</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO438</BillingCode>
            <Name>RibLoc U+ Chest Wall Plate</Name>
            <Description>RibLoc U+ Chest Wall Plate</Description>
            <Size>4 Hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5938</SubGroupID>
            <ARTGs>
                <ARTG>158695</ARTG>
            </ARTGs>
            <MinimumBenefit>1338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO439</BillingCode>
            <Name>RibLOc U+ Chest Wall Plate</Name>
            <Description>RibLoc U+ Chest Wall Plate</Description>
            <Size>16 Hole, 22 Hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5938</SubGroupID>
            <ARTGs>
                <ARTG>158695</ARTG>
            </ARTGs>
            <MinimumBenefit>1338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO440</BillingCode>
            <Name>RibLoc U+ Chest Wall Plate</Name>
            <Description>RibLoc U+ Chest Wall Plate</Description>
            <Size>8 Hole,12 Hole</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5938</SubGroupID>
            <ARTGs>
                <ARTG>158695</ARTG>
            </ARTGs>
            <MinimumBenefit>1338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MZ019</BillingCode>
            <Name>Strasbourg Costal Osteosynthesis System (StraCos/StraTos)</Name>
            <Description>Titanium 3D Rib Clip, 6, 9 &amp; 13 Segments, Standard width and XL</Description>
            <Size>6 segments (46 mm)&#xD;
9 segments (70 mm)&#xD;
13 segments XL (25.5 mm width)</Size>
            <SupplierCode>MZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5938</SubGroupID>
            <ARTGs>
                <ARTG>235762</ARTG>
            </ARTGs>
            <MinimumBenefit>1338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI928</BillingCode>
            <Name>RibFix Blu</Name>
            <Description>Rib Osteosynthesis Plates</Description>
            <Size>8-24 hole</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>5938</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>1338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MZ021</BillingCode>
            <Name>Strasbourg Costal Osteosynthesis System (StraCos/StraTos) - Titanium Connecting Bar,&#xD;
(partially &amp; completely serrated)</Name>
            <Description>Titanium Connecting Bar for Straight and Angled 3D Rip Clips&#xD;
partially serrated&#xD;
completely serrated</Description>
            <Size>Three Sizes of Partially Serrated :&#xD;
150, 190 &amp; 230mm;&#xD;
Two sizes of Completely Serrated:&#xD;
190 &amp; 230mm.</Size>
            <SupplierCode>MZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1772</GroupID>
            <SubGroupID>6181</SubGroupID>
            <ARTGs>
                <ARTG>235762</ARTG>
            </ARTGs>
            <MinimumBenefit>1204</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM247</BillingCode>
            <Name>Compression Staples</Name>
            <Description>Compression Staples</Description>
            <Size>Multiple sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>COMP</Suffix>
            <ARTGs>
                <ARTG>236772</ARTG>
            </ARTGs>
            <MinimumBenefit>396</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM386</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PB061</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Compression Staple</Name>
            <Description>Compression Staple</Description>
            <Size>Multiple Sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>COMP</Suffix>
            <ARTGs>
                <ARTG>328461</ARTG>
            </ARTGs>
            <MinimumBenefit>396</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB061</BillingCode>
            <Name>Compression Staple</Name>
            <Description>Compression Staple</Description>
            <Size>Multiple Sizes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>COMP</Suffix>
            <ARTGs>
                <ARTG>319175</ARTG>
            </ARTGs>
            <MinimumBenefit>396</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA023</BillingCode>
            <Name>Arcus Staple System</Name>
            <Description>Compression Staple</Description>
            <Size>8-20mm width</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>COMP</Suffix>
            <ARTGs>
                <ARTG>308503</ARTG>
            </ARTGs>
            <MinimumBenefit>396</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV025</BillingCode>
            <Name>Staplizer Bone Staple Cartridge</Name>
            <Description>5 Titanium staples per cartridge</Description>
            <Size>7 x 7mm, 7 x 10mm, 10 x 7mm, 10 x 10mm, 10 x 15mm, 13 x 7mm, 13 x 10mm, 13 x 15mm, 13 x 20mm, 16 x 10mm, 16 x 15mm, 16 x 20mm, 16 x 25mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MI</Suffix>
            <ARTGs>
                <ARTG>93500</ARTG>
            </ARTGs>
            <MinimumBenefit>255</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU008</BillingCode>
            <Name>Arcad osteosynthesis memory staples</Name>
            <Description>Memory metal implants</Description>
            <Size>8 to 25mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>235764</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER439</BillingCode>
            <Name>Paragon 28 JAWS Nitinol Staple System</Name>
            <Description>Paragon 28 JAWS Nitinol Staple System</Description>
            <Size>bridge width 8-25 mm, angle 0 or 30, step height 4-12 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>291681</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HJ006</BillingCode>
            <Name>MEMODYN Hot Shape Memory Bipode Staple</Name>
            <Description>Nitinol Memory Staple</Description>
            <Size>6mm - 30mm </Size>
            <SupplierCode>HJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>340094</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU160</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE646</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DynaNite</Name>
            <Description>Nitinol Staple for Osteotomy Fixation</Description>
            <Size>Width (9mm-25mm)    Length (7mm-20mm)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>350734</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW462</BillingCode>
            <Name>Memometal Memory Staples</Name>
            <Description>Memory Metal Implants</Description>
            <Size>10 mm to 25 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>149534</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW832</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR290</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Eleos staple</Name>
            <Description>Foot staple</Description>
            <Size>4-34/38mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>122968</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW833</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR291</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fuseforce Fixation System</Name>
            <Description>Osteosynthesis Staple Memory Alloy</Description>
            <Size>8-25mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>122968</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM214</BillingCode>
            <Name>Highly Elastic Staples</Name>
            <Description>Nitinol Staples</Description>
            <Size>8-25mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>229705</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM355</BillingCode>
            <Name>Compression Staple</Name>
            <Description>Memory Metal Compression Staple</Description>
            <Size>Multiple Sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>338955</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM364</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH518</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Clover Staple</Name>
            <Description>Plate Staple, 3 or 4 leg</Description>
            <Size>(10-16)mm x (8-16)mm plate x (10-15)mm leg length x (3 or 4) leg</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>218346</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH527</BillingCode>
            <Name>Dynafit System Staples</Name>
            <Description>Nitinol Memory Staples</Description>
            <Size>8mm - 25mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>221403</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF089</BillingCode>
            <Name>Speyside Memory Staple</Name>
            <Description>Speyside Memory Staple  - Medium</Description>
            <Size>Width 11-20 mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK614</BillingCode>
            <Name>M-Fix</Name>
            <Description>Nitinol</Description>
            <Size>10-19mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>140683</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY837</BillingCode>
            <Name>Nitinol Implant System</Name>
            <Description>Bone staples</Description>
            <Size>Bridge size 9-30</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <Suffix>MM</Suffix>
            <ARTGs>
                <ARTG>95685</ARTG>
            </ARTGs>
            <MinimumBenefit>507</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH191</BillingCode>
            <Name>Barouk System Staples</Name>
            <Description>Varisation Staple  Stainless Steel</Description>
            <Size>26-90Deg x 8-10mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>127053</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU015</BillingCode>
            <Name>Arcad osteosynthesis memory staples</Name>
            <Description>Stainless steel static staples</Description>
            <Size>8 to 10 mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>235764</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR118</BillingCode>
            <Name>LARS Ligament Staple</Name>
            <Description>CoCr synthetic ligament anchor</Description>
            <Size>Width 8mm &amp; length 20mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>138574</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO101</BillingCode>
            <Name>Medartis All-in-One Staples</Name>
            <Description>Orthopaedic Stainless Steel Bone Staple</Description>
            <Size>8 - 10 mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>322413</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU240</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE062</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ligament Staples</Name>
            <Description>Cobalt Chromium Molybdenium Alloy</Description>
            <Size>6mm - 16mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>354063</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU263</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE292</PriorBillingCode>
            </PriorBillingCodes>
            <Name>QuickFix Staple System</Name>
            <Description>Compression Staple for Fusion</Description>
            <Size>8mm 10mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>367491</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW317</BillingCode>
            <Name>Rutherford Staple</Name>
            <Description>Ellison Arched Staple, Vitallium</Description>
            <Size>9,12,15mm x 23mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>139631</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW318</BillingCode>
            <Name>Rutherford Staple</Name>
            <Description>Ellison Flat Staple, Vitallium</Description>
            <Size>8,11,14 x 23mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>139631</ARTG>
                <ARTG>16229</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW319</BillingCode>
            <Name>Rutherford Staple</Name>
            <Description>Ellison Soft Tissue Retainer,  Vitallium</Description>
            <Size>8,11,14mm </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>139631</ARTG>
                <ARTG>16229</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW557</BillingCode>
            <Name>Stryker Memometal Varisation Staple</Name>
            <Description>Varisation Staple Stainless Steel</Description>
            <Size>26-90Deg x 8-10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>149534</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW700</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Foot &amp; Ankle System</Name>
            <Description>Compression Staple, Stainless Steel</Description>
            <Size>13, 15, 20, 25mm interaxis, leg lengths 11, 13, 15, 17, 20 &amp; 25mm, 10 Sizes in Total</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>122968</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW701</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Charlotte Foot &amp; Ankle System</Name>
            <Description>Quick Staple, Stainless Steel</Description>
            <Size>One Size Only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>122968</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW920</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR400</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix Compression Staples</Name>
            <Description>The NexFix Compression Staple is made of stailess steel and is used for internal fixation of fractures, fusions, bone grafts and osteotomies in the bones of the hand and foot. It is designed so the surgeon can control the amount of compression depending on the type of osteotomy and on the patient’s bone quality</Description>
            <Size>10 mm in width, leg length varies 13 mm - 20 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>219433</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW921</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR401</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NexFix Closing Wedge Osteotomy Staples</Name>
            <Description>The NexFix Closing wedge osteotomy staples are made of stainless steel and are intended to be used for internal fixation of fusions, bone grafts and osteotomies in the bones of the hand and foot following alignment correction</Description>
            <Size>8mm x 90 deg, 8mm x 64 deg</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>219433</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM248</BillingCode>
            <Name>OS2®-V Varisation Staple</Name>
            <Description>Varisation Staple</Description>
            <Size>8 &amp; 10mm, 26 degrees &amp; 90 degrees</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>236772</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM362</BillingCode>
            <Name>X-Clips</Name>
            <Description>X-Clips</Description>
            <Size>Multiple sizes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>164980</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH528</BillingCode>
            <Name>Dynafit System Staples</Name>
            <Description>Foot Staples</Description>
            <Size>8-10mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>221403</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB070</BillingCode>
            <Name>Static Staple</Name>
            <Description>Static Staple</Description>
            <Size>8mm - 10mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>332960</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF125</BillingCode>
            <Name>Speyside STAPLE</Name>
            <Description>STAPLE 90° 10MM, STAPLE 26° 10MM, STAPLE 90° 8MM, STAPLE 26° 8MM</Description>
            <Size>STAPLE 90° 10MM WIDE, STAPLE 26° 10MM WIDE, STAPLE 90° 8MM WIDE, STAPLE 26° 8MM WIDE</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK621</BillingCode>
            <Name>StaFIX</Name>
            <Description>The StaFIX Staples are retained implants and removable used primarily for the following applications: Synthesis of fractures; Synthesis of osteotomies; Arthrodesis; Reattachment of ligaments ot tendons.  The aim of the StaFIX staple is to provide a effective fixation of the bone fragments during healing.</Description>
            <Size>6x6, 6x12,8x8, 8x16, 10x10, 10x20, 12x24</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>140683</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL196</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG075</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Solustaple Standard Staple</Name>
            <Description>Stainless steel 90 deg &amp; 26 degree</Description>
            <Size>8 &amp; 10mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>173961</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL207</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IG103</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Uni-Clip Compression Staple</Name>
            <Description>Stainless Steel, Notched and Non-Notched</Description>
            <Size>Width 11-30mm, Length 13-32mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>173961</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN463</BillingCode>
            <Name>Bone Staple</Name>
            <Description>Fixation - Osteotomy</Description>
            <Size>Fixation Staple 5mm- 14mm.  McConnel HTO PF 15mm 0-S</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>120322</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN464</BillingCode>
            <Name>Bone Staple</Name>
            <Description>Fixation - Short Leg</Description>
            <Size>Xsmall - large</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>120322</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN465</BillingCode>
            <Name>Bone Staple</Name>
            <Description>Fixation - Table</Description>
            <Size>Small -Medium  13mm - 16mm. </Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>120322</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN466</BillingCode>
            <Name>Bone Staple</Name>
            <Description>Krackow HTO</Description>
            <Size>12,14,16mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>120322</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ071</BillingCode>
            <Name>Mini Staple</Name>
            <Description>Varisation Staple&#xD;
Straight, Angled</Description>
            <Size>26° - 90°&#xD;
8 x 10 mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1773</GroupID>
            <SubGroupID>5514</SubGroupID>
            <ARTGs>
                <ARTG>167049</ARTG>
            </ARTGs>
            <MinimumBenefit>127</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU247</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE126</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Chondral Dart</Name>
            <Description>Polylactide Compositition</Description>
            <Size>Length 18mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>140552</ARTG>
                <ARTG>360372</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW007</BillingCode>
            <Name>Biotek ligament anchor, knotless</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 2.8mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW375</BillingCode>
            <Name>Howmedica Mainstay Soft Tissue Anchor</Name>
            <Description>Zip anchor - Titanium</Description>
            <Size>Sip 4.5 anchor with #5 suture and #2 suture 2 strands, zip 3.5 anchor with #2 suture and #0 suture 2 strands, zip 2.7 anchor with #0 suture</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <ARTGs>
                <ARTG>139736</ARTG>
                <ARTG>16234</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM455</BillingCode>
            <Name>VIMS ligament anchor, knotless</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 2.8mm; 5.0mm; 5.5mm; 6.0mm; 7.0mm; 8.0mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <ARTGs>
                <ARTG>338393</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM491</BillingCode>
            <Name>Knotless Suture Anchors</Name>
            <Description>Knotless Suture Anchors</Description>
            <Size>Various sizes </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <ARTGs>
                <ARTG>364759</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV071</BillingCode>
            <Name>Contour Meniscus Arrow</Name>
            <Description>80L/20D, LPLA &amp; PLLA</Description>
            <Size>1.1mm x 10, 13,16mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <ARTGs>
                <ARTG>139661</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK048</BillingCode>
            <Name>Stryker Cuff Anchor</Name>
            <Description>Titanium anchor kit for soft tissue reattachment</Description>
            <Size>Length 5-8mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <ARTGs>
                <ARTG>139736</ARTG>
                <ARTG>78130</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VY004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM390</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Suture Anchor No Suture</Name>
            <Description>Suture Anchor No Suture</Description>
            <Size>All sizes</Size>
            <SupplierCode>VY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5382</SubGroupID>
            <ARTGs>
                <ARTG>324214</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ421</BillingCode>
            <Name>MicroFix Anchor with Suture</Name>
            <Description>Anchor with suture</Description>
            <Size>Anchor with Suture and Multiple size needles</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>140549</ARTG>
                <ARTG>161091</ARTG>
            </ARTGs>
            <MinimumBenefit>503</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ926</BillingCode>
            <Name>MiniLok Anchor System</Name>
            <Description>Suture Anchor</Description>
            <Size>2.3mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>140353</ARTG>
            </ARTGs>
            <MinimumBenefit>503</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV125</BillingCode>
            <Name>GENESYS PressFT Suture Anchor 2.1mm</Name>
            <Description>The ConMed Linvatec GENESYS PressFT (biocomposite) Suture Anchors are manufactured from polylactide copolymer (96L/4D PLA co-polymer) and beta-tricalcium phosphate (B-TCp), and are provided sterile, preloaded on a single-use driver and pre-threaded with either one or two Hi-Fi Sutures</Description>
            <Size>2.1mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>208881</ARTG>
            </ARTGs>
            <MinimumBenefit>503</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN906</BillingCode>
            <Name>Smith and Nephew Small Absorbable Anchor</Name>
            <Description>Absorbable suture anchor for repair and reattachment of the soft tissue</Description>
            <Size>≤2.3mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>164725</ARTG>
                <ARTG>164726</ARTG>
                <ARTG>164727</ARTG>
                <ARTG>204889</ARTG>
                <ARTG>204890</ARTG>
            </ARTGs>
            <MinimumBenefit>503</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV115</BillingCode>
            <Name>Sequent Meniscal Repair Device</Name>
            <Description>The Sequent Meniscal Repair Device is pre-loaded with polyetheretherketone (PEEK) implants threaded onto one size #0 (3.5 metric) HiFi® suture.  The device sequentially deplos the implants and suture that are tightened down to create multiple stitches to create fixation points along a soft tissue tear</Description>
            <Size>7 (5.1mm x 1.3mm Implants)</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <Suffix>MI</Suffix>
            <ARTGs>
                <ARTG>120427</ARTG>
            </ARTGs>
            <MinimumBenefit>755</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH360</BillingCode>
            <Name>JuggerKnot/JuggerLoc Soft Anchor</Name>
            <Description>Suture Anchor, Polyester, PE</Description>
            <Size>1.0mm, 1.4mm,1.45mm, 1.5mm, 2.1mm, 2.3mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>208040</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI969</BillingCode>
            <Name>JuggerStitch</Name>
            <Description>Meniscal Repair Device</Description>
            <Size>one size</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>117747</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PF030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ARC Anchors</Name>
            <Description>All Suture Anchor, multiple suture options</Description>
            <Size>Small, Medium</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>336706</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW009</BillingCode>
            <Name>Biotek Ligament Anchor</Name>
            <Description>Soft tissue ligament anchor loaded with UHMWPE fiber and needle </Description>
            <Size>Diameter: 1.8mm - 2.00mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW014</BillingCode>
            <Name>Biotek Ligament Anchor PEEK</Name>
            <Description>Soft tissue ligament anchor loaded with UHMWPE fiber and needle</Description>
            <Size>Diameter: 1.8mm - 2.00mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW019</BillingCode>
            <Name>Biotek Soft Ligament Anchor</Name>
            <Description>Soft tissue ligament anchor loaded with UHMWPE fiber and needle </Description>
            <Size>Diameter 1.2mm - 2.00mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ080</BillingCode>
            <Name>PEEK Suture Anchor</Name>
            <Description>PEEK Suture Anchor</Description>
            <Size>1.5mm, 2.3mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>325207</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ089</BillingCode>
            <Name>PEEK Suture Anchor</Name>
            <Description>PEEK Suture Anchor</Description>
            <Size>1.5mm, 2.3mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>352376</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU211</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE430</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Corkscrew Suture Anchor</Name>
            <Description>Titanium alloy with Fibrewire suture</Description>
            <Size>2.2mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU212</BillingCode>
            <Name>FiberTak Suture Anchor</Name>
            <Description>Suture anchor with 2 x #2 FibreWire CL or 1.3mm SutureTape</Description>
            <Size>1.3mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU213</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE654</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Nano Corkscrew FT Suture Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>1.7mm x 5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU214</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE697</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mini Hip SutureTak</Name>
            <Description>Suture anchor</Description>
            <Size>Diameter: 2mm  Length: 8.6mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU325</BillingCode>
            <Name>DX Knotless FiberTak</Name>
            <Description>Soft Tissue Fixation Anchor</Description>
            <Size>2.4-3.9mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>384730</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HV003</BillingCode>
            <Name>OzAnchor All Suture</Name>
            <Description>Anchor with suture</Description>
            <Size>1.4mm</Size>
            <SupplierCode>HV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>351431</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW542</BillingCode>
            <Name>ICONiX Anchor</Name>
            <Description>ICONiX Anchor soft-tissue fixation </Description>
            <Size>1.4mm, 2.3mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW583</BillingCode>
            <Name>ICONiX w/ Needles</Name>
            <Description>ICONiX w/ Needles Anchor for soft tissue fixation</Description>
            <Size>1.4mm, 2.3mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW634</BillingCode>
            <Name>ICONiX Speed Anchor</Name>
            <Description>All Suture</Description>
            <Size>2.3mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ087</BillingCode>
            <Name>Mitek Tacit Quick Anchor </Name>
            <Description>Titanium Suture Anchor</Description>
            <Size>2.0 x 3.6mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136374</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ091</BillingCode>
            <Name>Mini Quick Anchor with Suture</Name>
            <Description>Anchor with Suture</Description>
            <Size>Anchor with Suture and Multiple size needles</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136374</ARTG>
                <ARTG>154626</ARTG>
                <ARTG>154627</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ100</BillingCode>
            <Name>Micro Quick Anchor </Name>
            <Description>Titanium Suture Anchor</Description>
            <Size>1.3 x 3.7mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136374</ARTG>
                <ARTG>161092</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH065</BillingCode>
            <Name>Rejoin Healfix Suture Anchor</Name>
            <Description>Suture Anchor System</Description>
            <Size>Less than 2.4mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH069</BillingCode>
            <Name>Rejoin Peek Anchor</Name>
            <Description>Suture Anchor System</Description>
            <Size>less than 2.4mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH070</BillingCode>
            <Name>Rejoin JoinFix All Suture Anchor</Name>
            <Description>Suture Anchor System</Description>
            <Size>less than 2.4mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM457</BillingCode>
            <Name>VIMS Ligament Anchor</Name>
            <Description>Soft tissue ligament anchor loaded with UHMWPE fiber and needle </Description>
            <Size>Diameter: 1.8mm - 2.00mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>338393</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM467</BillingCode>
            <Name>Soft Anchor</Name>
            <Description>Soft Anchor</Description>
            <Size>≤2.3mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>339014</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM488</BillingCode>
            <Name>Fully Threaded Suture Anchor</Name>
            <Description>Fully Threaded Suture Anchor</Description>
            <Size>≤2.3mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>364759</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV005</BillingCode>
            <Name>Ultrafix MiniMite StitchPak Suture Anchor</Name>
            <Description>Soft Tissue Re-attachment - Stainless Steel</Description>
            <Size>2.3mm predeployed diameter</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV024</BillingCode>
            <Name>Ultrafix MicroMite Small Joint Anchor</Name>
            <Description>Suture Anchoring Device - Titanium</Description>
            <Size>1.5mm predeployed diameter</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV119</BillingCode>
            <Name>Y-Knot Suture Anchor</Name>
            <Description>Y-Knot All Suture Anchor</Description>
            <Size>1.3mm to 2.1mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV124</BillingCode>
            <Name>PressFT PEEK Suture Anchor 2.1mm</Name>
            <Description>The ConMed Linvatec PressFT Suture Anchors are manufactured from PEEK and are provided, preloaded on a single use driver and pre-threaded with either one or two Hi-Fi Sutures.</Description>
            <Size>2.1mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV150</BillingCode>
            <Name>Paradigm ClickLok Anchor</Name>
            <Description> The Paradigm ClickLok Anchor (UHMWPE) is a High Strength Flat Braided Suture Anchor with Hi-Fi (UHMWPE) Braided Suture preloaded on Stainless Steel driver. It may be used in either arthroscopic or open surgical procedures. After the suture is anchored to the bone, it may be used to reattach soft tissue, such as ligaments, tendons, or joint capsules to the bone. The suture anchor system thereby stabilizes the damaged soft tissue, in conjunction with appropriate postoperative immobilization throughout the healing period.   </Description>
            <Size>1.8 mm all suture anchor</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN330</BillingCode>
            <Name>VERSALOOP Anchor System</Name>
            <Description>All-Suture Anchor</Description>
            <Size>1.5 mm, 1.8 mm, 1.5 mm XL</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>379270</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU178</BillingCode>
            <Name>All-Suture Anchor Size 1</Name>
            <Description>Suture Anchor</Description>
            <Size>Ø  1.4 and 1.8 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>330998</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF030</BillingCode>
            <Name>ARC Anchors</Name>
            <Description>All Suture Anchor, multiple suture options</Description>
            <Size>Small, Medium</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>308785</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ032</BillingCode>
            <Name>Draw Tight Suture Anchors</Name>
            <Description>Suture Anchor</Description>
            <Size>1.8 mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ048</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV078</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Parcus MiTi Titanium Screw In Suture Anchor -Small</Name>
            <Description>Threaded, tapered fastener for use in attachment of soft tissue to bone. The device is made from a Titanium alloy, TI-6A1-4V.</Description>
            <Size>2.0mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF147</BillingCode>
            <Name>S-Knot Anchor</Name>
            <Description>All suture anchors</Description>
            <Size>1.3 and 1.8mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK583</BillingCode>
            <Name>Nanotack Suture Anchor</Name>
            <Description>1.4mm High Strength PEEK suture anchor pre-loaded with suture and inserter for arthrosopic hip labral reattachment</Description>
            <Size>1.4mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>207253</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL160</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SL025</PriorBillingCode>
                <PriorBillingCode>SL063</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Smith and Nephew All Suture Anchors</Name>
            <Description>All Suture Repair</Description>
            <Size>Less than or equal to 2.3mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
                <ARTG>271876</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM146</BillingCode>
            <Name>RAPTOR Anchor</Name>
            <Description>Suture anchor for repair and reattachment of the soft tissue</Description>
            <Size>≤2.3mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM162</BillingCode>
            <Name>SPYROMITE</Name>
            <Description>A non-absorbable polymer (PEEK) anchor for use in ligament/tendon reconstruction in small joint applications</Description>
            <Size>2mm in diameter</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM163</BillingCode>
            <Name>DYNOMITE</Name>
            <Description>A non-absorbable polymer (PEEK) anchor for use in ligament/tendon reconstruction in small joint applications</Description>
            <Size>2mm in diameter</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY417</BillingCode>
            <Name>Titanium Wire, Barb and Needle</Name>
            <Description>Titanium wire surture and needle with titanium alloy barb fixation</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>139010</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA107</BillingCode>
            <Name>JuggerKnot Soft Anchor</Name>
            <Description>Suture Anchor, Ultra-high molecular weight polyethylene (UHMWPE), Polyester</Description>
            <Size>1.4mm, 1.45mm, 1.5mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5384</SubGroupID>
            <ARTGs>
                <ARTG>368790</ARTG>
            </ARTGs>
            <MinimumBenefit>294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU248</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE304</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioComposite SutureTak</Name>
            <Description>Suture Anchor</Description>
            <Size>2.4-3mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>164047</ARTG>
                <ARTG>354970</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ927</BillingCode>
            <Name>Panalok RC Anchor System</Name>
            <Description>Suture Anchor</Description>
            <Size>2.9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>143375</ARTG>
                <ARTG>143376</ARTG>
                <ARTG>143379</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ928</BillingCode>
            <Name>Bioknotless Anchor System</Name>
            <Description>Suture Anchor</Description>
            <Size>3.9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>143371</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ945</BillingCode>
            <Name>GRYPHON BR Instability Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>2.4-3.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>165434</ARTG>
                <ARTG>165465</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ950</BillingCode>
            <Name>HEALIX BR Anchor</Name>
            <Description>Biocryl Rapide anchor with suture</Description>
            <Size>3.4 to 3.9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>160908</ARTG>
                <ARTG>160909</ARTG>
                <ARTG>160910</ARTG>
                <ARTG>160911</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV126</BillingCode>
            <Name>GENESYS PressFT Suture Anchor 2.6mm</Name>
            <Description>The ConMed Linvatec GENESYS PressFT (biocomposite) Suture Anchors are manufactured from polylactide copolymer (96L/4D PLA co-polymer) and beta-tricalcium phosphate (B-TCp), and are provided sterile, preloaded on a single-use driver and pre-threaded with either one or two Hi-Fi Sutures</Description>
            <Size>2.6mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>208881</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN171</BillingCode>
            <Name>Lupine Anchor System</Name>
            <Description>Suture Anchor</Description>
            <Size>3.9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>125674</ARTG>
                <ARTG>125675</ARTG>
                <ARTG>143370</ARTG>
                <ARTG>143372</ARTG>
                <ARTG>154628</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN340</BillingCode>
            <Name>GRYPHON BR Instability Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>3.0 x 10.7mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>388083</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ054</BillingCode>
            <Name>Parcus AP knotless</Name>
            <Description>AP knotless push in anchors</Description>
            <Size>2.8, mm Anchors</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>375791</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF077</BillingCode>
            <Name>Signature Vector™ Anchor</Name>
            <Description>These are an hydroxyapatite incorporated absorbable suture anchor for repair and&#xD;
reattachment of the labrum in shoulder and hip arthroscopy.</Description>
            <Size>2.9mm, 3.2mm, 3.5mm and 3.7mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF129</BillingCode>
            <Name>FAA Anchor</Name>
            <Description>These are PLA/TCP absorbable anchor with suture for repair and reattachment of the labrum in shoulder and hip arthroscopy.</Description>
            <Size>2.4mm, 3.0mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL155</BillingCode>
            <Name>RAPTOR Anchor - Absorbable</Name>
            <Description>Absorbable suture anchor for repair and reattachment of the soft tissue</Description>
            <Size>2.4 – 3.9mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>161696</ARTG>
                <ARTG>164725</ARTG>
                <ARTG>164726</ARTG>
                <ARTG>164727</ARTG>
                <ARTG>169170</ARTG>
                <ARTG>348730</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH361</BillingCode>
            <Name>JuggerKnot/JuggerLoc Soft Anchor</Name>
            <Description>Suture Anchor, Polyester, PE</Description>
            <Size>2.9mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>208040</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI968</BillingCode>
            <Name>ToggleLoc</Name>
            <Description>Femoral Fixation Device</Description>
            <Size>15mm-60mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>116765</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU021</BillingCode>
            <Name>Memofix</Name>
            <Description>Threaded Titanium Suture Anchor</Description>
            <Size>Diameter 3mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>288706</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PF029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ARC Anchors</Name>
            <Description>All suture soft tissue anchor</Description>
            <Size>Large</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>336706</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW004</BillingCode>
            <Name>Biotek ligament anchor titanium</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 2.8mm; 3.5mm;</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW005</BillingCode>
            <Name>Biotek ligament anchor PEEK</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 2.8mm; 3.0mm; 3.5mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW020</BillingCode>
            <Name>Biotek Soft Ligament Anchor</Name>
            <Description>Soft tissue ligament anchor loaded with UHMWPE fiber and needle </Description>
            <Size>Diameter: 2.9mm </Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY576</BillingCode>
            <Name>Healix Anchor System</Name>
            <Description>Titanium anchor with suture</Description>
            <Size>2.9 - 3.9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ081</BillingCode>
            <Name>PEEK Suture Anchor</Name>
            <Description>PEEK Suture Anchor</Description>
            <Size>2.9mm, 3.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>325207</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ085</BillingCode>
            <Name>PEEK Suture Anchor</Name>
            <Description>PEEK Suture Anchor</Description>
            <Size>2.9mm, 3.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>352376</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU215</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE198</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fastak Suture Anchor (Small Bone)</Name>
            <Description>With Fibrewire Suture</Description>
            <Size>Dia. 2.4mm x Length 7.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU216</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE225</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fastak Anchor</Name>
            <Description>Titanium with fibrewire suture</Description>
            <Size>2.8mm x 11.7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU217</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE428</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Corkscrew Suture Anchor</Name>
            <Description>Titanium alloy with Fibrewire suture</Description>
            <Size>3.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU224</BillingCode>
            <Name>Knotless Hip SutureTak</Name>
            <Description>Knotless suture anchor for hip labral fixation</Description>
            <Size>Diameter: 3mm  Length: 12.7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU225</BillingCode>
            <Name>FiberTak DR/ FiberTak RC/FiberTak Knotless</Name>
            <Description>Suture Anchor</Description>
            <Size>2.6mm&gt;</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU226</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE559</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dx Swivelock SL</Name>
            <Description>A knotless screw in Anchor used for Soft Tissue Fixation</Description>
            <Size>3.5mm Diameter x 8.5mm length</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU227</BillingCode>
            <Name>Dx Swivelock</Name>
            <Description>A knotless screw in anchor used for soft tissue fixation to bone</Description>
            <Size>2.4 - 3.9mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU230</BillingCode>
            <Name>SwiveLock Suture Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>3.5mm - 3.9mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU231</BillingCode>
            <Name>SutureTak</Name>
            <Description>Suture Anchor</Description>
            <Size>2.4mm - 3.9mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU234</BillingCode>
            <Name>Pushlock Suture Anchor</Name>
            <Description>Knotless Suture Anchor</Description>
            <Size>2.5 - 3.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU250</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE706</PriorBillingCode>
            </PriorBillingCodes>
            <Name>FiberStitch</Name>
            <Description>Meniscal suture anchor</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>328289</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU269</BillingCode>
            <Name>BioComposite PushLock</Name>
            <Description>BioComposite Pushlock Knotless Suture Anchor</Description>
            <Size>2.4 - 3.5 mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>164045</ARTG>
                <ARTG>354973</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU270</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE475</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biocomposite Swivelock Anchor</Name>
            <Description>Knotless Suture Anchor</Description>
            <Size>3.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>164046</ARTG>
                <ARTG>354972</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU274</BillingCode>
            <Name>Nano Swivelock Anchor</Name>
            <Description>Soft Tissue Fixation Anchor</Description>
            <Size>2.5mm x 7mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU307</BillingCode>
            <Name>Dx FiberTak double loaded with 0.9mm SutureTape</Name>
            <Description>Soft Tissue Fixation Device</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU318</BillingCode>
            <Name>FiberTak </Name>
            <Description>Self-Bunching Soft Anchor</Description>
            <Size>2.6</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HV004</BillingCode>
            <Name>OzAnchor All Suture</Name>
            <Description>Anchor with suture</Description>
            <Size>2.5mm</Size>
            <SupplierCode>HV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>351431</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW548</BillingCode>
            <Name>Knotilus Anchor</Name>
            <Description>Knotilus Anchor Soft Tissue Fixation </Description>
            <Size>Knotilus Anchor, 3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>229722</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW555</BillingCode>
            <Name>TwinLoop FLEX Anchor</Name>
            <Description>TwinLoop FLEX Anchor</Description>
            <Size>3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW559</BillingCode>
            <Name>ICONiX TT Anchor</Name>
            <Description>ICONiX TT Anchor soft-tissue fixation</Description>
            <Size>1.4mm, 2.3mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW570</BillingCode>
            <Name>CinchLock SS Flex Knotless Anchor</Name>
            <Description>CinchLock SS Flex Knotless Anchor for soft tissue fixation</Description>
            <Size>3mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW639</BillingCode>
            <Name>AIR+ Meniscus System</Name>
            <Description>All Inside Meniscal Device System</Description>
            <Size>2.4mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW667</BillingCode>
            <Name>Omega All-PEEK Knotless Anchor</Name>
            <Description>Knotless Suture Anchor</Description>
            <Size>3.9mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW841</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR302</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GRAVITY</Name>
            <Description>Titanium Suture Anchor System</Description>
            <Size>2.7mm - 3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>175633</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW878</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR348</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Piton Knotless Fixation Implant System</Name>
            <Description>System includes Piton Knotless anchors (single) NiTi and two Force Fiber sutures size #2 UHMWPE</Description>
            <Size>Anchor: one size. Suture: size 2 in the system, options: blue/white or black/white</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>163843</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW935</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR422</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Insite FT PEEK Knotless Suture Anchor</Name>
            <Description>PEEK knotless suture anchor, fully threaded</Description>
            <Size>4.5mm to 6.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>163843</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW939</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR426</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Piton 2.8mm</Name>
            <Description>Soft Tissue Fixation Implant</Description>
            <Size>2.8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>163843</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB008</BillingCode>
            <Name>AIM-TEC MINI PK</Name>
            <Description>Peek screw type suture anchor system</Description>
            <Size>3mm</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>259865</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT034</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IT016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anchor It</Name>
            <Description>Fully threaded Titanium suture anchor with fibrewire suture</Description>
            <Size>2.5mm - 3.5mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>271554</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ083</BillingCode>
            <Name>Mitek GII Anchor Threader Tab</Name>
            <Description>Titanium Suture Anchor</Description>
            <Size>2.4 x 8.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
                <ARTG>136374</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ089</BillingCode>
            <Name>Mitek GII QuickAnchor Plus </Name>
            <Description>Titanium Anchor, with various sutures</Description>
            <Size>2.4 x 8.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
                <ARTG>140532</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ093</BillingCode>
            <Name>Mitek Rotator Cuff Quick Anchor Plus </Name>
            <Description>Titanium  Anchor, with various sutures</Description>
            <Size>2.8 x 11mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
                <ARTG>140533</ARTG>
                <ARTG>140797</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ095</BillingCode>
            <Name>Mitek Super Quick Anchor Plus </Name>
            <Description>Titanium  Anchor, with various sutures</Description>
            <Size>2.8 x 11.4mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
                <ARTG>140548</ARTG>
                <ARTG>140796</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ946</BillingCode>
            <Name>GRYPHON PEEK Instability Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>2.4-3.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>165465</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ948</BillingCode>
            <Name>Healix Anchor System</Name>
            <Description>PEEK anchor with suture</Description>
            <Size>2.9 - 3.9mm anchor diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>155607</ARTG>
                <ARTG>155608</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH062</BillingCode>
            <Name>Healfix Anchor System</Name>
            <Description>Titanium Suture Anchor</Description>
            <Size>2.4mm - 3.9mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH063</BillingCode>
            <Name>Rejoin Peek Anchor System</Name>
            <Description>Suture Anchor System</Description>
            <Size>2.4mm - 3.9mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH064</BillingCode>
            <Name>Rejoin JoinFix All-Suture Anchor</Name>
            <Description>Suture Anchor System</Description>
            <Size>2.4mm - 3.9mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH066</BillingCode>
            <Name>Rejoin Rapidlink</Name>
            <Description>Suture-Anchor Meniscus Repair Device</Description>
            <Size>One Size</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM452</BillingCode>
            <Name>VIMS ligament anchor titanium</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 2.8mm; 3.5mm;</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>338393</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM453</BillingCode>
            <Name>VIMS ligament anchor PEEK</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 2.8mm; 3.0mm; 3.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>338393</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM468</BillingCode>
            <Name>Soft Anchor</Name>
            <Description>Soft Anchor</Description>
            <Size>2.4 – 3.9mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>339014</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM489</BillingCode>
            <Name>Fully Threaded Suture Anchor </Name>
            <Description>Fully Threaded Suture Anchor </Description>
            <Size>2.4-3.9mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>364759</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV010</BillingCode>
            <Name>Mini-Revo Screw</Name>
            <Description>Soft Tissue Re-attachment - Titanium</Description>
            <Size>2.7mm diameter</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV027</BillingCode>
            <Name>Pre-Loaded Ultrafix RC Anchor</Name>
            <Description>Surgical Grade Stainless Steel, preloaded with 2 #2 sutures</Description>
            <Size>Dia 2.9mm, length 6.5mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV123</BillingCode>
            <Name>Press FT PEEK Suture Anchor</Name>
            <Description>Press FT PEEK Suture Anchor - preloaded on a single driver</Description>
            <Size>2.6mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV139</BillingCode>
            <Name>Y-Knot RC &amp; Y-Knot Pro RC Suture Anchor</Name>
            <Description>The Y-Knot RC All-Suture Anchor is constructed from High Strength Flat Braided Suture.</Description>
            <Size>2.8mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN329</BillingCode>
            <Name>GRYPHON PEEK Suture Anchor </Name>
            <Description>Anchor with suture</Description>
            <Size>3.0 x 10.7mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN334</BillingCode>
            <Name>VERSALOOP Anchor System</Name>
            <Description>All-Suture Anchor</Description>
            <Size>2.5 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>379270</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU170</BillingCode>
            <Name>Mectalock PEEK</Name>
            <Description>Suture Anchor</Description>
            <Size>2.4 - 3.4 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>320484</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU179</BillingCode>
            <Name>All-Suture Anchor Size 2</Name>
            <Description>Suture Anchor</Description>
            <Size>Ø 2.4 and 2.8 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>330998</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB066</BillingCode>
            <Name>Full Thread Suture Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>2.4mm - 3.9mm </Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>323905</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB071</BillingCode>
            <Name>Peek Suture Anchor</Name>
            <Description>Non-absorbable suture anchor</Description>
            <Size>2.4mm - 3.9mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>323905</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF029</BillingCode>
            <Name>ARC Anchors</Name>
            <Description>All suture soft tissue anchor</Description>
            <Size>Large</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>308785</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ025</BillingCode>
            <Name>Parcus Series 3 Peek CF Suture Anchor</Name>
            <Description>Knotless push in Anchor with 2 sutures and suture passer.</Description>
            <Size>3.5mm diameter</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ030</BillingCode>
            <Name>Knotless PEEK CF Suture Anchors</Name>
            <Description>Suture Anchor, PEEK CF</Description>
            <Size>2.8mm   3.5mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ037</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PJ029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Draw tight, </Name>
            <Description>Push in anchors suture based. Recommended for use in both large and small repairs. with two sutures </Description>
            <Size>3.2 mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ038</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PJ029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Draw tight</Name>
            <Description>Draw tight suture based anchor with two suture tapes.  Recommended for use in both large and small joint repairs.</Description>
            <Size>3.2</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ047</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV077</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Parcus MiTi Titanium Screw In Suture Anchor - Medium and XL</Name>
            <Description>Threaded, tapered fastener for attachment of soft tissue to bone. The device is made from a Titanium Alloy, Ti-6A1-4V.</Description>
            <Size>2.5mm  3.5mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ053</BillingCode>
            <Name>Parcus Knotless PEEK push in  suture anchor</Name>
            <Description>Knotless PEEK push in suture anchors w/suture passer</Description>
            <Size>2.8mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF146</BillingCode>
            <Name>S-Knot Suture Anchor</Name>
            <Description>The S-Knot Suture Anchor is constructed from High Strength Flat Braided Suture threaded with either 2 or 3 #2 suture strands. The anchor may be inserted either by pre-punching using a 2.8mm bone punch or in the instance of softer bone and driven in using a mallet. Once the anchor is below the level of the cortical  bone the anchor is seated by pulling back on the sutures.</Description>
            <Size>2.8mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK584</BillingCode>
            <Name>Pivot Anatomic Labrum Restoration Anchors</Name>
            <Description>High Strength PEEK anchor pre-laoded with suture and inserter for arthroscopic hip labral reattachment</Description>
            <Size>12mm x 2.4-2.8mm, 1.4-2.0mm, 2.8-3.5mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>207253</ARTG>
                <ARTG>232914</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL056</BillingCode>
            <Name>ArthRoCare Anchor System</Name>
            <Description>Anchor fixating soft tissue to bone</Description>
            <Size>2.8 - 3.4mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>271876</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL061</BillingCode>
            <Name>Speedlock HIP Knotless Fixation Implant</Name>
            <Description>PEEK knotless suture anchor implant for fixation of soft tissue to bone in the hip</Description>
            <Size>3.4mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>271876</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL064</BillingCode>
            <Name>Q-Fix All Suture Anchor</Name>
            <Description>Soft suture anchor</Description>
            <Size>2.8mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>271876</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL183</BillingCode>
            <Name>MICRORAPTOR Knotless REGENESORB</Name>
            <Description>Knotless Suture Anchor, absorbable</Description>
            <Size>2.4 – 2.75mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>368071</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM177</BillingCode>
            <Name>RAPTORMITE 3.0 PK</Name>
            <Description>An non-absorbable polymer (PEEK) suture anchor for use in ligament/tendon reconstruction</Description>
            <Size>3mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN854</BillingCode>
            <Name>Fast-Fix Ultra</Name>
            <Description>Meniscal suture anchor</Description>
            <Size>One Size</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>120338</ARTG>
                <ARTG>154955</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN902</BillingCode>
            <Name>FAST-FIX 360</Name>
            <Description>This is a double anchor, self tying device for all-inside meniscal repair</Description>
            <Size>One size</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>120338</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN903</BillingCode>
            <Name>Minitac</Name>
            <Description>This is a titanium suture anchor with needles for repair and reattachment of the ligaments in small joint arthroscopy</Description>
            <Size>2.0mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN907</BillingCode>
            <Name>TWINFIX Ti</Name>
            <Description>This is a titanium suture anchor for repair and reattachment of ligaments to bone in joint arthroscopy</Description>
            <Size>2.8mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN909</BillingCode>
            <Name>RAPTOR Anchor</Name>
            <Description>Suture anchor for repair and reattachment of the soft tissue</Description>
            <Size>2.4 – 3.9mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VY001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM385</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Suture Anchors with Suture</Name>
            <Description>Suture Anchors with Suture</Description>
            <Size>2.4 - 3.9mm </Size>
            <SupplierCode>VY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>324214</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Quattro Anchor</Name>
            <Description>Anchor manufactured from PEEK-OPTIMA polymer pre-assembled to stainless steel inserter.</Description>
            <Size>2.9mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>209509</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA108</BillingCode>
            <Name>JuggerKnot Soft Anchor</Name>
            <Description>Suture Anchor, Ultra-high molecular weight polyethylene (UHMWPE), Polyester</Description>
            <Size>2.9mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>368790</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA115</BillingCode>
            <Name>Betta Link Knotless Anchor</Name>
            <Description>Knotless Anchor manufactured from PEEK-OPTIMA polymer pre-assembled to stainless steel inserter. Provided as a single-use sterile device.</Description>
            <Size>3.2mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5385</SubGroupID>
            <ARTGs>
                <ARTG>387052</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU251</BillingCode>
            <Name>BioComposite SwiveLock</Name>
            <Description>BC SwiveLock</Description>
            <Size>&gt;4mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>164046</ARTG>
                <ARTG>222906</ARTG>
                <ARTG>222907</ARTG>
                <ARTG>354972</ARTG>
                <ARTG>354974</ARTG>
                <ARTG>354975</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU252</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE436</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioComposite PushLock</Name>
            <Description>Knotless Suture Anchor</Description>
            <Size>4.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>354973</ARTG>
                <ARTG>164045</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU273</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE302</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioComposite Corkscrew Suture Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>&gt;4mm-6.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>354971</ARTG>
                <ARTG>164048</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT022</BillingCode>
            <Name>Loop It</Name>
            <Description>Titanium or stainless steel fixation device with non-absorbable fibrewire suture material</Description>
            <Size>One Size Only</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>297561</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ099</BillingCode>
            <Name>Panalok Anchor System</Name>
            <Description>Polylactic acid absorbable anchor with absorbable and non-absorbable suture</Description>
            <Size>4.1 x 6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>143370</ARTG>
                <ARTG>143372</ARTG>
                <ARTG>143378</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ929</BillingCode>
            <Name>BioKnotless RC Anchor System</Name>
            <Description>Suture Anchor</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>143373</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ949</BillingCode>
            <Name>HEALIX Anchor System</Name>
            <Description>Biocryl Rapide anchor with suture</Description>
            <Size>4.5-6.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>330848</ARTG>
                <ARTG>217856</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV118</BillingCode>
            <Name>Genesys CrossFT</Name>
            <Description>Micro TCP Soft Tissue Suture Anchor with multiple sutures with or without needles</Description>
            <Size>4.5mm, 5.5mm, 6.5mm diameters</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>194022</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN245</BillingCode>
            <Name>HEALIX Anchor System</Name>
            <Description>Biocryl Rapide anchor with Permatape suture</Description>
            <Size>4.5-6.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>311080</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN257</BillingCode>
            <Name>HEALIX Anchor System</Name>
            <Description>Biocryl Rapide anchor with Dynacord suture</Description>
            <Size>4.5-6.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>330845</ARTG>
                <ARTG>330847</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ049</BillingCode>
            <Name>Parcus AP large</Name>
            <Description>AP knotless push in Anchors Large</Description>
            <Size>4.5, 5,5 mm </Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>375791</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ050</BillingCode>
            <Name>Parcus AP twist</Name>
            <Description>Twist screw in AP anchor</Description>
            <Size>4.5-6.5 mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>375791</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF076</BillingCode>
            <Name>Signature Vortex™ Anchor</Name>
            <Description>These are an hydroxyapatite incorporated PEEK suture anchor for repair and reattachment of&#xD;
the soft tissue in the shoulder.</Description>
            <Size>4.5mm, 5.5mm and 6.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF079</BillingCode>
            <Name>Carbine CF Anchor</Name>
            <Description>These are CF PEEK suture anchor for repair and reattachment of the soft tissue in the&#xD;
shoulder.</Description>
            <Size>4.5mm, 5.5mm and 6.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL046</BillingCode>
            <Name>Healicoil Regenesorb</Name>
            <Description>HEALICOIL REGENESORB Suture Anchor</Description>
            <Size>4.75mm and 5.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>231879</ARTG>
                <ARTG>276921</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN703</BillingCode>
            <Name>TWINFIX ULTRA - Absorbable Suture Anchor</Name>
            <Description>Preloaded Absorbable HA Suture Anchor (combines PLLA with HA)</Description>
            <Size>4.5 mm to 6.5 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>181413</ARTG>
            </ARTGs>
            <MinimumBenefit>501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU022</BillingCode>
            <Name>Memofix</Name>
            <Description>Threaded Titanium Suture Anchor</Description>
            <Size>Diameter 4mm to 5mm</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>288706</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW006</BillingCode>
            <Name>Biotek large ligament anchor titanium</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 5.0mm; 5.5mm; 6.5mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW008</BillingCode>
            <Name>Biotek large suture anchor PEEK</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 5.5mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW010</BillingCode>
            <Name>Biotek Ligament Anchor</Name>
            <Description>Soft tissue ligament anchor loaded with UHMWPE fiber and needle </Description>
            <Size>4.50mm - 8.00mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY577</BillingCode>
            <Name>Healix Anchor System</Name>
            <Description>Titanium anchor with suture</Description>
            <Size>4.5 - 6.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU220</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE688</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cinch II</Name>
            <Description>Meniscal anchor</Description>
            <Size>L: 5.3mm   D: 1.1 mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU221</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE707</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TightRope Implant with FiberTag Suture</Name>
            <Description>TightRope implant pre-loaded with FiberTag suture</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU229</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE474</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Achilles Speedbridge Convenience Pack</Name>
            <Description>Disposable convenience pack for Achilles Insertional Tendonopathy</Description>
            <Size>one size</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU232</BillingCode>
            <Name>Swivelock</Name>
            <Description>Twist-in knotless suture anchor</Description>
            <Size>≥4mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU233</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE434</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pushlock Suture Anchor</Name>
            <Description>Knotless Suture Anchor</Description>
            <Size>4.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU235</BillingCode>
            <Name>Corkscrew FT</Name>
            <Description>Suture Anchor with Fiberwire</Description>
            <Size>4mm - 6.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU236</BillingCode>
            <Name>Corkscrew Suture Anchor</Name>
            <Description>Non Absorbable Suture Anchor</Description>
            <Size>&gt;4mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU280</BillingCode>
            <Name>DX Swivelock Anchor</Name>
            <Description>Soft Tissue Fixation Anchor</Description>
            <Size>4.75mm x 12mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>353482</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU319</BillingCode>
            <Name>ACL Repair TightRope</Name>
            <Description>Knotless tensionable system pre-loaded with FiberTape for ACL Repair. The kit includes the button/ anchor with the construct.</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>383904</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HV005</BillingCode>
            <Name>OzAnchor Knotless PEEK</Name>
            <Description>PEEK Suture Anchor</Description>
            <Size>4.5mm</Size>
            <SupplierCode>HV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>351629</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW552</BillingCode>
            <Name>PEEK Intraline Suture Anchor</Name>
            <Description>PEEK Intraline Suture Anchor</Description>
            <Size>5.5mm, 6.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW553</BillingCode>
            <Name>PEEK Zip Anchor</Name>
            <Description>PEEK Zip Anchor</Description>
            <Size>5.5mm, 6.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW554</BillingCode>
            <Name>ReelX STT Anchor</Name>
            <Description>ReelX STT Knotless Anchor (PEEK)</Description>
            <Size>5.5mm, 4.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>226667</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW556</BillingCode>
            <Name>Titanium Intraline Anchor</Name>
            <Description>Titanium Intraline Anchor</Description>
            <Size>5.5mm, 6.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW638</BillingCode>
            <Name>NanoTack TT Anchor</Name>
            <Description>NanoTack TT Anchor with tape</Description>
            <Size>1.4mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW666</BillingCode>
            <Name>Omega All-PEEK Knotless Anchor</Name>
            <Description>Knotless Suture Anchor</Description>
            <Size>4.75mm to 7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW840</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR299</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GRAVITY</Name>
            <Description>Titanium Suture Anchor System</Description>
            <Size>5.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>175633</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW891</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR364</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Insite FT anchors</Name>
            <Description>Bone anchors Ti or PEEK, preloaded with suture with or without needle.</Description>
            <Size>4.5mm, 5.5mm or 6.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>163843</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB007</BillingCode>
            <Name>AIM-TEC PRIM PK</Name>
            <Description>Peek screw type suture anchor system</Description>
            <Size>5mm, 6.5mm</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>259865</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT033</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IT016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anchor It 5mm</Name>
            <Description>Fully threaded suture anchor with fibrewire suture</Description>
            <Size>5mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>271554</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ096</BillingCode>
            <Name>Mitek Fastin Anchor </Name>
            <Description>Titanium Suture Anchor</Description>
            <Size>3 x 8.4mm, 4 x 9.7mm, 5.2 x 11.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ097</BillingCode>
            <Name>Fastin Anchor System</Name>
            <Description>Suture Anchor</Description>
            <Size>4 - 6.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
                <ARTG>140534</ARTG>
                <ARTG>140798</ARTG>
                <ARTG>152661</ARTG>
                <ARTG>152662</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ678</BillingCode>
            <Name>Versalok Bone Anchor System</Name>
            <Description>Suture anchor</Description>
            <Size>4.9-6.3mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>154329</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ947</BillingCode>
            <Name>Healix  Anchor System</Name>
            <Description>PEEK anchor system</Description>
            <Size>4.5 - 6.5mm anchor diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>330849</ARTG>
                <ARTG>217857</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH071</BillingCode>
            <Name>Rejoin HealFix Suture Anchor</Name>
            <Description>Suture Anchor System</Description>
            <Size>Greater than 4mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH072</BillingCode>
            <Name>Rejoin Peek Suture Anchor</Name>
            <Description>Suture Anchor System</Description>
            <Size>Greater than 4.0mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI114</BillingCode>
            <Name>AClip Femoral</Name>
            <Description>Ligament or tendon anchoring device</Description>
            <Size>One size only</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>294174</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM454</BillingCode>
            <Name>VIMS large ligament anchor titanium</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 5.0mm; 5.5mm; 6.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>338393</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM456</BillingCode>
            <Name>VIMS large suture anchor PEEK</Name>
            <Description>A device designed to be implanted into bone for the attachment of soft tissues either directly or via a suture attached to the device. It is typically used in shoulder and some lower-limb operations, and functions as an alternative to drilling a hole in bone for passing a suture. The device is made of a material that cannot be chemically degraded or absorbed via natural body processes</Description>
            <Size>Diameter: 5.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>338393</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM458</BillingCode>
            <Name>VIMS Ligament Anchor</Name>
            <Description>Soft tissue ligament anchor loaded with UHMWPE fiber and needle </Description>
            <Size>4.50mm - 8.00mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>338393</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM490</BillingCode>
            <Name>Fully Threaded Suture Anchor </Name>
            <Description>Fully Threaded Suture Anchor </Description>
            <Size>≥4mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>364759</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV009</BillingCode>
            <Name>Revo Cancellous Screw</Name>
            <Description>Soft Tissue Re-attachment - Titanium</Description>
            <Size>4mm diameter</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV090</BillingCode>
            <Name>Super Revo Suture Anchor with Hi-Fi Suture</Name>
            <Description>Titanium Suture Anchor</Description>
            <Size>5.0mm O.D x 14.2mm L</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV091</BillingCode>
            <Name>ThRevo Suture Anchor</Name>
            <Description>Titanium screw-in suture anchor</Description>
            <Size>5.0mm OD x 14.2mm L</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV112</BillingCode>
            <Name>CrossFT Suture Anchor</Name>
            <Description>PEEK Optima Suture Anchor with multiple sutures with or without needles</Description>
            <Size>4.5mm, 5.5mm &amp; 6.5mm diameters</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV113</BillingCode>
            <Name>PopLok Suture Anchor</Name>
            <Description>PEEK Optima Suture Anchor with or without sutures</Description>
            <Size>2.8mm, 3.3mm, 3.5mm &amp; 4.5mm diameters</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV114</BillingCode>
            <Name>Super Revo-FT,ThRevo-FT</Name>
            <Description>Fully Threaded Suture Anchor pre-threaded with two or three sutures with or without needles</Description>
            <Size>5mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV116</BillingCode>
            <Name>Sequent Meniscal Repair Device</Name>
            <Description>The Sequent Meniscal Repair Device is pre-loaded with polyetheretherketone (PEEK) implants threaded onto one size #0 (3.5 metric) HiFi® suture.  The device sequentially deplos the implants and suture that are tightened down to create multiple stitches to create fixation points along a soft tissue tear</Description>
            <Size>4 (5.1mm  x 1.3mm Implants</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>120427</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV117</BillingCode>
            <Name>CrossFT Suture Anchor Polyester</Name>
            <Description>PEEK Optima Suture Anchor with Multiple Polyester Sutures</Description>
            <Size>4.5mm, 5.5mm and 6.5mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV122</BillingCode>
            <Name>Sequent Meniscal Repair Device - 3 Implant</Name>
            <Description>The Sequential Meniscal Repair Device is pre-loaded with polyetheretheketone (PEEK) implants threaded onto one size #0 (3.5 metric) HiFi suture.</Description>
            <Size>5.1mm x 1.3mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>120427</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV143</BillingCode>
            <Name>TenoLok</Name>
            <Description>Soft tissue anchor with or without suture</Description>
            <Size>5.0mm and 6.0mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV145</BillingCode>
            <Name>CrossFt Knotless DT</Name>
            <Description>Screw in knotless anchor</Description>
            <Size>4.0mm CrossFT Knotless Anchor  4.0mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape)  4.0mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape)  4.75mm CrossFT Knotless Anchor   4.75mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape)  4.75mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape)  5.5mm CrossFT Knotless Anchor   5.5mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape)  5.5mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape)</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV151</BillingCode>
            <Name>Argo Knotless PEEK NSP Anchor</Name>
            <Description>The CONMED Argo KnotlessTM Anchors are manufactured from PolyEtherEtherKetone (PEEK). Non-self-punching products include tips manufactured from PEEK. The anchors are provided sterile, preloaded on a single-use driver and pre-threaded with one Hi-Fi® Ribbon. It may be used in either arthroscopic or open surgical procedures. After the suture is anchored to the bone, it may be used to reattach soft tissue, such as ligaments, tendons, or joint capsules to the bone. The suture anchor system thereby stabilizes the damaged soft tissue, in conjunction with appropriate postoperative immobilization throughout the healing period.</Description>
            <Size>4.75mm, 5.5mm PEEK NSP suture anchors</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>376571</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV152</BillingCode>
            <Name>Argo Knotless PEEK SP Anchor</Name>
            <Description>The CONMED Argo KnotlessTM Anchors are manufactured from PolyEtherEtherKetone (PEEK). Self-punching products include tips manufactured from Titanium. The anchors are provided sterile, preloaded on a single-use driver and pre-threaded with one Hi-Fi® Ribbon. It may be used in either arthroscopic or open surgical procedures. After the suture is anchored to the bone, it may be used to reattach soft tissue, such as ligaments, tendons, or joint capsules to the bone. The suture anchor system thereby stabilizes the damaged soft tissue, in conjunction with appropriate postoperative immobilization throughout the healing period.</Description>
            <Size>4.75mm, 5.5mm PEEK suture anchors with Ti self-punching tip  </Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>376571</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV153</BillingCode>
            <Name>Infinity AIM</Name>
            <Description>The Infinity AIM™ is an implantable suture retention device which facilitates percutaneous or endoscopic repair of meniscal tears. The Infinity AIM™ is composed of two (2) polyetheretherketone (PEEK) implants and a strand of #2-0 ultra-high molecular weight polyethylene (UHMWPE) Hi-Fi® suture, blue in color, from solid blue DSM fiber (Cr-Co-Al Oxidecolorant).  </Description>
            <Size>Infinity AIM™, KMR2R - 15° Reverse with two 5mm polyetheretherketone (PEEK) implants and a strand of #2-0 ultra-high molecular weight polyethylene (UHMWPE) Hi-Fi® suture between them        Infinity AIM™ KMR2S 25° Curved with two 5mm polyetheretherketone (PEEK) implants and a strand of #2-0 ultra-high molecular weight polyethylene (UHMWPE) Hi-Fi® suture between them  </Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN101</BillingCode>
            <Name>OmniSpan Meniscal Repair System</Name>
            <Description>Pre-loaded Peek backstops and ORTHOCORD suture</Description>
            <Size>0 to 27 degrees</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>181253</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN211</BillingCode>
            <Name>Truespan meniscal repair system</Name>
            <Description>Pre-loaded Peek backstops and ORTHOCORD suture</Description>
            <Size>0 to 24 degree</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>292990</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN246</BillingCode>
            <Name>HEALIX Anchor System</Name>
            <Description>PEEK anchor with Dynacord suture</Description>
            <Size>4.5 - 6.5mm anchor diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN271</BillingCode>
            <Name>HEALIX Anchor System</Name>
            <Description>Self-Punching PEEK Anchor</Description>
            <Size>4.9 mm, 5.5 mm , 6.5 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN325</BillingCode>
            <Name>HEALIX Anchor System </Name>
            <Description>Self-Punching Biocomposite Anchor</Description>
            <Size>4.9 mm, 5.5 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>382170</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN331</BillingCode>
            <Name>HEALIX ADVANCE™ Anchor with DYNATAPE™ Suture</Name>
            <Description>PEEK anchor with DYNATAPE suture and DYNACORD suture</Description>
            <Size>4.5-6.5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO408</BillingCode>
            <Name>Acu-Sinch Repair System</Name>
            <Description>This is a suture-and-anchor soft tissue repair system designed to complement the Acumed Clavicle Plating system by treating coracoclavicular ligament repair injuries associated with clavicle fractures and is used in conjuction midshaft or distal clavicle plate. All Acu-Sinch kits come in a sterile procedure pack.</Description>
            <Size>Titanium Anchor: D=5.5mm, L=12mm&#xD;
Titanium Suture Retainer: L=5.3mm, W=4mm</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>45062</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU173</BillingCode>
            <Name>Mectalock Ti</Name>
            <Description> Suture Anchor</Description>
            <Size>Ø 5 - 6.5</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>324941</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU174</BillingCode>
            <Name>MectaTap Ti</Name>
            <Description>Suture Anchor</Description>
            <Size>Ø 5 - 6.5</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>324941</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU181</BillingCode>
            <Name>MectaLock PEEK</Name>
            <Description>Suture Anchor</Description>
            <Size>Ø 4.5 - 5.5 - 6.5 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>320484</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB067</BillingCode>
            <Name>Full Thread Suture Anchor</Name>
            <Description>Suture Anchor</Description>
            <Size>&gt; 4mm </Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>323905</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB072</BillingCode>
            <Name>Peek Suture Anchor</Name>
            <Description>Peek suture anchor</Description>
            <Size>Great than 4mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>323905</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ031</BillingCode>
            <Name>Knotless PEEK CF Suture Anchors</Name>
            <Description>Suture Anchor, PEEK CF</Description>
            <Size>4.5mm   5.5mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ036</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>V-Lox Titanium Suture Anchors</Name>
            <Description>Titanium Fully Threaded Suture Anchor</Description>
            <Size>4.5mm; 5.0mm; 5.5mm; 6.5mm, double loaded and triple loaded suture anchors</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ041</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV041</PriorBillingCode>
            </PriorBillingCodes>
            <Name>V-Lox PEEK CF Suture Anchors</Name>
            <Description>PEEK CF Fully Threaded Suture Anchor</Description>
            <Size>4.5m; 5.5mm; 6.5mm,</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ044</BillingCode>
            <Name>Parcus Twist Screw in PEEK suture Anchors</Name>
            <Description>Screw in PEEK CF anchors recommended for small and large joints. Optimal cortical fixation, Non aborbable, radiolucent. PEEK body anchors assembled with 0, 1, 2, 3 sutures or suture tape.  </Description>
            <Size>4.25, 4.75, 5.5, 6.25, 6.5 mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ045</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PJ034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SLik Knot-less CF</Name>
            <Description>Knot-less screw in anchor recommended for use in large and small joint repairs</Description>
            <Size>5.5mm- 6.25mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ046</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PJ034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SLik Fix</Name>
            <Description>Screw in system recomended for teh use in both large and small joint repairs made from PEEK carbon fiber</Description>
            <Size>7mm, 8mm, 9mm </Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF003</BillingCode>
            <Name>Signature Turbine™ Anchor</Name>
            <Description>PEEK fully threaded suture anchor</Description>
            <Size>4.5mm, 5.5mm &amp;6.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF078</BillingCode>
            <Name>Christmas Anchor</Name>
            <Description>Titanium Anchor with sutures, with or without needles.</Description>
            <Size>4.5mm, 5.5mm and 6.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF103</BillingCode>
            <Name>Galileo Anchor</Name>
            <Description>PEEK Anchor with sutures, with or without needles.</Description>
            <Size>4.0mm, 4.5mm diameters</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF130</BillingCode>
            <Name>PEEKay knotless Anchor</Name>
            <Description>These are PEEK OPTIMA knotless anchors for repair and reattachment of soft tissue in the shoulder.</Description>
            <Size>4.5mm, 5.5mm and 6.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF148</BillingCode>
            <Name>Dynaloc Shoulder Anchor</Name>
            <Description>PEEK Optima Shoulder Anchor</Description>
            <Size>4.5, 5.5, 6.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF153</BillingCode>
            <Name>ATOK Anchor</Name>
            <Description>PEEK Shoulder Anchor</Description>
            <Size>4.5, 5.5, 6.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF184</BillingCode>
            <Name>Bondi</Name>
            <Description>Twist-in knotless Suture Anchor</Description>
            <Size>4.75mm, 5.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK176</BillingCode>
            <Name>Stryker Cuff Anchor</Name>
            <Description>Bio Zip PLLA anchor for soft tissue ligament/tendon fixation</Description>
            <Size>Dia 3 - 8mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>151656</ARTG>
                <ARTG>152291</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL055</BillingCode>
            <Name>ArthroCare Anchor System</Name>
            <Description>Anchor fixating soft tissue to bone</Description>
            <Size>4.5,5.5mm &amp; 6.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>271876</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL162</BillingCode>
            <Name>Smith and Nephew PEEK Anchor System</Name>
            <Description>Soft tissue anchor fixation </Description>
            <Size>≥4mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
                <ARTG>120338</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL182</BillingCode>
            <Name>HEALICOIL Knotless REGENESORB</Name>
            <Description>Absorbable Suture Anchors</Description>
            <Size>5.5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>382150</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL242</BillingCode>
            <Name>FAST-FIX FLEX Meniscal Repair System</Name>
            <Description>Soft Tissue Anchor Fixation – PEEK (FLEX Curved or Reverse Curved with or without Bend Tool and Slotted Cannula)</Description>
            <Size>5mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>120338</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM147</BillingCode>
            <Name>Twinfix PK</Name>
            <Description>PEEK Optima fully threaded suture anchor</Description>
            <Size>4.5mm 5.5mm and 6.5mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM179</BillingCode>
            <Name>TWINFIX Ti</Name>
            <Description>This is a titanium suture anchor for repair and reattachment of ligaments to bone in joint arthroscopy</Description>
            <Size>4.5mm, 5.5mm, 6.5mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN651</BillingCode>
            <Name>OBL Anchor System</Name>
            <Description>Preloaded Soft Tissue Anchor System Material: Titanium Alloy or Polyacetal Polymer. Comes with Insertion device and 2 Braided Polyester Sutures</Description>
            <Size>Anchor sizes - Titanium: 2.8, 3.5, 4.0 5.0, 6.5mm Anchor size - Polymer: 5.0mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN652</BillingCode>
            <Name>OBL Anchor System </Name>
            <Description>Soft Tissue Anchor System Non-preloaded Material:  Titanium Alloy</Description>
            <Size>4.0 and 6.5mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VY002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM387</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Suture Anchors with Suture</Name>
            <Description>Suture Anchors with Suture</Description>
            <Size>4.0mm or larger</Size>
            <SupplierCode>VY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>324214</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA011</BillingCode>
            <Name>Quattro X Suture Anchor</Name>
            <Description>Suture Anchor with sutures, manufactured from PEEK-OPTIMA polymer pre assembled to stainless stell inserter. Provided as a single-use sterile device.</Description>
            <Size>5.5mm and 6.5mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>209509</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Quattro Link Knotless Anchor</Name>
            <Description>Knotless Anchor manufactured from PEEK-OPTIMA polymer pre-assembled to stainless steel inserter. Provided as a single-use sterile device.</Description>
            <Size>4.5mm and 5.5mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>209509</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA066</BillingCode>
            <Name>Allthread Anchors</Name>
            <Description>suture anchors</Description>
            <Size>4.5-6.8mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>117747</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA072</BillingCode>
            <Name>Ventix Anchor</Name>
            <Description>soft tissue anchor</Description>
            <Size>4.75mm and 5.5mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>349650</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA088</BillingCode>
            <Name>Genie PEEK Anchors/Fix2Lock Anchors PEEK</Name>
            <Description>Knotless anchor manufactured from PEEK. Provided as a single use device</Description>
            <Size>4.5mm &amp; 5.5mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5387</SubGroupID>
            <ARTGs>
                <ARTG>354952</ARTG>
            </ARTGs>
            <MinimumBenefit>442</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH111</BillingCode>
            <Name>Ziptight Fixation System</Name>
            <Description>Ankle Syndesmosis device, stainless steel or titanium, PE suture with or without disposable instruments.</Description>
            <Size>One Size</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>116765</ARTG>
                <ARTG>208040</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI920</BillingCode>
            <Name>EZLoc Femoral fixation Device</Name>
            <Description>Ligament Anchor, Ti, PE</Description>
            <Size>7-8; 9-10mm x Short, std or long.</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>117747</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW016</BillingCode>
            <Name>Biotek Button System</Name>
            <Description>Adjustable Fiber Loop for attachable Button System and tibial base plate for button system  UHMWPE loop without button</Description>
            <Size>Round Button- Dia: 6 mm to 20 mm    Rectangular button- Length: 4 mm to 30 mm                                    Width: 2 mm to 10 mm    Button Shapes: Standard, round, oblong etc.  UHMWPE loop without button </Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU162</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE507</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mini Tightrope CMC</Name>
            <Description>CMC fixation device</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>350631</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU163</BillingCode>
            <Name>Mini Tightrope</Name>
            <Description>CMC Fixation Device</Description>
            <Size>One Size fits all</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>350631</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU222</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE252</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tightrope Syndesmosis Repair Kit</Name>
            <Description>Titanium or stainless steel, with non absorbable Fiberwire suture material</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU223</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE548</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tightrope</Name>
            <Description>Titanium or stainless steel fixation device, with non absorbable suture material</Description>
            <Size>2.6mm - 13mm, various shapes, adjustable length suture</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU239</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE271</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RetroButton</Name>
            <Description>Femoral Fixation Device</Description>
            <Size>12mm Button with 15-60mm loops, 15mm Button with 15-60mm loops</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU322</BillingCode>
            <Name>TightRope II ABS (Attachable Button System)</Name>
            <Description>Adjustable FiberLoop for Attachable Button System constructs combined with a button</Description>
            <Size>Round Button- Diameter: 11mm to 20mm  Standard Button: Length: 12mm, Width: 8mm; Oblong Button- Length: 13mm, Width: 3.4mm;    Button Shapes: standard, round, oblong; UHMWPE loop without button</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
                <ARTG>383904</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU323</BillingCode>
            <Name>BTB TightRope II</Name>
            <Description>Suture construct with button for soft tissue to bone fixation for ACL/PCL repair and reconstruction</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>383904</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU324</BillingCode>
            <Name>TightRope II RT Implant</Name>
            <Description>Suture construct with button for soft tissue to bone fixation for ACL/PCL repair and reconstruction. </Description>
            <Size>One Size Only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>383904</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU326</BillingCode>
            <Name>Knotless Distal Clavicle Plate Button TightRope® Implant</Name>
            <Description>Knotless Distal Clavicle Plate Button attached to a large Pec Button pre-loaded on an inserter. Titanium or stainless steel button, with nonabsorbable UHMWPE suture material.</Description>
            <Size>One size only</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>350871</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW540</BillingCode>
            <Name>VersiTomic G-Lok</Name>
            <Description>VersiTomic G-Lok suspension fixation device</Description>
            <Size>15mm, 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>229719</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW584</BillingCode>
            <Name>ProCinch</Name>
            <Description>ProCinch Adjustable Loop Fixation Device</Description>
            <Size>Length (cm): 35.6, 47.8  Width (cm): 9.7, 19.1  Height (cm): 2.5</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>229717</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW784</BillingCode>
            <Name>GRAVITY SYNCHFIX</Name>
            <Description>Titanium syndesmosis fixation device, with non absorbable suture material and including medial button.</Description>
            <Size>one size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>175633</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ951</BillingCode>
            <Name>RigidLoop Cortical Fixation System</Name>
            <Description>Cortical Fixation System - Button and thread</Description>
            <Size>15-60mm, Xlarge, adjustable</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH067</BillingCode>
            <Name>Rejoin Button</Name>
            <Description>Suture Button</Description>
            <Size>Multiple</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI110</BillingCode>
            <Name>Comete Anchor</Name>
            <Description>ACL Femoral Cortical Fixation</Description>
            <Size>Length 15mm to 40mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>285471</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM469</BillingCode>
            <Name>Button Loop System</Name>
            <Description>Fixed length or adjustable button loop system</Description>
            <Size>Multiple fixed and adjustable options to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>338954</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV109</BillingCode>
            <Name>XO Button with Continuous Loop</Name>
            <Description>Titanium suspensor, fixation device for femoral fixation in ACT and PCL repairs</Description>
            <Size>4.5mm x 13.5mm with Continuous Loop lengths 15-60mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV142</BillingCode>
            <Name>Knee Preservation System - GraftMax</Name>
            <Description>Adjustable loop button for soft tissue fixation</Description>
            <Size>KS-ALB and KS BTB (LxWxH):  14mm x 4.5mm x 2mm&#xD;
KS-BCA (Cradle) (LxWxH): 21mm x 6mm x 2.8mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV147</BillingCode>
            <Name>MicroLink All-Suture Button</Name>
            <Description>The MicroLink™ All-Suture Button (Radiopaque) is an all-suture suspension device with one strand of #2 (5  metric) Hi-Fi® suture, a radiopaque flat braid Hi-Fi® Suture Button and a radiopaque flat braid Hi-Fi® suture  Backstop</Description>
            <Size>N/A</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV148</BillingCode>
            <Name>Infinity Femoral Adjustable Loop Button</Name>
            <Description>The Infinity Fixation System is a metal buttons and non-absorbable Hi-Fi suture for suspensory fixation of soft tissue grafts to bone used in ligament reconstruction procedures.The cradle is an adaptor for the adjustable loop button, used for wide tunnels.</Description>
            <Size>N/A</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU171</BillingCode>
            <Name>Adjustable loop</Name>
            <Description>Pullup and Mblock Adjustable fixation system</Description>
            <Size>  4.5 mm    5 -10 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>322721</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU172</BillingCode>
            <Name>Cortical Fixation System</Name>
            <Description>ACL Femoral Cortical Fixation</Description>
            <Size>Length 15mm to 40mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>320480</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU184</BillingCode>
            <Name>FairFix Adjustable Button System</Name>
            <Description>Button with non absorbable suture material</Description>
            <Size>Adjustable loop length</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>365812</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB068</BillingCode>
            <Name>G Loop</Name>
            <Description>Titanium or Stainless Steel fixation device with non-absorbable suture material</Description>
            <Size>Adjustable Length</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>323905</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ035</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Parcus - GFS II Large and GFS Mini</Name>
            <Description>Parcus - GFS Fixation for knee ligament reconstruction</Description>
            <Size>Button Sizes:   3.9mm-4.4mm in width x 12mm-16.5mm in length.  Loop sizes:  12mm, 15mm, 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>178101</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ039</BillingCode>
            <Name>AcTiFlip Cinch loop</Name>
            <Description>Button fixation recommended for biceps repair both proximal and distal repairs.   With one size two suture</Description>
            <Size>12mm  10mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>178101</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ040</BillingCode>
            <Name>AcTiFlip Infinity loop</Name>
            <Description>Button fixation, recommended for proximal and distal tendon and ligament repair.    Comes with one suture and one needle </Description>
            <Size>12mm  10mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>178101</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ043</BillingCode>
            <Name>Parcus Sydn-EZ </Name>
            <Description>The Parcus Synd-EZ  is intended to be used as an adjunct in fracture repair involving metaphyseal and periarticular small bone fragments where screws are not indicated, and as adjuncts in external and intramedullary fixation systems involving plates and rods, with fracture braces and casting.</Description>
            <Size>3.9 mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>330545</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ052</BillingCode>
            <Name>Parcus Synd-Ez SS</Name>
            <Description>The Parcus Synd-EZ  is intended to be used as an adjunct in fracture repair involving metaphyseal and periarticular small bone fragments where screws are not indicated, and as adjuncts in external and intramedullary fixation systems involving plates and rods, with fracture braces and casting. Includes top hat, suture and button.</Description>
            <Size>3.2 mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>375955</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF019</BillingCode>
            <Name>EZ Flip ACL/PCL Fixation system</Name>
            <Description>Fixation for ACL/PCL fixation</Description>
            <Size>15-60mm length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF154</BillingCode>
            <Name>Signaflip</Name>
            <Description>Fixation for ACL/PCL repair</Description>
            <Size>Fixed/Adjustable loop, 15-60mm length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>193153</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL016</BillingCode>
            <Name>Endobutton Twinbridge</Name>
            <Description>A button/thread/button device for ligament reconstruction</Description>
            <Size>6mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>172519</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL082</BillingCode>
            <Name>INVISIKNOT</Name>
            <Description>Ankle Syndesmosis Repair Device</Description>
            <Size>Fracture or non fracture</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>287770</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN853</BillingCode>
            <Name>Endobutton</Name>
            <Description>Fixation for ACL/PCL reconstruction</Description>
            <Size>5-60mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA086</BillingCode>
            <Name>ToggleLoc Flip</Name>
            <Description>Consists of a metal plate, suture loop and non-absorbable sutures</Description>
            <Size>15mm to 60mm (5mm increments)</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>354952</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI973</BillingCode>
            <Name>Aperfix Femoral Fixation System</Name>
            <Description>Aperfix Femoral Fixation System</Description>
            <Size>9x24mm,10x24mm,9x29mm,10x29mm,11x29mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5389</SubGroupID>
            <ARTGs>
                <ARTG>152854</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW011</BillingCode>
            <Name>ONButton CL Fixation Button</Name>
            <Description>Titanium fixation button and UHMWPE braid (Ultra High Molecular Weight Poly  Ethylene braid) suture</Description>
            <Size>Loop Size 12mm - 40mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO111</BillingCode>
            <Name>APTUS</Name>
            <Description>Insert for Suture or Screw Fixation</Description>
            <Size>Various</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU228</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE500</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TightRope Button</Name>
            <Description>Titanium or stainless steel button</Description>
            <Size>5mm-20mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU237</BillingCode>
            <Name>Suture Button</Name>
            <Description>Multiple hole button for fixation of bone to bone or soft tissue to bone, and are intended as fixation posts, a distribution bridge, or for distributing suture tension over areas of ligament or tendon repair. A button implant system is supplied with suture.</Description>
            <Size>2.6mm - 7.5mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU327</BillingCode>
            <Name>Knotless Tension Tight Button</Name>
            <Description>Biceps Suture Button</Description>
            <Size>2.6mm - 7.5mm  </Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>353493</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HV002</BillingCode>
            <Name>OzLoop</Name>
            <Description>Fixation Button</Description>
            <Size>15mm to 60mm</Size>
            <SupplierCode>HV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>351392</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW539</BillingCode>
            <Name>VersiTomic G-Lok</Name>
            <Description>VersiTomic G-Lok suspension fixation device - No Loop</Description>
            <Size>No Loop</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>229719</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW971</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR368</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ArthroTunneler TunnelPro System</Name>
            <Description>Lateral button, PEEK</Description>
            <Size>10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>214982</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV018</BillingCode>
            <Name>Suture Button</Name>
            <Description>The Slotted Button device is a single-use, titanium implant used for  fixation of soft tissue to bone.</Description>
            <Size>11–20mm</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>381237</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV149</BillingCode>
            <Name>Infinity  Tibial Button</Name>
            <Description>The tibial buttons are available in two (2) sizes to accommodate various tunnel sizes and is meant to be used with the adjustable free loop for suspensory fixation of soft tissue grafts to bone in ligament reconstruction procedures.</Description>
            <Size>Standard and Large</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>136631</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN258</BillingCode>
            <Name>RigidLoop Cortical Fixation button</Name>
            <Description>Cortical Fixation Button</Description>
            <Size>4 x 12 mm, 4 x 20mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU150</BillingCode>
            <Name>Tibial Pull Suture Plate (PSP)</Name>
            <Description>Tibial Pull Suture Plate</Description>
            <Size>Single size</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>290767</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU151</BillingCode>
            <Name>Extracortical Femoral Button</Name>
            <Description>Extracortical Femoral Button</Description>
            <Size>Single size</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>290768</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU180</BillingCode>
            <Name>MectaFix Continuous Loop</Name>
            <Description>ACL reconstructions</Description>
            <Size>15 - 60 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>332525</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ042</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV076</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PARCUS GFS Naked</Name>
            <Description>Graft Fixation System  for use in the fixation of ligament or tendon repairs.</Description>
            <Size>Button widths: 1.4mm -4.4mm   Button lengths: 5.9mm - 21mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>178101</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL071</BillingCode>
            <Name>Ultrabutton Adjustable Fixation Device</Name>
            <Description>Soft tissue to bone fixation for ACL/PCL repair and reconstruction</Description>
            <Size>One size only</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>271876</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL078</BillingCode>
            <Name>Double ENDOBUTTON Fixation Device</Name>
            <Description>Titanium or stainless steel screwbutton, titanium and stainless steel round ENDOBUTTON device and UHMW polyethylene suture</Description>
            <Size>Various sizes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN426</BillingCode>
            <Name>ACL/PCL Reconstructions</Name>
            <Description>EndoButton</Description>
            <Size>4 x 12mm, 4mm x 18mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN428</BillingCode>
            <Name>ACL/PCL Reconstructions</Name>
            <Description>EndoButton CL and Xtendobutton</Description>
            <Size>10-60 mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA087</BillingCode>
            <Name>ToggleLoc Flipwasher</Name>
            <Description>Titanium Button</Description>
            <Size>15mm-20mm,  20mm (Extender)</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5390</SubGroupID>
            <ARTGs>
                <ARTG>354952</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU264</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE068</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Interference Screws</Name>
            <Description>ARTHREX Non-sheathed</Description>
            <Size>7 x 28mm - 12 x 28mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU265</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE166</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bio-Tenodesis Screw</Name>
            <Description>Soft Tissue Fixation</Description>
            <Size>3mm-9mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>230210</ARTG>
                <ARTG>230211</ARTG>
                <ARTG>360373</ARTG>
                <ARTG>360374</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW549</BillingCode>
            <Name>Bioabsorbable (PLLA) Wedge Interference Screws</Name>
            <Description>Bioabsorbable (PLLA) ACL Wedge Interference Screw </Description>
            <Size>9, 10, 11, 12 x35mm; 7, 8, 9, 10 x 28mm; 7,8,9 x 23mm </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>143167</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ127</BillingCode>
            <Name>Absolute Absorbable Interference Screw </Name>
            <Description>Polylactic acid screw</Description>
            <Size>7 to11mm x (23 to 30mm)</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>140560</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI109</BillingCode>
            <Name>Eclipse BCP Screw</Name>
            <Description>Absorbable, osteoconducting interference screw</Description>
            <Size>Diameter 7mm to 10mm&#xD;
Length 20mm to 30mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>284239</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV019</BillingCode>
            <Name>BioScrew Bioabsorbable Interference Screw</Name>
            <Description>ACL Fixation - PLLA</Description>
            <Size>Diameter 7.0 - 9.0mm, Length 20 - 30mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>151549</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV077</BillingCode>
            <Name>BioScrew XtraLok Tibial Fixation Device</Name>
            <Description>ACL Fixation - PLLA</Description>
            <Size>Diameter 8, 9, 10, 11mm; Length 35 &amp; 40mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>151586</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV103</BillingCode>
            <Name>Matryx Interference Screw</Name>
            <Description>Matryx (SR-96L/4D PLA with ß-TCP) Inteference Screw</Description>
            <Size>7.3 x 20mm; 7.3 x 25mm; 7.3 x 30mm; 8 x 20mm; 8 x 25mm; 8 x 30mm; 9 x 20mm; 9 x 25mm; 9 x 30mm; 9 x 38mm; 10 x 25mm; 10 x 33mm; 10 x 38mm; 11 x 25mm; 11 x 33mm; 11 x 38mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>139664</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV120</BillingCode>
            <Name>GENESYS Matryx Interference Screw, diameter 7 - 11mm</Name>
            <Description>GENESYS Matryx Interference Screw  - cannulated bioabsorbable</Description>
            <Size>7.0x20mm,7.0x25mm,7.0x30mm,8.0x20mm,8.0x25mm,8.0x30mm,8.0x35mm,9.0x20mm,9.025mm,9.0x30mm,9.0x35mm,10x20mm,10x25mm,10x30mm,10x35mm,11x20mm,11x25mm,11x25mm,11x25mm,11x25mm,11x30mm,11x35mm,11x40mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>194179</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV121</BillingCode>
            <Name>GENESYS Matrix Interference Screw, diameter 5-6.5mm.</Name>
            <Description>GENESYS Matrix Interference Screw - Cannulated,bioabsorbable</Description>
            <Size>5.0mm diameter x15,20,25,30mm lengths&#xD;
5.5mm diameter x15,20,25,30mm lengths&#xD;
6.0mm diameter x15,20,25,30mm lengths&#xD;
6.5mm diameter x15,20,25,30mm lengths</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>101275</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL159</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SN004</PriorBillingCode>
                <PriorBillingCode>SN421</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bioabsorbable Screw</Name>
            <Description>Absorbable Interference Screw</Description>
            <Size>Various</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>121752</ARTG>
                <ARTG>126191</ARTG>
                <ARTG>322284</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK020</BillingCode>
            <Name>CPS Screw Hexalon Biodegradable ACL/PCL Reconstruction</Name>
            <Description>Biodegradable ACL/PCL Recon Screw PLLA/PGA/TMC</Description>
            <Size>6 x 20, 6 x 25, 6 x 30, 7 x 20, 7 x 25, 7 x 30, 8 x 20, 8 x 25, 8 x 30, 9 x 20, 9 x 25, 9 x 30, 10 x 30</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>154551</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA025</BillingCode>
            <Name>ComposiTCP Interference Screw</Name>
            <Description>Interference Screw for ACL Reconstruction</Description>
            <Size>Diameters: 6 to 11 mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>308240</ARTG>
                <ARTG>308241</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU255</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE297</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioComposite Interference Screw</Name>
            <Description>Soft Tissue Fixation Device</Description>
            <Size>6mm - 35mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>164043</ARTG>
                <ARTG>360376</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW541</BillingCode>
            <Name>Biosteon (HA/PLLA) Screws</Name>
            <Description>Biosteon HA/PLLA reabsorbable bone screw</Description>
            <Size>6, 7, 8, 9, 10 x 23mm; 6, 7, 8, 9, 10, 11, 12 x 28mm; 9, 10, 11, 12 x 35mm </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>143167</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ484</BillingCode>
            <Name>MILAGRO Interference Screw</Name>
            <Description>TCP/PLGA Interference ACL Screw System</Description>
            <Size>5-12mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>122579</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ961</BillingCode>
            <Name>BioIntrafix</Name>
            <Description>Tibial soft tissue fastner screw/sheath</Description>
            <Size>30mm and 6 to 10mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>136255</ARTG>
                <ARTG>163254</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF096</BillingCode>
            <Name>Bio-Composite Interference Screw</Name>
            <Description>HA infused Polymer Interference Screws</Description>
            <Size>5-12mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF151</BillingCode>
            <Name>SignaLoc Screw</Name>
            <Description>HA infused polymer Interference Screw</Description>
            <Size>5-12mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL103</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF097</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bi-On™ Inteference Screw</Name>
            <Description>HA infused Polymer Interference Screws</Description>
            <Size>5-12mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM176</BillingCode>
            <Name>Bioabsorbable HA Screw</Name>
            <Description>Absorbable HA Interference Screw</Description>
            <Size>Various</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <Suffix>AB, HA</Suffix>
            <ARTGs>
                <ARTG>124506</ARTG>
                <ARTG>162821</ARTG>
            </ARTGs>
            <MinimumBenefit>457</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH168</BillingCode>
            <Name>Washerloc Tibial Fixation Device</Name>
            <Description>Screw - Ti</Description>
            <Size>24 - 60mm x 5.8mm diameter</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>116765</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI239</BillingCode>
            <Name>Arthrotek Ligament Fixation System</Name>
            <Description>Interference Screw, Titanium</Description>
            <Size>15-30mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>116765</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI241</BillingCode>
            <Name>Gentle Threads Ligament Fixation Screws</Name>
            <Description>Screw, Graft Interference, PGA/PLA</Description>
            <Size>7mm, 8mm, 9mm, 10mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>154007</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW017</BillingCode>
            <Name>Biotek SOFTFIX PK Interference screw</Name>
            <Description>Interference screw for use in ligament/tendon reconstruction</Description>
            <Size>Diameter: 4.0mm - 11.0mm    Length:  10mm - 35mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW018</BillingCode>
            <Name>Biotek SOFTFIX Interference screw</Name>
            <Description>Interference screw for use in ligament/tendon reconstruction</Description>
            <Size>Diameter 5.0mm - 11.0mm    Length 15mm - 35mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>314305</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR031</BillingCode>
            <Name>LARS Interference Screw</Name>
            <Description>Titanium Interference screw</Description>
            <Size>5.2 - 10mm diameter, 
15 - 30mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>138574</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU117</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE374</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GraftBolt</Name>
            <Description>Interference Screw and Sheath</Description>
            <Size>7mm, 8mm, 9mm and 10mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU118</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE439</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Peek Delta Screws</Name>
            <Description>Interference screw for soft tissue Fixation</Description>
            <Size>6-12mm Diameter x (23mm-35m) Length</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU119</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE440</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Interference Screws</Name>
            <Description>Interference screw for Soft Tissue Fixation</Description>
            <Size>7-10mm x (15-35mm)</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU120</BillingCode>
            <Name>Tenodesis Screw</Name>
            <Description>Non Absorbable Tenodesis Screw</Description>
            <Size>2.5mm-9mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU121</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE710</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PEEK Tenodesis Screw</Name>
            <Description>Interference Screw (2.5mm x 6mm)</Description>
            <Size>2.5mm x 6mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HV001</BillingCode>
            <Name>OzScrew</Name>
            <Description>PEEK Screw</Description>
            <Size>Diameter 8mm to 12mm  Lengths 25mm and 30mm</Size>
            <SupplierCode>HV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>351410</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW794</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR080</PriorBillingCode>
            </PriorBillingCodes>
            <Name>G-Force Tenodesis System</Name>
            <Description>Cannulated Interference Screw - PEEK Optima</Description>
            <Size>4-8mm diameter, 10-25mm width</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>175633</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ588</BillingCode>
            <Name>Femoral Intrafix System</Name>
            <Description>Screw and Sheath Fixation System for the Femur in ACL repairs</Description>
            <Size>7 to 10mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ912</BillingCode>
            <Name>Intrafix Interference System</Name>
            <Description>Non absorbable screw/sheath</Description>
            <Size>6 to 12mm diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH068</BillingCode>
            <Name>Rejoin Interference Screw</Name>
            <Description>Interference Screw</Description>
            <Size>6mm - 12mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>320191</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV016</BillingCode>
            <Name>Propel Interference Screws</Name>
            <Description>ACL Fixation - Titanium</Description>
            <Size>Diameter 7.0 - 9.0mm, Length 20 - 30mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>129072</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV017</BillingCode>
            <Name>Guardsman Femoral Interference Screws</Name>
            <Description>ACL Fixation - Titanium</Description>
            <Size>Diameter 7.0 - 9.0mm, Length 20 - 30mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>129072</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV018</BillingCode>
            <Name>Cannulated Interference Screws</Name>
            <Description>ACL Fixation - Titanium</Description>
            <Size>Diameter 7.0 - 9.0mm, Length 20 - 40mm</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>129072</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV146</BillingCode>
            <Name>EZStart Screw</Name>
            <Description>The EZStart™ Interference Screw is a dual threaded titanium interference screw with a tapered tip for easy insertion into  bone</Description>
            <Size>6-10mm width x 15 - 30mm long</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>129072</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN212</BillingCode>
            <Name>Milagro</Name>
            <Description>Interference Screw</Description>
            <Size>5 to 12mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>215753</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU169</BillingCode>
            <Name>Mectascrew PEEK</Name>
            <Description>Interference Screw</Description>
            <Size>6-12 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>320872</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF015</BillingCode>
            <Name>TLS - Tendon Anchoring System - Titanium</Name>
            <Description>Titanium screw for suspensory fixation of tendon</Description>
            <Size>10 x 20mm, 10 x 25mm, 12 x 20mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>181401</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF016</BillingCode>
            <Name>TLS - Tendon Anchoring Screw - PEEK</Name>
            <Description>PEEK screw for suspensory fixation of tendon</Description>
            <Size>10 x 20mm 10 x 25mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>181401</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Parcus PEEK CF Interface Screw</Name>
            <Description>PEEK CF Interface Screw</Description>
            <Size>7,8,9mm x 20-35mm 10,11,12mm x 25-35mm</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>177865</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ051</BillingCode>
            <Name>Parcus Interference Ti screws</Name>
            <Description>Interference screws for soft tissue fixation (Titanium)</Description>
            <Size>7-12 mm (20-35mm in length</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>177866</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF001</BillingCode>
            <Name>Tissue Loc Tenodesis Screw</Name>
            <Description>Cannulated Interference Screw - PEEK</Description>
            <Size>4x10mm, 5x10mm, 4x15mm, 5x15mm, 6x15mm, 6x20mm, 7x25mm, 8x25mm, 8x30mm, 9x25mm, 9x30mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF035</BillingCode>
            <Name>Signature ST Shoulder Anchor</Name>
            <Description>PEEK fully threaded suture anchor</Description>
            <Size>2.3mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK023</BillingCode>
            <Name>ACL Wedge Interference Screw</Name>
            <Description> Interference Screw</Description>
            <Size>Dia 7 - 12mm, length 20 - 40mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>140466</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK047</BillingCode>
            <Name>Stryker Wedge Interference Screw</Name>
            <Description>Threaded biosteon screw for ligment/tendon fixation</Description>
            <Size>Dia 7 - 12mm, length 20 - 40mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>143167</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL017</BillingCode>
            <Name>Biosure Healicoil</Name>
            <Description>interference screw</Description>
            <Size>6-10mm diameter</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM164</BillingCode>
            <Name>BIOSURE</Name>
            <Description>A non-absorbable polymer (PEEK) interference screw for use in ligament/tendon reconstruction</Description>
            <Size>6-12mm in diameter</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN420</BillingCode>
            <Name>ACL/PCL Reconstruction</Name>
            <Description>RCI Screws Titanium</Description>
            <Size>7-11mm diameter, 25-40mm length</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN425</BillingCode>
            <Name>ACL/PCL Reconstructions</Name>
            <Description>Cannuflex Silk &amp; Soft Silk Interference Screw</Description>
            <Size>5.5 x 20mm - 9x30mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN981</BillingCode>
            <Name>BIOSURE SYNC</Name>
            <Description>Soft tissue intra-tunnel tibial fixation device which includes Interference screw and sheath</Description>
            <Size>6-12mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>109451</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST830</BillingCode>
            <Name>Stryker Wedge Interference Screw</Name>
            <Description>Small threaded titanium screw for ligament/tendon fixation</Description>
            <Size>Diameter 7 - 9mm, Length 20 - 25mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>139736</ARTG>
                <ARTG>140466</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VY003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM384</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Interference Screws </Name>
            <Description>Interference Screws </Description>
            <Size>All sizes</Size>
            <SupplierCode>VY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>324214</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA089</BillingCode>
            <Name>Neo Advance PEEK Interference Screws</Name>
            <Description>PEEK Interference Screws</Description>
            <Size>7 × 25mm, 7 × 30mm, 8 × 25mm, 8 × 30mm, 9 × 25mm, 9× 30mm, 10× 25mm, 10× 30mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>354952</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI972</BillingCode>
            <Name>Aperfix Tibial Fixation System</Name>
            <Description>Aperfix Tibial Fixation System</Description>
            <Size>9x24mm,10x24mm,9x29mm,10x29mm,11x29mm,8x30mm,9x30mm,10x30mm11x30mm,7x20mm,7x25mm,8x20mm,8x25mm,8x30mm,9x20mm,9x25mm,9x30mm,10x25mm,10x30mm,11x30mm,12x30mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>152855</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI990</BillingCode>
            <Name>Quattro Bolt</Name>
            <Description>Tenodesis Screw</Description>
            <Size>10-16 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5391</SubGroupID>
            <ARTGs>
                <ARTG>209509</ARTG>
            </ARTGs>
            <MinimumBenefit>181</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU256</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE127</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bio-Transfix</Name>
            <Description>Composition Poly (L-lactide)</Description>
            <Size>Diameter 5mm, length 50mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>140563</ARTG>
                <ARTG>360377</ARTG>
            </ARTGs>
            <MinimumBenefit>462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ078</BillingCode>
            <Name>Rigidfix ACL Cross Pin</Name>
            <Description>Polylactic acid pin</Description>
            <Size>2.7 &amp; 3.3mm x 42mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <Suffix>AB</Suffix>
            <ARTGs>
                <ARTG>140561</ARTG>
            </ARTGs>
            <MinimumBenefit>462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU122</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE070</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TransFix Implant Screw System - Arthrex</Name>
            <Description>Titanium alloy</Description>
            <Size>40mm &amp; 50 mm</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <ARTGs>
                <ARTG>350870</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ952</BillingCode>
            <Name>Rigidfix ACL Cross Pin</Name>
            <Description>PEEK Pin</Description>
            <Size>3.3mm diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <ARTGs>
                <ARTG>133430</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA546</BillingCode>
            <Name>Ligamys Monoblock</Name>
            <Description>Dynamic spring system with clamping cone</Description>
            <Size>One size</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <ARTGs>
                <ARTG>230046</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF017</BillingCode>
            <Name>TLS, TLS Tendon Anchoring Screw</Name>
            <Description>Screw for graft fixation</Description>
            <Size>10 x 20mm, 10 x 25mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <ARTGs>
                <ARTG>181401</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK024</BillingCode>
            <Name>Stryker Cross-screw</Name>
            <Description>Cross screw</Description>
            <Size> 40-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <ARTGs>
                <ARTG>139735</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WF001</BillingCode>
            <Name>Quick Start Screw</Name>
            <Description>Titanium Interference Screw</Description>
            <Size>Diameter 6 to 12mm  Length 20 to 40mm</Size>
            <SupplierCode>WF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1774</GroupID>
            <SubGroupID>5394</SubGroupID>
            <ARTGs>
                <ARTG>339465</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR032</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament</Name>
            <Description>Woven polyester prosthetic ligaments</Description>
            <Size>60,80,100,120,160 &amp; Y shaped fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR201</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament -  AC30RA </Name>
            <Description>Woven polyester prosthesic ligament</Description>
            <Size>30 fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR202</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament – LAC 20</Name>
            <Description>Woven polyester prosthetic ligament</Description>
            <Size>20 fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR203</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament - LAC 30</Name>
            <Description>Woven polyester prosthetic ligament</Description>
            <Size>30 fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR204</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament - MCL 32</Name>
            <Description>Woven polyester prosthetic ligament</Description>
            <Size>32 fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR205</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament  - Rotator Cuff CR 25</Name>
            <Description>Woven polyester prosthetic ligament</Description>
            <Size>40 fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR206</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament  - Rotator Cuff CR 30</Name>
            <Description>Woven polyester prosthetic ligament</Description>
            <Size>48 fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR214</BillingCode>
            <Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament</Name>
            <Description>Woven polyester prosthetic ligaments</Description>
            <Size>8 fibres</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>138573</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM070</BillingCode>
            <Name>Lockdown LSSS Shoulder Stabilisation System - Ligament Prosthesis, non-absorbable</Name>
            <Description>Woven Polyester Prosthetic Ligament</Description>
            <Size>Various</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>135600</ARTG>
            </ARTGs>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA545</BillingCode>
            <Name>Ligamys DIS Suture with button</Name>
            <Description>UHMWPE braid with Ti alloy button</Description>
            <Size>One size</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>232098</ARTG>
            </ARTGs>
            <Note>That an Artificial Ligament should only be funded for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NY001</BillingCode>
            <Name>LK2 Poly-Tape</Name>
            <Description>Polyester tape</Description>
            <Size>Width 8mm-40mm  Length 500 and 800mm</Size>
            <SupplierCode>NY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>380417</ARTG>
            </ARTGs>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NY003</BillingCode>
            <Name>Infinity-Lock Button System</Name>
            <Description>Tube Tape with Infinity-Lock Button</Description>
            <Size>One size only</Size>
            <SupplierCode>NY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>5398</SubGroupID>
            <ARTGs>
                <ARTG>379210</ARTG>
            </ARTGs>
            <MinimumBenefit>4217</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW987</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR455</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cartiva® Synthetic Cartilage Implant</Name>
            <Description>Polymer Cartilage Implant</Description>
            <Size>Diameter: 6mm, 8mm, 10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1776</GroupID>
            <SubGroupID>7221</SubGroupID>
            <Suffix>≤ 10mm</Suffix>
            <ARTGs>
                <ARTG>278815</ARTG>
            </ARTGs>
            <MinimumBenefit>1420</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST947</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, dynamic tube assembly rod</Description>
            <Size>25mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>CDD</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>7864</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM197</BillingCode>
            <Name>MiniFlo Fixator</Name>
            <Description>Finger mini fixator system</Description>
            <Size>Radius: 25 and 30mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>222613</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM244</BillingCode>
            <Name>Ligamentotaxor</Name>
            <Description>Finger Mini Fixator System</Description>
            <Size>1 size only</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>235592</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO431</BillingCode>
            <Name>ACUMED Small Bone External Fixation System</Name>
            <Description>Designed for Metacarpal and Phalangeal bones</Description>
            <Size>mini</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>101930</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK612</BillingCode>
            <Name>MiniFix</Name>
            <Description>Finger Mini Fixator System</Description>
            <Size>One size</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>141004</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK617</BillingCode>
            <Name>MicroFix</Name>
            <Description>Finger Mini Fixator System</Description>
            <Size>one size</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>252452</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ162</BillingCode>
            <Name>Monoplanar Fixator System</Name>
            <Description>Mini Rail</Description>
            <Size>80 - 160 mm  </Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ163</BillingCode>
            <Name>Monoplanar Fixator System  </Name>
            <Description>Rail</Description>
            <Size>100 - 300 mm  </Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK013</BillingCode>
            <Name>Orthofix External Fixation Systems</Name>
            <Description>MiniRail System</Description>
            <Size>Short, Standard, Long and Articulated Horizontal and Vertical Axis</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>197364</ARTG>
            </ARTGs>
            <MinimumBenefit>1685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK613</BillingCode>
            <Name>RadioFix</Name>
            <Description>Radio Fixator System</Description>
            <Size>One size</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>141004</ARTG>
            </ARTGs>
            <MinimumBenefit>1704</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK615</BillingCode>
            <Name>Wrist Fixator PFII</Name>
            <Description>Wrist Fixator System</Description>
            <Size>One size</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>141004</ARTG>
            </ARTGs>
            <MinimumBenefit>1704</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK616</BillingCode>
            <Name>Poing Fix</Name>
            <Description>Wrist Fixator System</Description>
            <Size>One size</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>141004</ARTG>
            </ARTGs>
            <MinimumBenefit>1704</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK002</BillingCode>
            <Name>Orthofix External Fixation System Pennig Wrist Fixator</Name>
            <Description>Anodised aluminium and stainless steel</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>118320</ARTG>
                <ARTG>123604</ARTG>
            </ARTGs>
            <MinimumBenefit>1704</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK014</BillingCode>
            <Name>Orthofix External Fixation Systems</Name>
            <Description>Pennig Minifixator</Description>
            <Size>Short, Standard, Long</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Small, 3D, CDD</Suffix>
            <ARTGs>
                <ARTG>197364</ARTG>
            </ARTGs>
            <MinimumBenefit>2298</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM336</BillingCode>
            <Name>Osteo-x External Mini Fixator</Name>
            <Description>The Osteo-x® external fixator is a device used for the fixation and distraction of small bones, primarily in the hand. It incorporates four K-wires which are driven into the bone and placed to provide three-dimensional stability.</Description>
            <Size>One Size Only</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <Suffix>Small, CDD</Suffix>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>2298</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT019</BillingCode>
            <Name>Frame IT - Pre-assembled Frame</Name>
            <Description>Pre assembled Frame - used for the correction of deformities</Description>
            <Size>120mm-180mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>5105</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST945</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, dynamic tube assembly yellow</Description>
            <Size>15mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5105</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST946</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, dynamic tube assembly blue</Description>
            <Size>20mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5105</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK001</BillingCode>
            <Name>Orthofix External Fixation System Ankle Fixator</Name>
            <Description>Anodised aluminium and stainless steel</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <ARTGs>
                <ARTG>117273</ARTG>
                <ARTG>118320</ARTG>
                <ARTG>123604</ARTG>
                <ARTG>177324</ARTG>
            </ARTGs>
            <MinimumBenefit>5105</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK009</BillingCode>
            <Name>Orthopaedic External Fixation System - Xcaliber External Fixator</Name>
            <Description>Metadiaphyseal Fixator</Description>
            <Size>One size</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <ARTGs>
                <ARTG>117273</ARTG>
                <ARTG>118320</ARTG>
                <ARTG>123604</ARTG>
            </ARTGs>
            <MinimumBenefit>5105</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA060</BillingCode>
            <Name>FastFrame External Fixation System</Name>
            <Description>Knee Spanning and damage control external fixator system - fully assembled, sterile</Description>
            <Size>Length: 200mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <ARTGs>
                <ARTG>315769</ARTG>
            </ARTGs>
            <MinimumBenefit>5105</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA061</BillingCode>
            <Name>FastFrame External Fixation System</Name>
            <Description>Ankle Spanning - fully assembled, sterile</Description>
            <Size>Length: 100-200mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3401</SubGroupID>
            <ARTGs>
                <ARTG>315769</ARTG>
            </ARTGs>
            <MinimumBenefit>5105</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW517</BillingCode>
            <Name>HOFFMANN3 EXTERNAL FIXATION SYSTEM</Name>
            <Description>MULTIPLANAR CLAMP PIN/ROD-ROD</Description>
            <Size>STANDARD</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY664</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Mini Frame Holding Clamp</Description>
            <Size>3.0-4.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>312</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY727</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamps, connecting clamp</Description>
            <Size>1-3mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>312</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN966</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Monoplanar Clamp, 3 Dimensional</Description>
            <Size>Small</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>2913</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW850</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR312</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Clamp</Name>
            <Description>Clamp</Description>
            <Size>5mm and 6mm, 1 hole to 4 hole cube</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL021</BillingCode>
            <Name>Modular Rail System</Name>
            <Description>Monoplanar Clamp</Description>
            <Size>50mm - 100mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN947</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Monoplanar Clamp</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ164</BillingCode>
            <Name>Monoplanar Clamp  </Name>
            <Description>Clamp</Description>
            <Size>Standard</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST968</BillingCode>
            <Name>TenXor External Fixation System</Name>
            <Description>Anodized metal alloy, ring to monotube triax tube clamp</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY199</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis and Orthopaedic External Fixation System</Name>
            <Description>External fixator clamps, double clamp</Description>
            <Size>8.0 - 11mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY203</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamps, tube to tube/universal clamp</Description>
            <Size>11mm Diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY236</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamp components, halo with visor</Description>
            <Size>1.25-6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY247</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamp components, double joint</Description>
            <Size>1.25-6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3402</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>1281</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK567</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, dynamic tube blue</Description>
            <Size>20mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3756</SubGroupID>
            <Suffix>CDD</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>2411</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK568</BillingCode>
            <Name>Hoffmann II MRI System</Name>
            <Description>Anodized metal alloy, dynamic tube, MRI</Description>
            <Size>15/20mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3756</SubGroupID>
            <Suffix>CDD</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>2411</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN950</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Ilizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Monoplanar Clamp, compression distraction device</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3756</SubGroupID>
            <Suffix>CDD</Suffix>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>2411</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST948</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, dynamic tube yellow</Description>
            <Size>15mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3756</SubGroupID>
            <Suffix>Small, CDD</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>1673</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL018</BillingCode>
            <Name>Modular Rail System</Name>
            <Description>Rail</Description>
            <Size>Standard; small; small short</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3756</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ165</BillingCode>
            <Name>Monoplanar Body</Name>
            <Description>Body</Description>
            <Size>100 - 400 mm  </Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3756</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>1276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN948</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Monoplanar Clamp, 3 Dimensional</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3404</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>1322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN949</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Monoplanar clamp, Compresion Distraction Device</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3404</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>1322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST943</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Anodised metal alloy, adjustable connecting rod</Description>
            <Size>Long, short</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3404</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>1322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST953</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, T-Adapter yellow, blue, red</Description>
            <Size>15, 20, 25mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3404</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>1322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW476</BillingCode>
            <Name>HOFFMANN LRF - FULL CIRCULAR RING</Name>
            <Description>FULL CURCULAR RING</Description>
            <Size>DIAMETER - 80 - 270MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW845</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR307</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Full Rings</Name>
            <Description>Full Rings</Description>
            <Size>120mm - 200mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW960</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR450</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Full Ring</Name>
            <Description>Salvation External Fixation Full Ring</Description>
            <Size>120mm - 220mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT023</BillingCode>
            <Name>Frame It Full Ring</Name>
            <Description>Full Circular Ring</Description>
            <Size>Diameter 80mm-220mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL238</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Full Circular Ring</Description>
            <Size>105 - 230 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>384817</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN952</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Full Circular Ring</Description>
            <Size>standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ170</BillingCode>
            <Name>Orthex Full Circular Rings</Name>
            <Description>Ring, Full</Description>
            <Size>60-280mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY425</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Full Ring</Description>
            <Size>90mm-270mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY665</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Full Ring for Hybrid, RL MRI</Description>
            <Size>115-205mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK030</BillingCode>
            <Name>Orthofix Circular Frame Full ring</Name>
            <Description>The Orthofix circular frame is a surgeon designed, user friendly ring fixation system for trauma applications, limb lengthening and deformity correction. It is based on the science, methodology and principles of Prof Ilizarov. The circular frame is simple, offering preassembled functional components that are easy to connect and operate. The frame is stable with anti-rotational feature on connection elements that prevents any undesirable movement. Its unique wire and half pin fixation elements provide efficient bone segment stabilisation. A biomechanically superior metal-plastic interface is stable both during and between adjustments. The system is versatile, consisting of rings, half-rings, foot plates, 5/8 rings and arches. Full control of bone segments accomplished with Orthofix circular frame allows precise movement of segments without compromising stability.</Description>
            <Size>80mm - 300mm full rings</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3405</SubGroupID>
            <ARTGs>
                <ARTG>177324</ARTG>
                <ARTG>229624</ARTG>
            </ARTGs>
            <MinimumBenefit>685</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW478</BillingCode>
            <Name>HOFFMANN LRF - PARTIAL CIRCULAR RING</Name>
            <Description>PARTIAL CIRCULAR RING</Description>
            <Size>DIAMETER - 100-240MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW846</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR308</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Partial Ring</Name>
            <Description>Partial Ring</Description>
            <Size>120mm - 200mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW959</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR449</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Partial Ring</Name>
            <Description>Salvation External Fixation Partial Ring</Description>
            <Size>140mm - 220mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT024</BillingCode>
            <Name>Frame It Partial Ring</Name>
            <Description>Partial circular ring</Description>
            <Size>2/3 rings and half rings&#xD;
&#xD;
Diameter 80mm-220mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL019</BillingCode>
            <Name>Modular Rail System</Name>
            <Description>Rail Arc</Description>
            <Size>Various</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL239</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Partial Circular Ring</Description>
            <Size>105 - 230 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>384817</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN953</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Partial Circular Ring</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>156686</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ171</BillingCode>
            <Name>Orthex Partial Circular Rings</Name>
            <Description>Ring, 5/8, Half, Toe, Arch  </Description>
            <Size>60-280mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST965</BillingCode>
            <Name>TenXor External Fixation System</Name>
            <Description>Anodized metal alloy, open ring</Description>
            <Size>150, 180, 210, 250mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY422</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Partial Circular Ring, Arch Plate</Description>
            <Size>80-240mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>289708</ARTG>
                <ARTG>326183</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY666</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Partial Ring for Hybrid, RL MRI 1/4, 3/4</Description>
            <Size>115-205mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK011</BillingCode>
            <Name>Orthopaedic External Fixation System - Xcaliber External Fixator</Name>
            <Description>Hybrid Fixator</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>117273</ARTG>
                <ARTG>118320</ARTG>
                <ARTG>123604</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK029</BillingCode>
            <Name>Orthofix Circular Frame Partial ring</Name>
            <Description>The Orthofix circular frame is a surgeon designed, user-friendly ring fixation system for trauma applications, limb lengthening and deformity correction. It is based on the science, methodology and principles of Prof Ilizarov. The circular frame is simple offering pre-assembled functional components that are easy to connect and operate. The frame is stable with anti-rotational feature on connection elements that prevents any undesirable movement. It's unique wire and half pin fixation elements provide efficient bone segment stabilisation. A biomechanically superior metal-plastic interface is stable both during and between adjustments. The system is versatile, consisting of rings, half-rings, foot plates, 5/8 rings and arches. Full control of bone segments accomplished with orthodox circular frame allows precise movement of segments without compromising stability.</Description>
            <Size>100mm - 300mm partial rings</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3406</SubGroupID>
            <ARTGs>
                <ARTG>177324</ARTG>
                <ARTG>229624</ARTG>
            </ARTGs>
            <MinimumBenefit>996</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW474</BillingCode>
            <Name>HOFFMANN LRF</Name>
            <Description>Coupling</Description>
            <Size>SHORT , LONG</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3757</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>197935</ARTG>
                <ARTG>258035</ARTG>
            </ARTGs>
            <MinimumBenefit>282</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW482</BillingCode>
            <Name>HOFFMANN LRF - WIRE BOLT COUPLINGS</Name>
            <Description>WIRE BOLT COUPLING</Description>
            <Size>SHORT, MEDIUM, LONG</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3757</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>282</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT025</BillingCode>
            <Name>Frame It Coupling</Name>
            <Description>Coupling devices; Posts, Basic Struts, Plates, Hinges and Extenders</Description>
            <Size>Ranging from 1-12 holes</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3757</SubGroupID>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>282</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL240</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Circular Coupling Device</Description>
            <Size>Standard</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3757</SubGroupID>
            <ARTGs>
                <ARTG>384817</ARTG>
            </ARTGs>
            <MinimumBenefit>282</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN951</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Ilizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Monoplanar adaptor</Description>
            <Size>standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3757</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>282</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN954</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Circular Coupling device</Description>
            <Size>standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3757</SubGroupID>
            <ARTGs>
                <ARTG>108966</ARTG>
                <ARTG>156686</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>282</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY662</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Hybrid Ring Clamps; Combination, Rod, Rod/Wire, Adjustable, Tube/Tube RL MRI</Description>
            <Size>11.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>3757</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>282</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW633</BillingCode>
            <Name>Hoffmann LRF System</Name>
            <Description>Hexapod Strut</Description>
            <Size>XS, S, M, L</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>258035</ARTG>
            </ARTGs>
            <MinimumBenefit>1235</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT026</BillingCode>
            <Name>Frame It Struts</Name>
            <Description>Complex 3D Strut</Description>
            <Size>Standard</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>1235</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN244</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>ASSURE-STRUT™ Quick Adjust Strut - integral locking system, self-adjustment knob</Description>
            <Size>XShort - Long</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>1235</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ172</BillingCode>
            <Name>Orthex Struts</Name>
            <Description>Struts, Telescoping, Quick Lock</Description>
            <Size>70-295mm, small, medium, large</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>1235</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY793</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Circular frame struts</Description>
            <Size>XX Short - Long</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>326183</ARTG>
            </ARTGs>
            <MinimumBenefit>1235</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK032</BillingCode>
            <Name>3D Rapid Adjust Strut</Name>
            <Description>The rapid adjust strut is made of two metal casings encapsulating a threaded rod. It has the ability to correct acutely or gradually. The rapid adjust strut ends have 45 degree locking angulation with 360 degree rotation. The rapid adjust struts have unique ball and claw universal lockable joint at both ends of the strut. Two rapid adjust struts are sufficient for fracture reduction and initial stabilisation, whereas three rapid adjust struts are necessary for walking and weight bearing. Loosening of the ball claw joints allows for verification of the amplitude of angular correction and horizontal translation, magnitude of rotational correction and stability of fixation in coronal, sagittal and horizontal planes.</Description>
            <Size>Short 70 - 104mm range  Medium 98 - 188mm range  Long 163 - 300mm range</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>177324</ARTG>
                <ARTG>207662</ARTG>
            </ARTGs>
            <MinimumBenefit>1235</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK033</BillingCode>
            <Name>3D Telescopic Strut</Name>
            <Description>Struts consist of two telescopic aluminium tubes, outer tube and an inner tube, which can be locked together at various lengths using the side locking bolt and clamp washer. The inner tube is attached to a spring-loaded, black knurled adjustment knob. The adjustment knob mates with the threaded rod in a manner such that the rod translates relative to the inner tube when the knob is rotated. This will provide gradual changes of overall strut length in 0.5mm increments. A reference arrow with plus sign located on the base of the adjustment knob indicates the direction of turning to perform strut elongation - distraction. Each strut has two special joints and one at the base of the outer tube and the other at the end of the threaded rod. Each joint has a mounting stud, which can be inserted into the mounting holes on the ring tabs and held in place by the locking screw. The rapid adjustment of the strut length is achieved by untightening the side locking bolt, sliding the inner tube relative to the outer tube to the desired length. The rapid adjustment is indicated by the inner tube scale in 1mm increments relative to the orange line mark on the outer tube. The gradual adjustment is achieved by pulling and rotating the adjustment knob resulting in a noticeable detect click every 0.5mm of adjustment. Gradual adjustment is indicated by the scale relative to the green line mark.</Description>
            <Size>Struts are available in four sizes - ultrashort, short, medium and long providing adjustment range from 45mm to 318mm.  Ultrashort strut  45 - 101mm range  Short strut 92 - 122mm range  Medium strut 114 - 184mm range  Long strut 158 - 318mm range</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>177324</ARTG>
                <ARTG>207662</ARTG>
            </ARTGs>
            <MinimumBenefit>1235</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW480</BillingCode>
            <Name>HOFFMANN LRF - STATIC STRUT</Name>
            <Description>STATIC STRUT</Description>
            <Size>LENGTHS - 20 -60MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW481</BillingCode>
            <Name>HOFFMANN LRF - THREADED TELESCOPIC ROD</Name>
            <Description>THREADED TELESCOPIC ROD</Description>
            <Size>DIAMETER - 6MM LENGTHS  - 30-400MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW854</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR316</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Struts</Name>
            <Description>Struts</Description>
            <Size>60mm - 230mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW964</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR454</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Strut</Name>
            <Description>SALVATION External Fixation Strut</Description>
            <Size>60mm - 230mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL235</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Struts</Description>
            <Size>XX Short – Long</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>384817</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN955</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Ilizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Circular Frame Strut Device, 3 Dimensional</Description>
            <Size>standard</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
                <ARTG>384817</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ166</BillingCode>
            <Name>Orthex Distractor Strut</Name>
            <Description>Distractor/Clicker, Linear  </Description>
            <Size>100-200mm, Long</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR096</BillingCode>
            <Name>HOFFMANN LRF - TELESCOPIC STRUT</Name>
            <Description>TELESCOPIC STRUT</Description>
            <Size>LENGTHS - 100-277MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4505</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
                <ARTG>258035</ARTG>
            </ARTGs>
            <MinimumBenefit>882</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW475</BillingCode>
            <Name>HOFFMAN LRF</Name>
            <Description>FOOT RING PLATE/ARCH</Description>
            <Size>DIAMETER - 100-210MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW844</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR306</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Foot Plates</Name>
            <Description>Foot Plates</Description>
            <Size>120mm - 180mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT027</BillingCode>
            <Name>Frame It Foot Plate</Name>
            <Description>Foot plate</Description>
            <Size>Diameter 80mm-220mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL236</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Foot Plate</Description>
            <Size>155 - 180 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>384817</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN957</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Foot Plate</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ167</BillingCode>
            <Name>Orthex Foot Plate</Name>
            <Description>Foot Plate</Description>
            <Size>60-230mm, short</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY427</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Foot Rings, Foot Plates Short/Long, Footplate Support Kit - single unit with Left/Right Supports</Description>
            <Size>Rings/Plates 100mm-210mm, Supports One Size - Left &amp; Right</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
                <ARTG>289708</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK031</BillingCode>
            <Name>Orthofix Circular Frame Foot Plate</Name>
            <Description>The Orthofix circular frame is a surgeon designed, user-friendly ring fixation system for trauma applications, limb lengthening and deformity correction. It is based on the science, methodology and principles of Prof Ilizarov. The circular frame is simple, offering preassembled functional components that are easy to connect and operate. The frame is stable with anti-rotational feature on connection elements that prevents any undesirable movement. Its unique wire and half pin fixation elements provide efficient bone segment stabilisation. A biomechanically superior metal-plastic interface is stable both during and between adjustments. The system is versatile, consisting of rings, half-rings, foot plates, 5/8 rings and arches. Full control of bone segments accomplished with Orthofix circular frame allows precise movement of segments without compromising stability.</Description>
            <Size>100mm - 220mm foot plates</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4506</SubGroupID>
            <ARTGs>
                <ARTG>177324</ARTG>
                <ARTG>229624</ARTG>
            </ARTGs>
            <MinimumBenefit>2370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW477</BillingCode>
            <Name>HOFFMANNLRF - NUTS, WASHERS , SPACERS</Name>
            <Description>NUTS, WASHERS , SPACERS</Description>
            <Size>SHORT, LONG, M6,M8,1-7MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
                <ARTG>258035</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW849</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR311</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Circular Frame Nuts and Spacers</Name>
            <Description>Circular Frame Nuts and Spacers</Description>
            <Size>1mm - 120mm, 1 hole to 4 hole, Standard - Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT028</BillingCode>
            <Name>Frame It Nuts &amp; Bolts</Name>
            <Description>Nuts, Bolts and spacers</Description>
            <Size>standard</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL023</BillingCode>
            <Name>Modular Rail System</Name>
            <Description>Rail Accessories</Description>
            <Size>Various</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL237</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Bolts, Washers</Description>
            <Size>Standard</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>218416</ARTG>
                <ARTG>384817</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN958</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Circular Frame, Nuts &amp; Spacer</Description>
            <Size>standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>107550</ARTG>
                <ARTG>108966</ARTG>
                <ARTG>109591</ARTG>
                <ARTG>118355</ARTG>
                <ARTG>141018</ARTG>
                <ARTG>156686</ARTG>
                <ARTG>164373</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ160</BillingCode>
            <Name>Orthex Threaded Sockets</Name>
            <Description>Nut, Threaded</Description>
            <Size>18-60mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ161</BillingCode>
            <Name>Orthex Frame Components</Name>
            <Description>Circular Frame Components  </Description>
            <Size>Standard</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY228</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Connecting Plate / Spacer</Description>
            <Size>1 - 5 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY419</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Nuts, Washers &amp; Spacers, Bolts</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4507</SubGroupID>
            <ARTGs>
                <ARTG>289708</ARTG>
                <ARTG>305577</ARTG>
                <ARTG>326183</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY745</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Distractors and lengthening apparatus</Description>
            <Size>≥ 160mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <Suffix>CDD</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK206</BillingCode>
            <Name>Hoffmann II External Fixation System</Name>
            <Description>Hoffmann II Micro - Couplings </Description>
            <Size>Couplings, Rod to rod, Pin to Rod and Multipin</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>613</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST935</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Anodised metal alloy, rod to rod coupling</Description>
            <Size>8/8mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>622</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST936</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Anodised metal alloy, pin to rod coupling</Description>
            <Size>8/4, 5mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>622</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY746</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Frame Coupling Device</Description>
            <Size>2.0mm - 4.9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>622</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW448</BillingCode>
            <Name>Hoffmann3 External Fixation system - Posts</Name>
            <Description>Hoffmann3 posts</Description>
            <Size>straight, 30 deg, 90 deg</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW449</BillingCode>
            <Name>Hoffmann3 External Fixation System</Name>
            <Description>Rod &amp; Pin-Rod couplings</Description>
            <Size>Coupling, 5/8/11mm rods - 4/5/6mm pins</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW516</BillingCode>
            <Name>HOFFMANN3 EXTERNAL FIXATION SYSTEM</Name>
            <Description>ROD COUPLER</Description>
            <Size>0-120 DEGREES</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW847</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR309</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Wire Fixaters</Name>
            <Description>Wire Fixaters</Description>
            <Size>2mm - 40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK375</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Hoffman II MRI Coupling</Description>
            <Size>Pin to Rod, Rod to Rod, Tube to Rod, Pin Clamp Assembly</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK390</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Hoffman II MRI</Description>
            <Size>Compression/Dystraction Tube, Dynamisation Tube</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK485</BillingCode>
            <Name>Hoffmann Xpress - Universal Pin Clamp</Name>
            <Description>Hoffmann Xpress External Fixation Device - Adapted to fit the needs of medically trained staff of such occupations as the Armed Forces</Description>
            <Size>One size to fit the Rod to Rod</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK487</BillingCode>
            <Name>Hoffmann Xpress - 5 Pin Clamp Posts</Name>
            <Description>Hoffmann Xpress External Fixation Device - adapted to fit needs of medically trained staff of such occupations as the Armed Forces</Description>
            <Size>2 categories, a 1 post clamp and a 2 post clamp</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL020</BillingCode>
            <Name>Modular Rail System</Name>
            <Description>Caps, clamps (upper, lower &amp; stacked) &amp; hinges, clamp connectors</Description>
            <Size>Various</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL022</BillingCode>
            <Name>Modular Rail System</Name>
            <Description>Angle Clamps</Description>
            <Size>Various</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN959</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Coupling device, 3 dimensional</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>156686</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN964</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Articulating Hinge, 3 Dimensional</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>156686</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST950</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, dynamic tube red</Description>
            <Size>25mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST951</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, pin clamp yellow, blue, red</Description>
            <Size>15, 20, 25mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST952</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, single pin clamp yellow, blue, red</Description>
            <Size>15, 20, 25mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST954</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Anodized metal alloy, tube to tube clamp yellow, blue, red, yellow/blue, blue/red</Description>
            <Size>15, 20, 25mm, 15/20mm, 20/25mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST966</BillingCode>
            <Name>TenXor External Fixation System</Name>
            <Description>Anodized metal alloy, ring clamp</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST967</BillingCode>
            <Name>TenXor External Fixation System</Name>
            <Description>Anodized metal alloy, wire post, pin post</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST971</BillingCode>
            <Name>TenXor External Fixation System</Name>
            <Description>Anodized metal alloy, with sliding clamp</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST972</BillingCode>
            <Name>TenXor External Fixation System</Name>
            <Description>Anodized metal alloy,with sliding clamp and spacer</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY091</BillingCode>
            <Name>AO/ASIF k-Wires, Pins, Washers etc</Name>
            <Description>Pinless pins/clips</Description>
            <Size>Asymetric small and large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY237</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>3 degree, 6 degree, 11 degree. Medium, Large</Description>
            <Size>8.0 - 11.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY663</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Medium Frame; Rod, Threaded, Adjustable Clamps RL MRI</Description>
            <Size>5-11.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY744</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Distractors and lengthening apparatus</Description>
            <Size>20mm-250mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK003</BillingCode>
            <Name>Orthofix External Fixation System Elbow Fixator</Name>
            <Description>Anodised aluminium and stainless steel</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>117273</ARTG>
                <ARTG>118320</ARTG>
                <ARTG>123604</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK004</BillingCode>
            <Name>Orthofix External Fixation System Hybrid Fixator</Name>
            <Description>Anodised aluminium and stainless steel</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>117273</ARTG>
                <ARTG>118320</ARTG>
                <ARTG>123604</ARTG>
                <ARTG>177324</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK005</BillingCode>
            <Name>Orthofix External Fixation System Knee Fixator</Name>
            <Description>Anodised aluminium and stainless steel</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4508</SubGroupID>
            <ARTGs>
                <ARTG>117273</ARTG>
                <ARTG>118320</ARTG>
                <ARTG>123604</ARTG>
                <ARTG>177324</ARTG>
            </ARTGs>
            <MinimumBenefit>672</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK211</BillingCode>
            <Name>Hoffmann II External Fixation System</Name>
            <Description>Hoffmann II Micro - Carbon Fibre Rods, RL</Description>
            <Size>3mm (30-150mm)</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>49</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK212</BillingCode>
            <Name>Hoffmann II External Fixation System</Name>
            <Description>Hoffman II Micro - Stainless Steel Rods</Description>
            <Size>3mm x (30-180mm)</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>49</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ169</BillingCode>
            <Name>Orthex Threaded Rods</Name>
            <Description>Threaded Rods</Description>
            <Size>30-120mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>49</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST962</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Carbon tube yellow 015, RL</Description>
            <Size>15mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY193</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Rod / Bar</Description>
            <Size>2.0mm - 15mm (diameter)</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>326183</ARTG>
                <ARTG>289708</ARTG>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY668</BillingCode>
            <Name>Orthopaedic External Fixator  Systems</Name>
            <Description>Curved and straight rod, RL, MRI Carbon Fibre</Description>
            <Size>4.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI964</BillingCode>
            <Name>XtraFix External Fixation System</Name>
            <Description>Connecting rods</Description>
            <Size>6mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>270757</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW446</BillingCode>
            <Name>Hoffmann3 External Fixation system - MRI Curved and straight rod/coupler - carbon fibre</Name>
            <Description>MRI curved and straight rod/coupler - carbon fibre</Description>
            <Size>Diameter - 11mm, lengths 100-650mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW852</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR314</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Rods</Name>
            <Description>Rods</Description>
            <Size>60mm - 400mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT029</BillingCode>
            <Name>Frame It Rods</Name>
            <Description>Threaded Rods</Description>
            <Size>6mm Diameter&#xD;
Lengths from 80mm-200mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>282764</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK393</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Hoffmann II MRI Connecting Rods, RL </Description>
            <Size>8mm Connecting rod (100mm - 500mm), 5mm Connecting rod (100mm - 500mm), Semi Circular Curve Rod</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK486</BillingCode>
            <Name>Hoffmann Xpress External Fixation Device</Name>
            <Description>Hoffmann Xpress - Connnecting Tube, RL, MRI</Description>
            <Size>15 mm diameter / 150 to 440 mm in length</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN960</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Rods</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>156686</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN961</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Rods, telescopic</Description>
            <Size>standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>156686</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ168</BillingCode>
            <Name>Orthex Threaded Rods</Name>
            <Description>Threaded Rods</Description>
            <Size>60-450mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST963</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Carbon tube blue 015, RL</Description>
            <Size>150, 200, 250, 300mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST964</BillingCode>
            <Name>Monotube External Fixation System</Name>
            <Description>Carbon tube red 015, RL</Description>
            <Size>150, 200, 250, 300mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY196</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Rod/Bar</Description>
            <Size>8 - 11 mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY238</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamp components, connecting tube</Description>
            <Size>1.25-6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY421</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Threaded Rod</Description>
            <Size>60- 400mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY667</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>Curved and straight rod, RL, MRI Carbon Fibre</Description>
            <Size>8.0-11.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI965</BillingCode>
            <Name>XtraFix External Fixation System</Name>
            <Description>Connecting rods</Description>
            <Size>11mm, large</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4509</SubGroupID>
            <Suffix>Standard</Suffix>
            <ARTGs>
                <ARTG>270757</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW851</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR313</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Pins</Name>
            <Description>Pins</Description>
            <Size>1.8mm - 6mm diameter, 25mm - 180mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT020</BillingCode>
            <Name>Frame IT - Pins</Name>
            <Description>Fixation Pins used in conjunction with the external fixation frame to adjust the placement of frame to best suit individual patient</Description>
            <Size>6mm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>282833</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM198</BillingCode>
            <Name>MiniFlo pins</Name>
            <Description>Bone pins(screws)for finger mini fixator system</Description>
            <Size>Thread diameter: 1.6,&amp;2.0, 2.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>222614</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM334</BillingCode>
            <Name>Axis Pin</Name>
            <Description>Axis Pin</Description>
            <Size>2.5mm x 30mm-70mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK483</BillingCode>
            <Name>HA Apex Pins</Name>
            <Description>HA coated bone screw</Description>
            <Size>4-6mm diameters, various lengths.</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>139621</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL010</BillingCode>
            <Name>Smith &amp; Nephew Ex-Fix</Name>
            <Description>Frame Component - pins</Description>
            <Size>All sizes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>109512</ARTG>
                <ARTG>118355</ARTG>
                <ARTG>131082</ARTG>
                <ARTG>157919</ARTG>
                <ARTG>99767</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL233</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Frame Component - Pins</Description>
            <Size>150-200mm length</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>99767</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ189</BillingCode>
            <Name>Pins</Name>
            <Description>Pin, Half Pin,Transfixation, Large Bone, Small Bone, HA Coated</Description>
            <Size>75-350mm length  2-6mm thickness</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>345470</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST884</BillingCode>
            <Name>Apex Pins</Name>
            <Description>Stainless Steel Orthopaedic Pins</Description>
            <Size>2 - 6mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>139621</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY051</BillingCode>
            <Name>AO/ASIF Pins</Name>
            <Description>Seldrill, Schanz Screws, Steinmann Pins, Stainless Steel, Titanium Alloy</Description>
            <Size>3mm - 6mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>133927</ARTG>
                <ARTG>157068</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK007</BillingCode>
            <Name>Screw</Name>
            <Description>Frame Component - Pins</Description>
            <Size>Shaft Dia 3.0 - 6.0mm&#xD;
Thread Dia 6.0 - 2.00mm&#xD;
Total Length 40 - 260mm&#xD;
Thread Length 15 - 100mm</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>117274</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK008</BillingCode>
            <Name>Osteotite screw</Name>
            <Description>HA coated screw used for fixation of an external frame</Description>
            <Size>Shaft Dia 3.0 - 6.0mm, Thread Dia 6.0 - 2.0mm, Total Length 40 - 260mm, Thread Length 15 - 90mm</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>117274</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI968</BillingCode>
            <Name>XtraFix External Fixation System</Name>
            <Description>Pins</Description>
            <Size>2.5-6</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4510</SubGroupID>
            <ARTGs>
                <ARTG>272132</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI967</BillingCode>
            <Name>XtraFix External Fixation System</Name>
            <Description>Clamp, 3D</Description>
            <Size>Large</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>270757</ARTG>
            </ARTGs>
            <MinimumBenefit>2993</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST892</BillingCode>
            <Name>Hoffmann II Compact External Fixation System</Name>
            <Description>Pin clamp assembly with no post</Description>
            <Size>One Size Only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>602</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY224</BillingCode>
            <Name>MAXFRAME, Distraction Osteogenesis &amp; External Fixation System</Name>
            <Description>External fixator clamp components, angled piece</Description>
            <Size>Oblique, 1.0 - 3.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>602</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW447</BillingCode>
            <Name>Hoffmann3 External Fixation System - Pin Clamp</Name>
            <Description>Pin clamp Assembly</Description>
            <Size>5 hole with/without posts</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK373</BillingCode>
            <Name>Hoffman II External Fixation system</Name>
            <Description>Hoffman II MRI, Pin Clamp Assembly, MRI</Description>
            <Size>Pelvic Clamp</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL234</BillingCode>
            <Name>SMART TSF (Taylor Spatial Frame)</Name>
            <Description>Pin Clamp Assembly – Conversion Clamp</Description>
            <Size>Standard</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>218416</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN962</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Pin Clamp Assembly</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>156686</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN963</BillingCode>
            <Name>Smith &amp; Nephew External Fixation (Llizarov, Taylor Spatial Frame, Jet-X, Compass)</Name>
            <Description>Pin Clamp Assembly, 3 Dimensional</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>156686</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY200</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamps, transverse clamp</Description>
            <Size>1.25 - 6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY239</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamp components, angled piece with nut</Description>
            <Size>1.25-8.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY242</BillingCode>
            <Name>Orthopaedic External Fixator Systems</Name>
            <Description>External fixator clamp components, bar for upper jaw</Description>
            <Size>1.25-6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY418</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Bolt-connecting, clamp, eye, wire offset, wire slotted, MRI safe.</Description>
            <Size>One size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI966</BillingCode>
            <Name>XtraFix External Fixation System</Name>
            <Description>Pin clamp assembly</Description>
            <Size>large</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4511</SubGroupID>
            <ARTGs>
                <ARTG>270757</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST937</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Anodised metal alloy, 30 deg angled post, stainless steel</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4512</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST938</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Anodised metal alloy, straight post, stainless steel</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4512</SubGroupID>
            <Suffix>Small</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>86</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW479</BillingCode>
            <Name>HOFFMANN LRF - POSTS</Name>
            <Description>POSTS</Description>
            <Size>LENGTHS - 44-88MM</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4512</SubGroupID>
            <ARTGs>
                <ARTG>197935</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW848</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR310</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Posts</Name>
            <Description>Posts</Description>
            <Size>1 - 6 hole, short and tall</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4512</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW963</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR453</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION L Bracket</Name>
            <Description>L Bracket</Description>
            <Size>1-6 hole. Short and tall</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4512</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK374</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Hoffman II MRI</Description>
            <Size>Posts 8mm and 5mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4512</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY420</BillingCode>
            <Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name>
            <Description>Wire Post MRI Safe</Description>
            <Size>Short, Tall, Long and 1 to 5 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4512</SubGroupID>
            <ARTGs>
                <ARTG>289708</ARTG>
                <ARTG>383992</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST888</BillingCode>
            <Name>Howmedica Dynamic Joint Distractor</Name>
            <Description>Complete Y Body Frame - Stainless Steel</Description>
            <Size>One size only</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4513</SubGroupID>
            <Suffix>CDD</Suffix>
            <ARTGs>
                <ARTG>112434</ARTG>
                <ARTG>16241</ARTG>
            </ARTGs>
            <MinimumBenefit>3866</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW853</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR315</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Hinges</Name>
            <Description>Hinges</Description>
            <Size>Universal and In-line.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4513</SubGroupID>
            <Suffix>Mini</Suffix>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>2337</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ173</BillingCode>
            <Name>Orthex Articulating Hinge</Name>
            <Description>Hinges, 3D, Cannulated single plane, Multi-angle ball, Universal, 90 degree</Description>
            <Size>standard</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4513</SubGroupID>
            <ARTGs>
                <ARTG>324628</ARTG>
            </ARTGs>
            <MinimumBenefit>428</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY428</BillingCode>
            <Name>MAXFRAME, Distraction Osteogenesis &amp; External Fixation System</Name>
            <Description>Hinge</Description>
            <Size>One Size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>4513</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>428</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW489</BillingCode>
            <Name>HOFFMANN3 external fixation system</Name>
            <Description>Sterile field kit</Description>
            <Size>Standard kit A</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5485</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK396</BillingCode>
            <Name>Hoffmann II Compact Wrist Sterile Pre-Packs, RL</Name>
            <Description>Bridging &amp; Non-bridging</Description>
            <Size>Sterile Wrist Kit</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5508</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5485</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN965</BillingCode>
            <Name>Jet X Distal Radius Kit</Name>
            <Description>Complete Frame, 3 Dimensional &amp; Compression/Distraction Device</Description>
            <Size>Small</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5508</SubGroupID>
            <ARTGs>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>5485</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK006</BillingCode>
            <Name>Orthopaedic External Fixation System - Radiolucent Wrist Fixator</Name>
            <Description>Complete System Sterile</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5508</SubGroupID>
            <ARTGs>
                <ARTG>197444</ARTG>
            </ARTGs>
            <MinimumBenefit>5485</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA062</BillingCode>
            <Name>FastFrame External Fixation System</Name>
            <Description>Distal radius - fully assembled, sterile</Description>
            <Size>Length: 150mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5508</SubGroupID>
            <ARTGs>
                <ARTG>315769</ARTG>
            </ARTGs>
            <MinimumBenefit>5485</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW490</BillingCode>
            <Name>HOFFMANN3 external fixation system</Name>
            <Description>Sterile field kit</Description>
            <Size>Standard kit B</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW842</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR304</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Pre-Assembled Frame Assemblies</Name>
            <Description>Pre - Assembled Frame</Description>
            <Size>120mm - 180mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW843</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR305</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Limb Salvage Frame Assemblies</Name>
            <Description>Frame Assemblies</Description>
            <Size>160mm - 200mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW961</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR451</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Frame Assembly</Name>
            <Description>Salvation External Frames Assembly</Description>
            <Size>160mm - 180mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW962</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR452</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SALVATION Frame Assembly</Name>
            <Description>Salvation External Frame Assembly</Description>
            <Size>200mm -  220mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>198486</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK364</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Hoffman II Sterile Pre-pack kit, RL</Description>
            <Size>Standard Tibia</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK365</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Hoffmann II Ankle Sterile Pre-Pack kit, RL</Description>
            <Size>Standard Large Ankle Kit</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK378</BillingCode>
            <Name>Hoffman II External Fixation System</Name>
            <Description>Hoffman Pre-pack Pelvic kit</Description>
            <Size>Sterile Pelvic Kit</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>112434</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN946</BillingCode>
            <Name>Jet X Bar Ankle spanning kit</Name>
            <Description>Complete Frames, 3 Dimensional &amp; Compression/Distraction</Description>
            <Size>Standard</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>112731</ARTG>
                <ARTG>97612</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK010</BillingCode>
            <Name>Orthopaedic External Fixation System - Xcaliber External Fixator</Name>
            <Description>Articulated Ankle Fixator</Description>
            <Size>One size only</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>197444</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK012</BillingCode>
            <Name>Orthofix Limb Reconstruction System</Name>
            <Description>Orthofix Limb Reconstruction System</Description>
            <Size>Adult and paediatric - Short, Standard and Long</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>5509</SubGroupID>
            <ARTGs>
                <ARTG>197364</ARTG>
            </ARTGs>
            <MinimumBenefit>5397</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH557</BillingCode>
            <Name>IOS  Fixator Kit</Name>
            <Description>Complete kit of fixator, 6x bone pins, 6 x set screws, 6 x collets, drill bit.</Description>
            <Size>long, short</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1237</GroupID>
            <SubGroupID>6401</SubGroupID>
            <ARTGs>
                <ARTG>266632</ARTG>
            </ARTGs>
            <MinimumBenefit>3189</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM333</BillingCode>
            <Name>Internal joint articulating fixator Elbow</Name>
            <Description>Internal joint articulating fixator Elbow</Description>
            <Size>One size - adjustable</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>2945</GroupID>
            <SubGroupID>7348</SubGroupID>
            <ARTGs>
                <ARTG>278692</ARTG>
            </ARTGs>
            <MinimumBenefit>2417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP107</BillingCode>
            <Name>CMW Bone Cement</Name>
            <Description>CMW Bone Cement Various  without Antibiotic</Description>
            <Size>20, 40 grams</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>96550</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR043</BillingCode>
            <Name>Osteofix</Name>
            <Description>PMMA Bone Cement (High and Low Viscosity)</Description>
            <Size>One Size (19.2g, 10ml Vial)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>333240</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER389</BillingCode>
            <Name>Signus Introx Bone Cement System-Cement, low viscosity</Name>
            <Description>Signus Introx cement is a radiopaque bone cement for Percutaneous Vertebral Augmentation (PVA) procedures</Description>
            <Size>20 grams</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>287169</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HK005</BillingCode>
            <Name>Palacos or Palamed bone cement</Name>
            <Description>Single mix PMMA</Description>
            <Size>40g</Size>
            <SupplierCode>HK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>152109</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW322</BillingCode>
            <Name>Surgical Simplex P Radiopaque Bone Cement</Name>
            <Description>Polymethyl Methacrylate, Styrene Copolymer, Barium Sulfate</Description>
            <Size>40 grams</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>141277</ARTG>
                <ARTG>141278</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW538</BillingCode>
            <Name>Simplex HV  </Name>
            <Description>Simplex HV is a fast-setting acrylic resin for use in bone surgery. Mixing the two separate sterile components produces a ductile bone cement which, after hardening, fixes the implant and transfers stresses produced during movement evenly to the bone. Simplex HV cement powder also contains insoluble zirconium dioxide as an X-ray contrast medium. Simplex HV does not emit a signal and does not pose a safety risk in a magnetic resonance environment.</Description>
            <Size>There is only one size. Powder Component 40g, Liquid Component 20ml</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>220884</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW589</BillingCode>
            <Name>VertePlex</Name>
            <Description>PMMA Cement</Description>
            <Size>20 gram</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>289085</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW590</BillingCode>
            <Name>VertePlex HV</Name>
            <Description>High Viscosity PMMA Cement</Description>
            <Size>20 gram</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>289085</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ932</BillingCode>
            <Name>SmartSet</Name>
            <Description>PMMA bone cement</Description>
            <Size>20 to 40g</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>96550</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB164</BillingCode>
            <Name>AFFIRM Vertebral Compression Fracture System - Access Pack</Name>
            <Description>Bone Cement and Delivery System</Description>
            <Size>20g</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>192479</ARTG>
                <ARTG>274306</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB165</BillingCode>
            <Name>Fortress and Fortress-Plus Bone Cement</Name>
            <Description>Bone Cement</Description>
            <Size>20g</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>274306</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC202</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH526</PriorBillingCode>
            </PriorBillingCodes>
            <Name>G21 Bone Cement</Name>
            <Description>Bone Cement - std and low viscosity</Description>
            <Size>20-60g</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>329063</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC984</BillingCode>
            <Name>CD HORIZON Fenestrated Screw Cement</Name>
            <Description>Fenestrated screw cement - High viscosity, radiopaque, PMMA bone cement</Description>
            <Size>20g powder, 9g vial</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>181918</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH526</BillingCode>
            <Name>G21 Bone Cement</Name>
            <Description>Bone Cement - std and low viscosity</Description>
            <Size>20-60g</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>235604</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK458</BillingCode>
            <Name>Simplex P Speed Set Bone Cement</Name>
            <Description>PMMA Bone Cement</Description>
            <Size>40g pack</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4087</SubGroupID>
            <ARTGs>
                <ARTG>131533</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP108</BillingCode>
            <Name>CMW Antibiotic Bone Cement </Name>
            <Description>CMW Bone Cement Various with Antibiotic</Description>
            <Size>20, 40 grams</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>33482</ARTG>
                <ARTG>63146</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HK008</BillingCode>
            <Name>Copal G+C</Name>
            <Description>High-viscosity, radiopaque bone cement with gentamicin and clindamycin</Description>
            <Size>40g</Size>
            <SupplierCode>HK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>176198</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HK011</BillingCode>
            <Name>Copal G + V</Name>
            <Description>Specialised cement with gentamicin and vancomycin for use in septic revisions</Description>
            <Size>40g</Size>
            <SupplierCode>HK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>228234</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HK012</BillingCode>
            <Name>PALACOS® fast R+G</Name>
            <Description>Fast setting, high viscosity, radiopaque bone cement with gentamicin</Description>
            <Size>40g</Size>
            <SupplierCode>HK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>248254</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HK013</BillingCode>
            <Name>Palacos or Palmed Bone Cement with Gentamicin</Name>
            <Description>Single mix PMMA with Gentamicin</Description>
            <Size>20,40 gms</Size>
            <SupplierCode>HK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>133411</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW320</BillingCode>
            <Name>Antibiotic Simplex Bone Cement with Tobramycin</Name>
            <Description>Polymethyl Methacrylate, Styrene Copolymer, Barium Sulfate</Description>
            <Size>40 grams</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>158560</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW569</BillingCode>
            <Name>Simplex HV with Gentamicin</Name>
            <Description>High viscosity bone cement with antibiotic (Gentamicin)</Description>
            <Size>One unit contains: Powder Component 40.8g, Liquid Component 20ml</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>276417</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ933</BillingCode>
            <Name>SmartSet</Name>
            <Description>Bone cement with antibiotic</Description>
            <Size>20 to 40g</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>119257</ARTG>
                <ARTG>63146</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL164</BillingCode>
            <Name>RALLY</Name>
            <Description>Bone Cement, Polymethylmethacrylate, Gentamicin- Med &amp; High viscosity</Description>
            <Size>40g</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>323815</ARTG>
                <ARTG>323860</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER302</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cemex-genta bone cement</Name>
            <Description>1 mix Methylmethacrylate/ Polymethylmethacrylate with gentamiacin</Description>
            <Size>1 mix 40g powder and 13.3g liquid</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>209860</ARTG>
                <ARTG>209861</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BI243</PriorBillingCode>
                <PriorBillingCode>BI844</PriorBillingCode>
                <PriorBillingCode>BI845</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Refobacin Plus Bone Cemen</Name>
            <Description>Bone Cement, Methyl methacrylate, Gentamicin</Description>
            <Size>20-80gm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4088</SubGroupID>
            <ARTGs>
                <ARTG>168753</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP446</BillingCode>
            <Name>CMW</Name>
            <Description>Bone Cement with vaccum mixing system</Description>
            <Size>40 to 100g</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>141068</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR044</BillingCode>
            <Name>Osteofix + Delivery Systems</Name>
            <Description>Cement + Complex Delivery System</Description>
            <Size>All Sizes (Various Cannula Gauges/Lengths, Syringes and Connectors)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>333240</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER390</BillingCode>
            <Name>Signus Introx Bone Cement-Cement plus mixer/delivery system</Name>
            <Description>Signus Introx low viscosity bone cement plus preparation/delivery kit for mixing and delivering the bone cement.</Description>
            <Size>20 grams</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>287168</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER648</BillingCode>
            <Name>SIGNUS INTROX HighV Cement</Name>
            <Description>The INTROX® HighV cement is a radiopaque bone cement.</Description>
            <Size>Powder 20 g; Liquid 8.6 g</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>354819</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW591</BillingCode>
            <Name>PCD Precision Cement Delivery System with VertePlex HV</Name>
            <Description>High Viscosity PMMA Cement with Mixer and Delivery System</Description>
            <Size>20 gram</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>288933</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW785</BillingCode>
            <Name>AutoPlex Mixer and Delivery System with VertaPlex HV</Name>
            <Description>High Viscosity PMMA Cement with Mixer and Delivery System - Intended to be used for pedicle screw augmentation and vertebroplasty only. </Description>
            <Size>20 gram</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>288933</ARTG>
            </ARTGs>
            <Note>No PL benefit will be payable if the device is used for kyphoplasty surgery, as there is no evidence presented and no MBS item available for this procedure.</Note>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ582</BillingCode>
            <Name>SmartMix</Name>
            <Description>Bone Cement with Vacuum Mixing System</Description>
            <Size>40 to 100g</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>141068</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ736</BillingCode>
            <Name>Confidence Spinal cement system</Name>
            <Description>Spinal Bone Cement PMMA and Percutaneous Administration Kit</Description>
            <Size>5-11cc</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>152824</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC201</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH525</PriorBillingCode>
            </PriorBillingCodes>
            <Name>G21 Bone Cement + Delivery System</Name>
            <Description>Bone Cement – low &amp; std viscosity</Description>
            <Size>20-60g</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>329063</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH533</BillingCode>
            <Name>High V+ Cement with Delivery Kit</Name>
            <Description>PMMA Cement including Delivery Kit</Description>
            <Size>20gm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>239816</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH503</BillingCode>
            <Name>G-21 Radiopaque Bone cement for Vertebral Consolidation + V-Kit 06</Name>
            <Description>Radiopaque Bone Cement for Vertebroplasty – high and low viscosity</Description>
            <Size>10-20g</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>235604</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH525</BillingCode>
            <Name>G21 Bone Cement + Delivery System</Name>
            <Description>Bone Cement – low &amp; std viscosity</Description>
            <Size>20-60g</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>235604</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW014</BillingCode>
            <Name>StabiliT Bone Cement &amp; Saturate Mixing System</Name>
            <Description>A patented cement preparation and controlled delivery of high-viscosity cement.</Description>
            <Size>7cc and 10cc options available</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>291414</ARTG>
                <ARTG>291596</ARTG>
            </ARTGs>
            <Note>No PL benefit will be payable if the device is used for kyphoplasty surgery, as there is no MBS item available for this procedure.</Note>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY429</BillingCode>
            <Name>Traumacem</Name>
            <Description>Cement with mixing and delivery system</Description>
            <Size>10-20gm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4089</SubGroupID>
            <ARTGs>
                <ARTG>177835</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HK014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>HK010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Palacos R+G Pro or Palacos MV+G Pro</Name>
            <Description>Single Mix PMMA with Gentamicin and Complex Delivery System</Description>
            <Size>55g, 75g</Size>
            <SupplierCode>HK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4090</SubGroupID>
            <ARTGs>
                <ARTG>309121</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ583</BillingCode>
            <Name>SmartMix</Name>
            <Description>Antibiotic Bone Cement with Vacuum Mixing System</Description>
            <Size>40 to 100g</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4090</SubGroupID>
            <ARTGs>
                <ARTG>150881</ARTG>
                <ARTG>150882</ARTG>
                <ARTG>150883</ARTG>
                <ARTG>151144</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF082</BillingCode>
            <Name>Bone cement with vacuum mixing system</Name>
            <Description>Bone cement with vacuum mixing system</Description>
            <Size>40 to 100gm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4090</SubGroupID>
            <ARTGs>
                <ARTG>242598</ARTG>
                <ARTG>244560</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL165</BillingCode>
            <Name>RALLY All-in-One System</Name>
            <Description>Bone cement pre-dosed with PMMA powder with gentamicin</Description>
            <Size>70g</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4090</SubGroupID>
            <ARTGs>
                <ARTG>323816</ARTG>
                <ARTG>323820</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER304</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cemex® System Genta</Name>
            <Description>Bone Cement  with Gentamicin packaged in a complex delivery system</Description>
            <Size>40, 60, 70 and 80 grams</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4090</SubGroupID>
            <ARTGs>
                <ARTG>209862</ARTG>
                <ARTG>201043</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI937</BillingCode>
            <Name>Optipac</Name>
            <Description>Refobacin Plus, Prefilled Vaccum Mixing System, Gentamicin Sulphate, PMMA Cement</Description>
            <Size>40-80 gram</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4090</SubGroupID>
            <ARTGs>
                <ARTG>168753</ARTG>
            </ARTGs>
            <MinimumBenefit>437</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW006</BillingCode>
            <Name>Stryker Intramedullary/Bone Plugs</Name>
            <Description>Bone Plugs</Description>
            <Size>6 - 24mm&#xD;
small,medium,large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4091</SubGroupID>
            <ARTGs>
                <ARTG>289666</ARTG>
            </ARTGs>
            <MinimumBenefit>200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW864</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR333</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Plug</Name>
            <Description>UHMWPE - Cement Plug</Description>
            <Size>13mm and 24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4091</SubGroupID>
            <ARTGs>
                <ARTG>134451</ARTG>
            </ARTGs>
            <MinimumBenefit>200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK024</BillingCode>
            <Name>Cement Restrictors + inserter</Name>
            <Description>Restrictors</Description>
            <Size>12-18mm, 18-24mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1279</GroupID>
            <SubGroupID>4091</SubGroupID>
            <ARTGs>
                <ARTG>325020</ARTG>
            </ARTGs>
            <MinimumBenefit>200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX310</BillingCode>
            <Name>Actifuse ABX Easyfill</Name>
            <Description>Actifuse ABX Easyfill - A silicate substituted synthetic bone graft</Description>
            <Size>1.5mL to 4mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>188736</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX313</BillingCode>
            <Name>Actifuse ABX Easyfill Putty</Name>
            <Description>Actifuse ABX Easyfill Putty - A silicate substituted synthetic bone graft</Description>
            <Size>5ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>188736</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX314</BillingCode>
            <Name>ACTIFUSE SHAPE 1.6mL–BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>1.6mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>203922</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX315</BillingCode>
            <Name>ACTIFUSE SHAPE 2.6mL–BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>2.6mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>203922</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX320</BillingCode>
            <Name>ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>5mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209519</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX323</BillingCode>
            <Name>ACTIFUSE MICROGRANULES2.5mL–BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>2.5mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209520</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX324</BillingCode>
            <Name>ACTIFUSE MICROGRANULES 5mL–BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>5mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209520</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR297</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO288</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NanoBone - Granules</Name>
            <Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute granules</Description>
            <Size>0.6ml, 1.2ml, 2.4ml, 5ml</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>281303</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR298</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO290</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NanoBone - Putty</Name>
            <Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute putty</Description>
            <Size>0.5ml, 1.0ml, 2.5ml, 5ml</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>292263</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE655</BillingCode>
            <Name>NovaBone BioGlass</Name>
            <Description>Bioactive synthetic bone graft - calcium phospo-silicate</Description>
            <Size>0.25 - 5cc</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>302472</ARTG>
                <ARTG>302473</ARTG>
                <ARTG>320170</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR002</BillingCode>
            <Name>BioSphere Putty</Name>
            <Description>Bone Graft Substitue - Bioactive Glass Putty</Description>
            <Size>1cc, 2.5cc, 5cc</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>297474</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO289</BillingCode>
            <Name>NanoBone - Granules</Name>
            <Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute block</Description>
            <Size>0. 75ml (5x10x15 mm3)</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>281303</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW856</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR323</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Augment Bone Graft - rhPDGF-BB component</Name>
            <Description>rhPDGF-BB solution (0.3mg/ml)</Description>
            <Size>1.5cc (0.45mg)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>191454</ARTG>
            </ARTGs>
            <Note>The Prostheses List benefit is limited to reimbursement for the use of the device as an alternative to autograft in hindfoot and ankle fusion procedures that require supplemental graft material, including tibiotalar, tibiocalcaneal, talonavicular and calcaneocuboid fusions, or any other procedure if stated in the Intended Purpose in the Australian Register of Therapeutic Goods (ARTG) entry 191454.</Note>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GlassBONE Injectable Putty</Name>
            <Description>Injectable putty for bone grafting</Description>
            <Size>0.1cc to 5cc</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>341771</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB184</BillingCode>
            <Name>SIGNIFY Bioactive</Name>
            <Description>Osteostimulative and osteoconductive bioactive bone void filler</Description>
            <Size>2cc and 5cc</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>317260</ARTG>
                <ARTG>317427</ARTG>
                <ARTG>317449</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH562</BillingCode>
            <Name>i-FACTOR Putty Peptide Enhanced Bone Graft</Name>
            <Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description>
            <Size>0 - 5.0mL</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>169831</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM207</BillingCode>
            <Name>BonAlive Putty</Name>
            <Description>Bone Graft Substitute - Bioactive Glass Putty</Description>
            <Size>1cc, 2.5cc, 5cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>231484</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM215</BillingCode>
            <Name>BonAlive Granules</Name>
            <Description>Bone Graft Substitute - Bioactive Glass Granules</Description>
            <Size>Range (1-5cc)&#xD;
0.5-08mm (small) 1cc&#xD;
0.5-08mm (small) 2.5cc&#xD;
0.5-0.8mm (small) 5cc&#xD;
1.0-2.0mm (medium) 5cc&#xD;
2.0-3.15mm (large) 5cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>176953</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN341</BillingCode>
            <Name>FIBERGRAFT</Name>
            <Description>Bioactive Glass Bone Graft - BG Putty and BG Putty GPS</Description>
            <Size>1-4cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>387410</ARTG>
                <ARTG>387411</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN344</BillingCode>
            <Name>FIBERGRAFT</Name>
            <Description>Bioactive Glass (BG) Bone Graft Morsels</Description>
            <Size>2cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>387006</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OK003</BillingCode>
            <Name>NanoBone - Granulate</Name>
            <Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute granulate</Description>
            <Size>0.6ml, 1.2ml, 2.4ml, 5ml</Size>
            <SupplierCode>OK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>281251</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OK004</BillingCode>
            <Name>NanoBone - Block</Name>
            <Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute block</Description>
            <Size>0. 75ml (5x10x15 mm3)</Size>
            <SupplierCode>OK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>281252</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OK005</BillingCode>
            <Name>NanoBone - Putty</Name>
            <Description>QD and SBX Putty</Description>
            <Size>0.25ml, 0.5ml, 1.0ml, 2.5ml, 5ml</Size>
            <SupplierCode>OK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>314924</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ185</BillingCode>
            <Name>MagnetOS Putty</Name>
            <Description>Granule size 0.25-2mm</Description>
            <Size>0.5cc, 1cc, 2cc, 2.5cc, 5cc</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>345090</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ188</BillingCode>
            <Name>MagnetOS Granules</Name>
            <Description>Granule size 0.15-4mm</Description>
            <Size>0.5cc, 1cc, 2cc, 5cc</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>343493</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VG001</BillingCode>
            <Name>CERAMENT BVF</Name>
            <Description>Bone substitute with hydroxyapatite and iohexal</Description>
            <Size>5ml</Size>
            <SupplierCode>VG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>372270</ARTG>
            </ARTGs>
            <MinimumBenefit>1026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW568</BillingCode>
            <Name>Stryker DirectInject</Name>
            <Description>DirectInject bone cement</Description>
            <Size>3cc&#xD;
5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>278932</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW690</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset Bone Void Filler</Name>
            <Description>Calcium Sulphate</Description>
            <Size>3mm Syringe 1.25cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>171900</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW692</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset MIIG X3</Name>
            <Description>Injectable Calcium Sulphate Bone Void Filler, Includes Syringe</Description>
            <Size>5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172285</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW790</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ProDense / Osteoset XR</Name>
            <Description>Composite Injectable Bone Void Filler</Description>
            <Size>2cc-5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172032</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV016</BillingCode>
            <Name>ProDense 2.0</Name>
            <Description>Injectable Bone Graft Substitute</Description>
            <Size>2cc, 5cc</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172032</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM091</BillingCode>
            <Name>Injectable Calcium Phosphate Synthetic Bone Substitute</Name>
            <Description>Calcium Phosphate Bone Substitute</Description>
            <Size>5cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>115698</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN232</BillingCode>
            <Name>Chronos</Name>
            <Description>Bone Graft Substitute</Description>
            <Size>0-5cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>153247</ARTG>
                <ARTG>159907</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO387</BillingCode>
            <Name>Callos Bone Void Filler</Name>
            <Description>Calcium Phosphate Bone Void Fille</Description>
            <Size>3CC, 5CC</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>142009</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UQ007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SP131</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteovation</Name>
            <Description>Calcium Phosphate Bone substitute kit, quick set, EX/Impact/Inject</Description>
            <Size>0-5cc</Size>
            <SupplierCode>UQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB362</BillingCode>
            <Name>Nanogel</Name>
            <Description>Synthetic, Biomimetic Bone Substitute Material</Description>
            <Size>Syringe 0.5ml, 1.0ml, 2.5ml, 5.0ml</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>282244</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY362</BillingCode>
            <Name>Conduit</Name>
            <Description>Conduit Cylinder</Description>
            <Size>H8 - 20 x D10 - 20mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>136839</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY363</BillingCode>
            <Name>Conduit</Name>
            <Description>Conduit Wedge</Description>
            <Size>H6-18 x D15 x L15</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>136839</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER104</BillingCode>
            <Name>GeneX</Name>
            <Description>GeneX/GeneX DS paste</Description>
            <Size>2.5 and 5cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>158711</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER106</BillingCode>
            <Name>GeneX</Name>
            <Description>GeneX putty</Description>
            <Size>5cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>155298</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER107</BillingCode>
            <Name>GeneX</Name>
            <Description>GeneX putty</Description>
            <Size>2.5cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>155298</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER124</BillingCode>
            <Name>Stimulan Kit/Rapid Cure-5 cc</Name>
            <Description>Calcium Sulphate synthetic rapid cure bone void filler kit.</Description>
            <Size>5cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>123765</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER127</BillingCode>
            <Name>Stimulan kit -5cc</Name>
            <Description>Calcium Sulphate synthetic bone void filler kit</Description>
            <Size>5cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>123765</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER651</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER153</PriorBillingCode>
                <PriorBillingCode>ER155</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SIGNUS KAINOS</Name>
            <Description>Bioactive Bone Graft Substitute Granules </Description>
            <Size>2 or 5 cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>122272</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER652</BillingCode>
            <Name>Biocomposites Stimulan Rapid Cure 5 cc</Name>
            <Description>Calcium Sulfate synthetic rapid setting bone void filler kit.  </Description>
            <Size>5cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>391243</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER655</BillingCode>
            <Name>Biocomposites Stimulan kit 5 cc</Name>
            <Description>Calcium Sulfate synthetic bone void filler kit   </Description>
            <Size>5cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>391242</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC035</BillingCode>
            <Name>NEOBONE GEL</Name>
            <Description>Synthetic Bone Graft Putty</Description>
            <Size>0.5 - 5ml</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>351642</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU272</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE476</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Quickset</Name>
            <Description>Injectable Macroporous Calcium Phospahte</Description>
            <Size>5cc</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>267632</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW673</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SR061</PriorBillingCode>
                <PriorBillingCode>SK480</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HydroSet Injectable Calcium Phosphate Cement</Name>
            <Description>Injectable, rapid set, calcium phosphate bone substitute kit</Description>
            <Size>0-5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>138334</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW687</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OSTEOSET - BVT KIT (STANDARD CURE, FAST CURE)</Name>
            <Description>Mini Bead Kit</Description>
            <Size>5cc Standard/Fast Cure</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>173515</ARTG>
                <ARTG>173514</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW689</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset Bone Void Filler</Name>
            <Description>Calcium Sulphate</Description>
            <Size>3mm &amp; 4.8mm Pellets 5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>171899</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW691</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset Bone Void Filler</Name>
            <Description>Calcium Sulphate</Description>
            <Size>4.8mm Syringe 5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>171900</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW789</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ProDense / Osteoset</Name>
            <Description>Composite Bone Void Filler - Pellets</Description>
            <Size>2cc, 5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>172033</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW857</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR325</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Augment Bone Graft - β-TCP component</Name>
            <Description>β-TCP granules</Description>
            <Size>1.5 cc, 3cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>191454</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT021</BillingCode>
            <Name>Integrant Bone Graft Granules</Name>
            <Description>Osteo Conductive Bone Substitute, that promotes bone growth</Description>
            <Size>0.5cc - 5.0cc</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>282832</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA003</BillingCode>
            <Name>uDesis Gel 1cc-5cc</Name>
            <Description>uDesis™ is a synthetic, highly crystalline beta-tricalcium phosphate bone substitute.</Description>
            <Size>1cc, 2.5cc, 5cc</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>283845</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH560</BillingCode>
            <Name>JectOS</Name>
            <Description>Injectable synthetic bone graft substitute</Description>
            <Size>5cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>141918</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM235</BillingCode>
            <Name>HA/TCP Granules</Name>
            <Description>HA/TCP Bone graft substitute Granules</Description>
            <Size>2.5cc, 5cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>232997</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM239</BillingCode>
            <Name>Exabone HA/TCP Wedges, Blocks, Discs</Name>
            <Description>HA/TCP Bone Substitute</Description>
            <Size>Wedges: 15-35mm width x 20-15mm length x 6-14mm height 1 X 4-10mm height 2&#xD;
Blocks: 4-20mm length x 10-30mm width x 10-45mm height&#xD;
Discs: 5-20mm diameter x 5-20mm height</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>232997</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM240</BillingCode>
            <Name>Exabone Paste</Name>
            <Description>Preloaded Paste in Syringe</Description>
            <Size>0.5cc, 1cc, 2cc, 2.5cc, 5cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>232998</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC415</BillingCode>
            <Name>BCP</Name>
            <Description>Biphasic Calcium Phosphate Reabsorbable Graft Supplement</Description>
            <Size>1-3cc</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>144137</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC594</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Calcium Phosphate Ceramic Granules</Description>
            <Size>5cc Vial</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>96971</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC853</BillingCode>
            <Name>Nanostim</Name>
            <Description>Synthetic Bone Paste</Description>
            <Size>1cc</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>158926</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC854</BillingCode>
            <Name>Nanostim</Name>
            <Description>Synthetic Bone Paste</Description>
            <Size>2cc</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>158926</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC855</BillingCode>
            <Name>Nanostim</Name>
            <Description>Synthetic Bone Paste</Description>
            <Size>5cc</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>158926</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN233</BillingCode>
            <Name>Chronos</Name>
            <Description>Bone Graft Substitute</Description>
            <Size>0-5cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>153247</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU168</BillingCode>
            <Name>In'Oss</Name>
            <Description>Synthetic Bone Graft Putty Hydroxyapatite/Beta Calcium Phosphate (HA/beta-TCP) and Hydroxpropylmethylcellulose hydrogel carrier (HPMC).</Description>
            <Size>0.5 ÷ 5ml</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>303932</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV001</BillingCode>
            <Name>BondBone</Name>
            <Description>Biphasic Calcium Sulfate</Description>
            <Size>0.5cc, 1cc</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>189584</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV003</BillingCode>
            <Name>4Bone Synthetic Bone Graft</Name>
            <Description>HA/βTCP synthetic bone graft</Description>
            <Size>0.5cc, 1cc, 2cc</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>147636</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV075</BillingCode>
            <Name>AttraX bone graft substitute</Name>
            <Description>1cc Cylinder (Putty)&#xD;
2cc Cylinder (Putty)&#xD;
2.5cc Cylinder (Putty)&#xD;
5cc (2x2.5cc) Strip (Putty)</Description>
            <Size>1cc, 2cc 2.5cc, 5cc</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>180974</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC009</BillingCode>
            <Name>uDesis Gel 1cc-5cc</Name>
            <Description>uDesis  is a synthetic, highly crystalline beta-tricalcium phosphate bone substitute.</Description>
            <Size>1cc, 2.5cc, 5cc</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>353248</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV051</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GelOS™</Name>
            <Description>Gel based Synthetic bone substitute</Description>
            <Size>1cc, 2.5cc, 5cc</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>233982</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ004</BillingCode>
            <Name>In'Oss</Name>
            <Description>Synthetic Bone Graft Putty &#xD;
Hydroxyapatite/Beta Calcium Phosphate (HA/beta-TCP) and Hydroxpropylmethylcellulose hydrogel carrier (HPMC)</Description>
            <Size>0.5 - 5ml</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>203574</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ005</BillingCode>
            <Name>ReproBone</Name>
            <Description>TCP/HA Synthetic Bone Graft Granules</Description>
            <Size>0.5-5cc</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>231295</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ009</BillingCode>
            <Name>ReproBone novo</Name>
            <Description>HA Synthetic Bone Graft Paste</Description>
            <Size>0.5-5ml</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>217839</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ056</BillingCode>
            <Name>ReproBone fusion</Name>
            <Description>HA paste with HA/TCP granules</Description>
            <Size>1cc&#xD;
2.5cc&#xD;
5cc</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>297896</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG001</BillingCode>
            <Name>Nanogel</Name>
            <Description>Injectable Synthetic Bone Substitute Paste In A Syringe</Description>
            <Size>0.5ml  1.0ml  2.5ml  5.0ml</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>325849</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF005</BillingCode>
            <Name>Osteoflo</Name>
            <Description>Biphasic Calcium Phosphate; Hydrated Biphasic Calcium Phosphate (Putty)</Description>
            <Size>1ml, 2ml, 5ml</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>185876</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF060</BillingCode>
            <Name>Osteoflo G</Name>
            <Description>Biphasic Calcium Phosphate</Description>
            <Size>1cc,2cc, 5cc Granules</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>273800</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK184</BillingCode>
            <Name>VITOSS - Synthetic cancellous bone void filler</Name>
            <Description>Beta-tricalcium phosphate</Description>
            <Size>1.2cc dowel</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>140557</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK191</BillingCode>
            <Name>VITOSS - Synthetic Cancellous bone void filler</Name>
            <Description>Beta-tricalcium phosphate</Description>
            <Size>5cc morsels</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>140557</ARTG>
                <ARTG>77710</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY331</BillingCode>
            <Name>Norian®</Name>
            <Description>Fast Set Putty</Description>
            <Size>5cc</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>154949</ARTG>
                <ARTG>190838</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA074</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI194</PriorBillingCode>
                <PriorBillingCode>ZI195</PriorBillingCode>
                <PriorBillingCode>ZI196</PriorBillingCode>
                <PriorBillingCode>ZI198</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Graft Substitute</Name>
            <Description>Triosite block and wedges</Description>
            <Size>10-20mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>143036</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI192</BillingCode>
            <Name>Bone Graft Substitute</Name>
            <Description>Triosite Granules (0.5 - 1.0 mm grain sizes)- HATCP</Description>
            <Size>1 g Tube</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>143036</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI193</BillingCode>
            <Name>Bone Graft Substitute</Name>
            <Description>Triosite Granules (2 - 3mm grain size) - HATCP</Description>
            <Size>5g Tube</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>143036</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI197</BillingCode>
            <Name>Bone Graft Substitute</Name>
            <Description>Triosite Block 5 x 5 x 20mm Box of 2 - HATCP</Description>
            <Size>20mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4092</SubGroupID>
            <ARTGs>
                <ARTG>143036</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX308</BillingCode>
            <Name>Actifuse ABX MIS</Name>
            <Description>Actifuse ABX MIS, Refill Cartridge, 7.5ml</Description>
            <Size>7.5ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>193684</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX309</BillingCode>
            <Name>Actifuse ABX MIS</Name>
            <Description>Actifuse ABX MIS, Applicator and Cartridge, 7.5ml</Description>
            <Size>7.5ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>193684</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX312</BillingCode>
            <Name>Actifuse ABX Easyfill Putty</Name>
            <Description>Actifuse ABX Easyfill Putty - A silicate substituted synthetic bone graft</Description>
            <Size>10ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>188736</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX317</BillingCode>
            <Name>ACTIFUSE SHAPE 8.0mL –BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>8.0mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>203922</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX319</BillingCode>
            <Name>ACTIFUSE GRANULES 10mL–BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>10mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209519</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX322</BillingCode>
            <Name>ACTIFUSE EASY PREP –BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>10ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209521</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX325</BillingCode>
            <Name>ACTIFUSE MICROGRANULES –BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>10mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209520</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR299</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO291</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NanoBone - Putty</Name>
            <Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute putty</Description>
            <Size>10ml</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>292263</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE656</BillingCode>
            <Name>NovaBone BioGlass</Name>
            <Description>Bioactive synthetic bone graft - calcium phospho-silicate</Description>
            <Size>8cc-10cc</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>302472</ARTG>
                <ARTG>302473</ARTG>
                <ARTG>302474</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR003</BillingCode>
            <Name>BioSphere Putty</Name>
            <Description>Bone Graft Substrate - Bioactive Glass</Description>
            <Size>6cc-10cc</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>297474</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GlassBONE Injectable Putty</Name>
            <Description>Injectable putty for bone grafting</Description>
            <Size>10cc</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>341771</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB183</BillingCode>
            <Name>SIGNIFY Bioactive</Name>
            <Description>Osteostimulative and osteoconductive bioactive bone void filler</Description>
            <Size>10cc</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>317260</ARTG>
                <ARTG>317427</ARTG>
                <ARTG>317449</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH566</BillingCode>
            <Name>i-FACTOR Putty Peptide Enhanced Bone Graft</Name>
            <Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description>
            <Size>5.0ml - 10ml</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>169831</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM208</BillingCode>
            <Name>BonAlive Putty</Name>
            <Description>Bone Graft Substitute - Bioactive Glass Putty</Description>
            <Size>10cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>231484</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM216</BillingCode>
            <Name>BonAlive Granules</Name>
            <Description>Bone Graft Substitute - Bioactive Glass Granules</Description>
            <Size>(5.1-10cc)&#xD;
13140 - 0.5-0.8mm small granules, 10cc syringe&#xD;
13340 - 1.0-2.0mm medium granules, 10cc syringe&#xD;
13440 - 2.0-3.15mm large granules, 10cc syringe</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>176953</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN342</BillingCode>
            <Name>FIBERGRAFT</Name>
            <Description>Bioactive Glass Bone Graft - BG Putty and BG Putty GPS</Description>
            <Size>6cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>387410</ARTG>
                <ARTG>387411</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN345</BillingCode>
            <Name>FIBERGRAFT</Name>
            <Description>Bioactive Glass (BG) Bone Graft Morsels</Description>
            <Size>6cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>387006</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OK006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO291</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NanoBone - Putty</Name>
            <Description>QD and SBX Putty</Description>
            <Size>10ml</Size>
            <SupplierCode>OK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>314924</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ183</BillingCode>
            <Name>MagnetOS Granules</Name>
            <Description>Granule size 0.15-4mm</Description>
            <Size>10cc</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>343493</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ186</BillingCode>
            <Name>MagnetOS Putty</Name>
            <Description>Granule size 0.25-2mm</Description>
            <Size>10cc</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>345090</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VG002</BillingCode>
            <Name>CERAMENT BVF</Name>
            <Description>Bone substitute with hydroxyapatite and iohexal</Description>
            <Size>10ml</Size>
            <SupplierCode>VG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>372270</ARTG>
            </ARTGs>
            <MinimumBenefit>2185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW573</BillingCode>
            <Name>Stryker DirectInject</Name>
            <Description>DirectInject bone cement</Description>
            <Size>10cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>278932</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW993</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ProDense / Osteoset XR</Name>
            <Description>Composite Injectable Bone Void Filler</Description>
            <Size>10cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172032</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV017</BillingCode>
            <Name>ProDense 2.0</Name>
            <Description>Injectable Bone Graft Substitute </Description>
            <Size>7cc, 10cc</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172032</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN231</BillingCode>
            <Name>Chronos</Name>
            <Description>Bone Graft Substitute</Description>
            <Size>5 - 10cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>153247</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MO388</BillingCode>
            <Name>Callos Bone Void Filler</Name>
            <Description>Calcium Phosphate Bone Void Filler</Description>
            <Size>10CC</Size>
            <SupplierCode>MO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>142009</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK189</BillingCode>
            <Name>CORTOSS - Synthetic cortical bone void filler</Name>
            <Description>-</Description>
            <Size>10cc CORTOSS kit</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>140547</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UQ008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SP066</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteovation</Name>
            <Description>Calcium Phosphate Bone substitute kit; Quick Set; EX/Impact/Inject</Description>
            <Size>10cc</Size>
            <SupplierCode>UQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>159382</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER103</BillingCode>
            <Name>GeneX</Name>
            <Description>GeneX paste</Description>
            <Size>10cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>158711</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER105</BillingCode>
            <Name>GeneX</Name>
            <Description>GeneX putty</Description>
            <Size>10cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>155298</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER125</BillingCode>
            <Name>Stimulan Kit/Rapid Cure-10cc</Name>
            <Description>Calcium Sulphate synthetic rapid cure bone void filler kit</Description>
            <Size>10 cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>123765</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER128</BillingCode>
            <Name>Stimulan kit-10cc</Name>
            <Description>Calcium Sulphate synthetic bone void filler kit</Description>
            <Size>10cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>123765</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER157</BillingCode>
            <Name>Kainos</Name>
            <Description>Granules</Description>
            <Size>1x10cm3</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>122272</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER653</BillingCode>
            <Name>Biocomposites Stimulan Rapid Cure 10 cc</Name>
            <Description>Calcium Sulfate synthetic rapid setting bone void filler kit.  </Description>
            <Size>10 cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>391243</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER656</BillingCode>
            <Name>Biocomposites Stimulan kit 10 cc</Name>
            <Description>Calcium Sulfate synthetic bone void filler kit  </Description>
            <Size>10 cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>391242</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU271</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE477</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Quickset</Name>
            <Description>Injectable Macropourous Calcium Phosphate</Description>
            <Size>8cc</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>267632</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW683</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ProDense / Osteroset XR</Name>
            <Description>Composite Bone Void Filler - Pellets</Description>
            <Size>10cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>172033</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW686</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset</Name>
            <Description>Calcium Sulphate</Description>
            <Size>4.8mm pellets 10cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>171899</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA002</BillingCode>
            <Name>uDesis™ Gel 10cc</Name>
            <Description>uDesis™ is a synthetic, highly crystalline beta-tricalcium phosphate bone substitute.</Description>
            <Size>10cc</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>283845</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM236</BillingCode>
            <Name>HA/TCP Granules</Name>
            <Description>HA/TCP Bone graft substitute Granules</Description>
            <Size>10cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>232997</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM241</BillingCode>
            <Name>Exabone Paste</Name>
            <Description>Preloaded Paste in Syringe</Description>
            <Size>10cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>232998</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC595</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Calcium Phosphate Ceramic Granules</Description>
            <Size>10cc Vial</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>96971</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC856</BillingCode>
            <Name>Nanostim</Name>
            <Description>Synthetic Bone Paste</Description>
            <Size>10cc</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>158926</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV002</BillingCode>
            <Name>4Bone Synthetic Bone Graft</Name>
            <Description>HA/βTCP synthetic bone graft</Description>
            <Size>6cc</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>147636</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV076</BillingCode>
            <Name>AttraX bone graft substitute (&gt;5cc&lt;=10cc)</Name>
            <Description>6cc (2x3cc) Blocks (Putty)&#xD;
10cc (2x5cc) Strip (Putty)</Description>
            <Size>6cc, 10cc</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>180974</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV052</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GelOS™</Name>
            <Description>Gel based Synthetic bone substitute</Description>
            <Size>10cc</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>233982</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ006</BillingCode>
            <Name>ReproBone</Name>
            <Description>TCP/HA Synthetic Bone Graft Granules</Description>
            <Size>6-10cc</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>231295</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ010</BillingCode>
            <Name>ReproBone novo</Name>
            <Description>HA Synthetic Bone Graft Paste</Description>
            <Size>6-10ml</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>217839</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF061</BillingCode>
            <Name>Osteoflo G</Name>
            <Description>Biphasic Calcium Phosphate</Description>
            <Size>6cc,10cc Granules</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>185876</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK188</BillingCode>
            <Name>VITOSS - Synthetic cancellous bone void filler</Name>
            <Description>Beta-tricalcium phosphate</Description>
            <Size>10cc morsels and 10cc dowels</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>140557</ARTG>
                <ARTG>77710</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR054</BillingCode>
            <Name>HydroSet Injectable Calcium Phosphate</Name>
            <Description>Injectable, rapid set, calcium phosphate bone substitute kit</Description>
            <Size>10cc</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>138334</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY002</BillingCode>
            <Name>Chronos</Name>
            <Description>Bone Graft Substitute</Description>
            <Size>5 - 10cc</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>153247</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY332</BillingCode>
            <Name>Norian®</Name>
            <Description>Fast Set Putty</Description>
            <Size>10cc</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>154949</ARTG>
                <ARTG>190838</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER290</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tecres CAL-CEMEX bone void filler</Name>
            <Description>CAL-CEMEX bone void filler with optional mixing device</Description>
            <Size>10 grams</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>223957</ARTG>
                <ARTG>219764</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER291</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tecres CAL-CEMEX Bone Void Filler</Name>
            <Description>CAL-CEMEX Bone Void Filler with delivery system</Description>
            <Size>10 gram</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4093</SubGroupID>
            <ARTGs>
                <ARTG>220245</ARTG>
                <ARTG>223957</ARTG>
                <ARTG>219764</ARTG>
            </ARTGs>
            <MinimumBenefit>1140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX311</BillingCode>
            <Name>ACTIFUSE ABX Putty</Name>
            <Description>Actifuse AVX Putty - A silicated substituted synthetic bone graft.</Description>
            <Size>20ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>188736</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX316</BillingCode>
            <Name>ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>20mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209519</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX318</BillingCode>
            <Name>ACTIFUSE SHAPE15.8mL –BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>15.8mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>203922</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE657</BillingCode>
            <Name>NovaBone BioGlass</Name>
            <Description>Bioactive synthetic bone graft - calcium phospho-silicate</Description>
            <Size>15cc - 20cc</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>302475</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN343</BillingCode>
            <Name>FIBERGRAFT</Name>
            <Description>Bioactive Glass Bone Graft - BG Putty and BG Putty GPS</Description>
            <Size>11cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>387410</ARTG>
                <ARTG>387411</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN346</BillingCode>
            <Name>FIBERGRAFT</Name>
            <Description>Bioactive Glass (BG) Bone Graft Morsels</Description>
            <Size>11cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>387006</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ184</BillingCode>
            <Name>MagnetOS Granules</Name>
            <Description>Granule size 0.25-4mm</Description>
            <Size>15cc, 20cc</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>343493</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ187</BillingCode>
            <Name>MagnetOS Putty</Name>
            <Description>Granule size 1-2mm</Description>
            <Size>20cc</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>345090</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VG003</BillingCode>
            <Name>CERAMENT BVF</Name>
            <Description>Bone substitute with hydroxyapatite and iohexal</Description>
            <Size>18ml</Size>
            <SupplierCode>VG</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>372270</ARTG>
            </ARTGs>
            <MinimumBenefit>4370</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU249</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE478</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Quickset</Name>
            <Description>Injectable Macroporous Calcium Phosphate</Description>
            <Size>16cc</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>267632</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW682</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ProDense/Osteoset XR</Name>
            <Description>Composite Injectable Bone Void Filler</Description>
            <Size>20cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172032</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW693</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset MIIG X3</Name>
            <Description>Injectable Calcium Sulphate Bone Void Filler, Includes Syringe</Description>
            <Size>15cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172285</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW800</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR215</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Dense core Decompression Kit</Name>
            <Description>Composite Injectable Bone Void Filler plus instrumentation kit for core decompression</Description>
            <Size>15cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172105</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV015</BillingCode>
            <Name>ProDense 2.0</Name>
            <Description>Injectable Bone Graft Substitute </Description>
            <Size>12cc, 15cc</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>172032</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY452</BillingCode>
            <Name>Chronos</Name>
            <Description>Bone Graft Substitute</Description>
            <Size>10-20cc</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <Suffix>CDS</Suffix>
            <ARTGs>
                <ARTG>159907</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER126</BillingCode>
            <Name>Stimulan Kit/Rapid Cure-20cc</Name>
            <Description>Calcium Sulphate synthetic rapid cure bone void filler kit.</Description>
            <Size>20cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>123765</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER654</BillingCode>
            <Name>Biocomposites Stimulan Rapid Cure 20 cc</Name>
            <Description>  Calcium Sulfate synthetic rapid setting bone void filler kit  </Description>
            <Size>20 cc</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>391243</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW684</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ProDense / Osteoset XR</Name>
            <Description>Composite Bone Void Filler - Pellets</Description>
            <Size>20cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>172033</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW688</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset Pellets - Bone Graft Substitute</Name>
            <Description>Calcium Sulphate</Description>
            <Size>4.8mm Pellets 20cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>171899</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM237</BillingCode>
            <Name>HA/TCP Granules</Name>
            <Description>HA/TCP Bone graft substitute Granules</Description>
            <Size>15cc, 20cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>232997</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM242</BillingCode>
            <Name>Exabone Paste</Name>
            <Description>Preloaded Paste in Syringe</Description>
            <Size>15cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>232998</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC596</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Calcium Phosphate Ceramic Granules</Description>
            <Size>15cc Vial</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>96971</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PJ028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV059</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GelOS</Name>
            <Description>Gel based synthetic bone substitute</Description>
            <Size>15cc</Size>
            <SupplierCode>PJ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>233982</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ007</BillingCode>
            <Name>ReproBone</Name>
            <Description>TCP/HA Synthetic Bone Graft Granules</Description>
            <Size>11-20cc</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>231295</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ011</BillingCode>
            <Name>ReproBone novo</Name>
            <Description>HA Synthetic Bone Graft Paste</Description>
            <Size>11-20ml</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>217839</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK185</BillingCode>
            <Name>VITOSS - Synthetic cancellous bone void filler</Name>
            <Description>Beta-tricalcium phosphate</Description>
            <Size>15cc morsels</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>140557</ARTG>
                <ARTG>77710</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK481</BillingCode>
            <Name>HydroSet injectable Calcium Phosphate Cement</Name>
            <Description>Injectable, rapid set, calcium phosphate bone substitute kit</Description>
            <Size>15cc</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4094</SubGroupID>
            <ARTGs>
                <ARTG>138334</ARTG>
            </ARTGs>
            <MinimumBenefit>1425</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX321</BillingCode>
            <Name>ACTIFUSE GRANULES 40mL–BONE MATRIX IMPLANT ARTIFICIAL</Name>
            <Description>A silicate substituted synthetic bone graft</Description>
            <Size>40mL</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>209519</ARTG>
            </ARTGs>
            <MinimumBenefit>5700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH564</BillingCode>
            <Name>i-Factor Flex &amp; Flex FR Peptide Enhanced Bone Graft – 25mm</Name>
            <Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description>
            <Size>25mm x 25mm x 4mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>176753</ARTG>
                <ARTG>231653</ARTG>
            </ARTGs>
            <MinimumBenefit>5700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH567</BillingCode>
            <Name>i-Factor Flex &amp; Flex FR Peptide Enhanced Bone Graft – 25mm</Name>
            <Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description>
            <Size>50mm x 25mm x 4mm, 100mm x 25mm x 4mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <Suffix>AUG</Suffix>
            <ARTGs>
                <ARTG>176753</ARTG>
                <ARTG>231653</ARTG>
            </ARTGs>
            <MinimumBenefit>5700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY361</BillingCode>
            <Name>Conduit </Name>
            <Description>Conduit Blocks</Description>
            <Size>10 x 10 x 10mm to 25 x 25 x 30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>136839</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC029</BillingCode>
            <Name>Bone substitute</Name>
            <Description>Synethetic Resorbable Bone Graft</Description>
            <Size>H;4-20mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>283972</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW685</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteoset BVF Kit</Name>
            <Description>Kit contains calcium sulfate, diluent, mould, spatula and mixing bowl</Description>
            <Size>25cc only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>173514</ARTG>
                <ARTG>173515</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM238</BillingCode>
            <Name>HA/TCP Granules</Name>
            <Description>HA/TCP Bone graft substitute Granules</Description>
            <Size>25cc, 30cc</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>232997</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC597</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Calcium Phosphate Ceramic Granules</Description>
            <Size>30cc Vial</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>96971</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ008</BillingCode>
            <Name>ReproBone</Name>
            <Description>TCP/HA Synthetic Bone Graft Granules</Description>
            <Size>21-30cc</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>231295</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF062</BillingCode>
            <Name>Osteoflo G</Name>
            <Description>Biphasic Calcium Phosphate</Description>
            <Size>30cc Granules</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>185876</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK187</BillingCode>
            <Name>VITOSS - Synthetic cancellous bone void filler</Name>
            <Description>Beta-tricalcium phosphate</Description>
            <Size>30cc morsels and 30cc dowels</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>140557</ARTG>
                <ARTG>77710</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST021</BillingCode>
            <Name>Stryker Bone Substitute</Name>
            <Description>Bonesave, Calcium Phosphate</Description>
            <Size>40gms, sizes 2 - 4 and  4-6mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4095</SubGroupID>
            <ARTGs>
                <ARTG>143522</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI003</BillingCode>
            <Name>Bio-Oss Bone Natural Bone Mineral</Name>
            <Description>Derived from bovine bone</Description>
            <Size>Granule size 1 - 2mm, 1.0gm (3cc)  Granule size 0.25 - 1mm, 2.0gm (4cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4111</SubGroupID>
            <ARTGs>
                <ARTG>229987</ARTG>
            </ARTGs>
            <MinimumBenefit>503</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI004</BillingCode>
            <Name>Bio-Oss</Name>
            <Description>This bone block consists of anorganic bovine bone matrix sterilised by gamma-irradiation.  Bio-Oss is a natural bone mineral for filling of bone defects in maxillofacial surgery, implantology, and periodontology.</Description>
            <Size>approx 1.4-1.6g, 2cc</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4111</SubGroupID>
            <ARTGs>
                <ARTG>229987</ARTG>
            </ARTGs>
            <MinimumBenefit>503</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH476</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthoss - Bone implant material</Name>
            <Description>Orthoss Spongiosa Block. Bone Implant material, biological, animal source.</Description>
            <Size>1 x 1x 2 approx. 1.6g</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4111</SubGroupID>
            <ARTGs>
                <ARTG>146885</ARTG>
            </ARTGs>
            <MinimumBenefit>503</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI005</BillingCode>
            <Name>Bio-Oss</Name>
            <Description>Natural bone mineral derived from bovine bone</Description>
            <Size>1 to 2mm; 2.0g (6cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4112</SubGroupID>
            <ARTGs>
                <ARTG>229987</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH474</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthoss - Bone implant material</Name>
            <Description>Orthoss Granules Spongiosa.  Bone implant material, biological, animal source</Description>
            <Size>Granule Size 2-4mm, 3g (approx. 8-10cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4112</SubGroupID>
            <ARTGs>
                <ARTG>146885</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH475</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthoss - Bone implant material</Name>
            <Description>Orthoss Spongiosa Block. Bone Implant material, biological, animal source.</Description>
            <Size>2 x 2 x 1.3cm (approx. 3.6g)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4112</SubGroupID>
            <ARTGs>
                <ARTG>146885</ARTG>
            </ARTGs>
            <MinimumBenefit>1330</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH473</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthoss - Bone implant material</Name>
            <Description>Orthoss Granules Spongiosa,  Bone implant material, biological, animal source</Description>
            <Size>Granule size 1-2mm, 5g-7g; (approx.. 13-20cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4113</SubGroupID>
            <ARTGs>
                <ARTG>146885</ARTG>
            </ARTGs>
            <MinimumBenefit>1710</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI015</BillingCode>
            <Name>Bio-Oss Collagen</Name>
            <Description>The product consists of Bio-Oss granules, embedded in 10% porcine collagen.  The collagen component is resorbed within a few weeks.  The properties of the Bio-Oss granules remain unchanged. Facilitates handling. </Description>
            <Size>1 preformed block of cancellous-bone granulate and collagen, block sizes 500mg</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>229994</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI016</BillingCode>
            <Name>Bio-Oss Collagen</Name>
            <Description>The product consists of Bio-Oss granules, embedded in 10% porcine collagen.  The collagen component is resorbed within a few weeks.  The properties of the Bio-Oss granules remain unchanged. Facilitates handling. </Description>
            <Size>1 preformed block of cancellous-bone granulate and collagen, block size 250mg</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>229994</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI017</BillingCode>
            <Name>Bio-Oss Collagen</Name>
            <Description>The product consists of Bio-Oss granules, embedded in 10% porcine collagen.  The collagen component is resorbed within a few weeks.  The properties of the Bio-Oss granules remain unchanged. Facilitates handling. </Description>
            <Size>1 preformed block of cancellous-bone granulate and collagen, block size 100mg</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>229994</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW664</BillingCode>
            <Name>VITOSS Foam - Compression Resistant Synthetic Cancellous Bone Void Filler</Name>
            <Description>Highly porous bone graft material made from beta-tricalcium phosphate (β-TCP) and Type I bovine collagen</Description>
            <Size>0-5cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>322495</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW858</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR326</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Augment Injectable Bone Graft – β-TCP/bovine Type I collagen matrix</Name>
            <Description>β-TCP/bovine Type I collagen matrix</Description>
            <Size>1.5cc  3cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>231499</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC660</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Matrix</Description>
            <Size>5cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>283420</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI142</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Mastergraft Putty</Description>
            <Size>&gt;0cc-5cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>215319</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI022</BillingCode>
            <Name>nanOss Bioactive Bone Void Filler, 1-5cc</Name>
            <Description>Granular bone graft material comprised of porous hydroxyapatite and porcine gelatin based carrier. Granules supplied in jar (1cc, 2cc, &amp;5cc) or in a prefilled mixing chamber with delivery accessories (5cc) packaging variant.</Description>
            <Size>1cc, 2cc, &amp; 5cc</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4114</SubGroupID>
            <ARTGs>
                <ARTG>279230</ARTG>
            </ARTGs>
            <MinimumBenefit>808</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW665</BillingCode>
            <Name>VITOSS Foam - Compression Resistant Synthetic Cancellous Bone Void Filler</Name>
            <Description>Highly porous bone graft material made from beta-tricalcium phosphate (β-TCP) and Type I bovine collagen.</Description>
            <Size>&gt;5cc - 10cc</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4115</SubGroupID>
            <ARTGs>
                <ARTG>322495</ARTG>
            </ARTGs>
            <MinimumBenefit>1889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC663</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Matrix</Description>
            <Size>10cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4115</SubGroupID>
            <ARTGs>
                <ARTG>283420</ARTG>
            </ARTGs>
            <MinimumBenefit>1889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI143</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Mastergraft Putty</Description>
            <Size>&gt;5cc-10cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4115</SubGroupID>
            <ARTGs>
                <ARTG>215319</ARTG>
            </ARTGs>
            <MinimumBenefit>1889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI023</BillingCode>
            <Name>nanOss Bioactive Bone Void Filler, 10cc</Name>
            <Description>Granular bone graft material comprised of porous hydroxyapatite and porcine gelatin based carrier. Granules supplied in jar (10cc) or in a prefilled mixing chamber with delivery accessories (10cc) packaging variant.</Description>
            <Size>10cc</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4115</SubGroupID>
            <ARTGs>
                <ARTG>279230</ARTG>
            </ARTGs>
            <MinimumBenefit>1889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC662</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Matrix</Description>
            <Size>20cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4116</SubGroupID>
            <ARTGs>
                <ARTG>283420</ARTG>
            </ARTGs>
            <MinimumBenefit>2143</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI144</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Mastergraft Strip</Description>
            <Size>&gt;10cc-20cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4116</SubGroupID>
            <ARTGs>
                <ARTG>215317</ARTG>
            </ARTGs>
            <MinimumBenefit>2143</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI024</BillingCode>
            <Name>nanOss Bioactive Bone Void Filler, 20cc</Name>
            <Description>Granular bone graft material comprised of porous hydroxyapatite and porcine gelatin based&#xD;
carrier</Description>
            <Size>20cc</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4116</SubGroupID>
            <ARTGs>
                <ARTG>279230</ARTG>
            </ARTGs>
            <MinimumBenefit>2143</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK469</BillingCode>
            <Name>VITOSS Foam - Compression Resistant Synthetic Cancellous Bone Void Filler</Name>
            <Description>Highly porous bone graft material made from beta-tricalcium phosphate (β-TCP) and Type I bovine collagen.</Description>
            <Size>20cc Foam strip (25x100x8)</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4116</SubGroupID>
            <ARTGs>
                <ARTG>142666</ARTG>
            </ARTGs>
            <MinimumBenefit>2143</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI145</BillingCode>
            <Name>Mastergraft</Name>
            <Description>Mastergraft Strip</Description>
            <Size>&gt;20cc</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4117</SubGroupID>
            <ARTGs>
                <ARTG>215317</ARTG>
            </ARTGs>
            <MinimumBenefit>2850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK475</BillingCode>
            <Name>VITOSS Foam - Compression Resistant Synthetic Cancellous Bone Void Filler.</Name>
            <Description>Highly porous bone graft material made from beta-tricalcium phosphate (β-TCP) and Type I bovine collagen.</Description>
            <Size>Sheet (Wide Strip) 75x100x4mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4117</SubGroupID>
            <ARTGs>
                <ARTG>142666</ARTG>
            </ARTGs>
            <MinimumBenefit>2850</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI956</BillingCode>
            <Name>TM Interpositional Spacers</Name>
            <Description>Trabecular Metal Interpositional Spacer</Description>
            <Size>S,M,L with heights of 25, 30, 35 and 40mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1241</GroupID>
            <SubGroupID>4122</SubGroupID>
            <ARTGs>
                <ARTG>242595</ARTG>
            </ARTGs>
            <MinimumBenefit>1219</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO107</BillingCode>
            <Name>APTUS Wedge</Name>
            <Description>Titanium Wedges</Description>
            <Size>Wedges 4mm-12mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1777</GroupID>
            <SubGroupID>5399</SubGroupID>
            <Suffix>3D anatomical</Suffix>
            <ARTGs>
                <ARTG>206157</ARTG>
            </ARTGs>
            <MinimumBenefit>1219</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HU241</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE577</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioSync Anatomic Reconstruction Wedge</Name>
            <Description>Titanium metal scaffold for angular correction in ankle and foot</Description>
            <Size>Cotton Wedges 16mm-20mm Depth x 4.5mm-7.5mm Thickness  Evans Wedges  18mm-22mm Width &amp; Depth x 6.5mm-12mm Thickness</Size>
            <SupplierCode>HU</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1777</GroupID>
            <SubGroupID>5399</SubGroupID>
            <Suffix>3D anatomical</Suffix>
            <ARTGs>
                <ARTG>355042</ARTG>
            </ARTGs>
            <MinimumBenefit>1219</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW718</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WR071</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioFoam Bone Wedge</Name>
            <Description>Titanium metal scaffold for angular correction in ankle and foot</Description>
            <Size>Depth 14 - 44mm  Width 10 - 44mm  Thickness 4.5 - 12mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1777</GroupID>
            <SubGroupID>5399</SubGroupID>
            <Suffix>3D anatomical</Suffix>
            <ARTGs>
                <ARTG>198485</ARTG>
            </ARTGs>
            <MinimumBenefit>1219</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW525</BillingCode>
            <Name>Exeter Hip X-Change Revision System</Name>
            <Description>X-Change Stainless steel Revision Mesh - Medial Wall,Rim, Femoral. Flat</Description>
            <Size>Small, medium and large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1777</GroupID>
            <SubGroupID>5399</SubGroupID>
            <ARTGs>
                <ARTG>205495</ARTG>
            </ARTGs>
            <MinimumBenefit>902</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW013</BillingCode>
            <Name>Keep Walking Spacer</Name>
            <Description>Polyethylene spacer</Description>
            <Size>Size: Small, Medium, Large.  Diameter: 54mm, 58mm, 62mm.</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5402</SubGroupID>
            <ARTGs>
                <ARTG>307660</ARTG>
            </ARTGs>
            <MinimumBenefit>6242</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH661</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO121</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Arthrodesis body</Name>
            <Description>Arthrodesis Body</Description>
            <Size>120mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5402</SubGroupID>
            <ARTGs>
                <ARTG>242292</ARTG>
                <ARTG>284220</ARTG>
            </ARTGs>
            <MinimumBenefit>6242</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BR001</BillingCode>
            <Name>OPRA System</Name>
            <Description>Central screw - titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>BR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5404</SubGroupID>
            <ARTGs>
                <ARTG>145488</ARTG>
            </ARTGs>
            <MinimumBenefit>1767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH670</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO131</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS humerus screw</Name>
            <Description>MUTARS humerus screw</Description>
            <Size>15mm,35mm,55mm,75mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5404</SubGroupID>
            <ARTGs>
                <ARTG>246973</ARTG>
                <ARTG>250513</ARTG>
            </ARTGs>
            <MinimumBenefit>1767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BR002</BillingCode>
            <Name>OPRA System</Name>
            <Description>Healing cylinder - titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>BR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5405</SubGroupID>
            <ARTGs>
                <ARTG>145488</ARTG>
            </ARTGs>
            <MinimumBenefit>2993</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BR003</BillingCode>
            <Name>OPRA System</Name>
            <Description>Healing screw - titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>BR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5406</SubGroupID>
            <ARTGs>
                <ARTG>145488</ARTG>
            </ARTGs>
            <MinimumBenefit>2337</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY011</BillingCode>
            <Name>Healing Plug Unidirectional Locking</Name>
            <Description>Unidirectional locking&#xD;
Highly polished to minimise soft tissue irritation&#xD;
Fixation of offset Antirotational bushing, Taper sleeve into the stem &amp; cone&#xD;
An elongated deep groove to prevent rotation&#xD;
Composed of a forged CoCrMo alloy accordingto ISO 5832-12, the M14 male thread of the&#xD;
screw locks with the M 14 female thread of the abutment.</Description>
            <Size>3 size</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5406</SubGroupID>
            <ARTGs>
                <ARTG>229716</ARTG>
            </ARTGs>
            <MinimumBenefit>2337</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BR004</BillingCode>
            <Name>OPRA System</Name>
            <Description>Fixture  Biohelix</Description>
            <Size>15 - 80mm</Size>
            <SupplierCode>BR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5407</SubGroupID>
            <ARTGs>
                <ARTG>145488</ARTG>
            </ARTGs>
            <MinimumBenefit>35055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW012</BillingCode>
            <Name>Keep Walking Femoral stem</Name>
            <Description>Titanium alloy femoral stem component</Description>
            <Size>Length: 120mm - 180mm Diameter: 12mm - 17mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5407</SubGroupID>
            <ARTGs>
                <ARTG>307660</ARTG>
            </ARTGs>
            <MinimumBenefit>35055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HR004</BillingCode>
            <Name>OTNI Osseointegration Femur Prosthesis</Name>
            <Description>The medical device acts as an abutment and provides a fixed support for the connection of an artificial limb prosthesis to the residual femoral bone after transfemoral amputation.</Description>
            <Size>OTNi Femur Stem Ø15x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø16x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø17x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø18x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø19x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø20x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø21x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø22x140 + OTNi Proximal Screw + OTNi Healing Plug  </Size>
            <SupplierCode>HR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5407</SubGroupID>
            <ARTGs>
                <ARTG>354881</ARTG>
            </ARTGs>
            <MinimumBenefit>35055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY001</BillingCode>
            <Name>Intramedullary Femoral Stem Type B</Name>
            <Description>Modular Stem w/proximal fixation/THR option</Description>
            <Size>14mm-22mm, 1mm increaments</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5407</SubGroupID>
            <ARTGs>
                <ARTG>228038</ARTG>
            </ARTGs>
            <MinimumBenefit>35055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY002</BillingCode>
            <Name>Intramedullary Femoral Stem Type C</Name>
            <Description>Modular anatomic stem w/screw options</Description>
            <Size>Left &amp; Right 17mm - 24mm</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5407</SubGroupID>
            <ARTGs>
                <ARTG>228038</ARTG>
            </ARTGs>
            <MinimumBenefit>35055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY003</BillingCode>
            <Name>Intramedullary Femoral Stem Type A</Name>
            <Description>Modular Intramedullary stem</Description>
            <Size>14mm - 21mm, 1mm increments</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5407</SubGroupID>
            <ARTGs>
                <ARTG>228038</ARTG>
            </ARTGs>
            <MinimumBenefit>35055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY008</BillingCode>
            <Name>Fem Stem Cem'Less lntraMed</Name>
            <Description>Stem Cem'Less lntraMed</Description>
            <Size>83 items with sizes ranging in stem length from 140mm to 180mm</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5407</SubGroupID>
            <ARTGs>
                <ARTG>195008</ARTG>
                <ARTG>195009</ARTG>
            </ARTGs>
            <MinimumBenefit>35055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BR005</BillingCode>
            <Name>OPRA System</Name>
            <Description>Abutment - titanium</Description>
            <Size>Length 20mm - 78mm</Size>
            <SupplierCode>BR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5408</SubGroupID>
            <ARTGs>
                <ARTG>145495</ARTG>
            </ARTGs>
            <MinimumBenefit>18288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HR006</BillingCode>
            <Name>OTNi DC Adapter</Name>
            <Description>The modular dual cone transcutaneous adapter, interconnects the femur at the stoma region to an external esoprosthesis by means of the OTN click safety adapter and OTN cannulated self-locking screw.</Description>
            <Size>available in lengths of 60mm , 70mm, 80mm, 90mm, 100mm and 110mm of unique diameter of 18mm</Size>
            <SupplierCode>HR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5408</SubGroupID>
            <ARTGs>
                <ARTG>354839</ARTG>
            </ARTGs>
            <MinimumBenefit>18288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY004</BillingCode>
            <Name>Dual Cone Extension Niobium aluminum oxide coated Abutment</Name>
            <Description>Dual Cone Extension Niobium aluminum oxide coated Abutment</Description>
            <Size>5 sizes</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5408</SubGroupID>
            <ARTGs>
                <ARTG>228038</ARTG>
                <ARTG>229715</ARTG>
                <ARTG>229734</ARTG>
            </ARTGs>
            <MinimumBenefit>18288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY005</BillingCode>
            <Name>Modular Cylinder Extension abutment full Niobium aluminium oxide coated</Name>
            <Description>Modular Cylinder Extension abutment full Niobium aluminium oxide coated</Description>
            <Size>10 sizes</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5408</SubGroupID>
            <ARTGs>
                <ARTG>228038</ARTG>
                <ARTG>229715</ARTG>
                <ARTG>229734</ARTG>
            </ARTGs>
            <MinimumBenefit>18288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY009</BillingCode>
            <Name>Orthodynamics The Integral Leg Prostheses-Dual Cone Extension (as a component of the Orthodynamics The Integral Leg Prosthesis</Name>
            <Description>Orthodynamics The Integral Leg Prosthesis-Dual Cone Extension</Description>
            <Size>6 sizes</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5408</SubGroupID>
            <ARTGs>
                <ARTG>109214</ARTG>
                <ARTG>195008</ARTG>
                <ARTG>195009</ARTG>
            </ARTGs>
            <MinimumBenefit>18288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BR006</BillingCode>
            <Name>OPRA System</Name>
            <Description>Abutment screw - titanium</Description>
            <Size>Size Range in Length from 23 mm to 87 mm</Size>
            <SupplierCode>BR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5409</SubGroupID>
            <ARTGs>
                <ARTG>145495</ARTG>
            </ARTGs>
            <MinimumBenefit>5486</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW015</BillingCode>
            <Name>Keep Walking Washer-Screw Assembly</Name>
            <Description>Washer and screw assembly</Description>
            <Size>one size only</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5409</SubGroupID>
            <ARTGs>
                <ARTG>307660</ARTG>
            </ARTGs>
            <MinimumBenefit>5486</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HR005</BillingCode>
            <Name>OTNI locking screw</Name>
            <Description>Titanium screw for structural reinforcement of internal cone extension of proximal</Description>
            <Size>One size M6x1 </Size>
            <SupplierCode>HR</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5409</SubGroupID>
            <ARTGs>
                <ARTG>354839</ARTG>
            </ARTGs>
            <MinimumBenefit>5486</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OY010</BillingCode>
            <Name>Abutment Screw</Name>
            <Description>Titanium screw for structural reinforcement of the internal Cone Extension</Description>
            <Size>5 sizes</Size>
            <SupplierCode>OY</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5409</SubGroupID>
            <ARTGs>
                <ARTG>229716</ARTG>
            </ARTGs>
            <MinimumBenefit>5486</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW256</BillingCode>
            <Name>HMRS Oncology Humeral Stem</Name>
            <Description>Cobalt Chromium</Description>
            <Size>7x75mm, 7x115mm, 9x75mm, 9x115mm, 11x115mm, 25mmx75mm, 25mmx100mm, 50mmx75mm, 50mmx100mm,75mmx100mm, 100mmx50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5410</SubGroupID>
            <ARTGs>
                <ARTG>128450</ARTG>
                <ARTG>16234</ARTG>
            </ARTGs>
            <MinimumBenefit>5486</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH672</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO133</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS humeral stem</Name>
            <Description>MUTARS humeral stems</Description>
            <Size>7-16mm diameter  75mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5410</SubGroupID>
            <ARTGs>
                <ARTG>238835</ARTG>
                <ARTG>244655</ARTG>
                <ARTG>250512</ARTG>
            </ARTGs>
            <MinimumBenefit>5486</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW222</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humeral Anchorage Piece -  Vitallium</Description>
            <Size>9, 10, 11, 12mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5411</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
            </ARTGs>
            <MinimumBenefit>4539</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW221</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humerus Extension Piece -  Vitallium</Description>
            <Size>5, 15, 30, 45, 60, 75, 90, 105, 120, 135, 150, 165mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5412</SubGroupID>
            <ARTGs>
                <ARTG>128026</ARTG>
            </ARTGs>
            <MinimumBenefit>4173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH664</BillingCode>
            <Name>MUTARS Humerus diaphyseal implant</Name>
            <Description>MUTARS Humerus diaphyseal implant</Description>
            <Size>8-9 mm diameter, 80mm resection length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5412</SubGroupID>
            <ARTGs>
                <ARTG>221739</ARTG>
                <ARTG>284242</ARTG>
            </ARTGs>
            <MinimumBenefit>4173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH668</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO129</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS extension piece</Name>
            <Description>MUTARS humerus extension piece</Description>
            <Size>20mm/40mm/60mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5412</SubGroupID>
            <ARTGs>
                <ARTG>244561</ARTG>
                <ARTG>284403</ARTG>
            </ARTGs>
            <MinimumBenefit>4173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW218</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humerus Connection Piece -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5414</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
            </ARTGs>
            <MinimumBenefit>4351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH667</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO128</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Humerus connecting part</Name>
            <Description>MUTARS Humerus connecting part</Description>
            <Size>80mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5414</SubGroupID>
            <ARTGs>
                <ARTG>244561</ARTG>
                <ARTG>284241</ARTG>
            </ARTGs>
            <MinimumBenefit>4351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH669</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO130</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS humerus reducer</Name>
            <Description>MUTARS humerus reducer</Description>
            <Size>10/100mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5414</SubGroupID>
            <ARTGs>
                <ARTG>244561</ARTG>
                <ARTG>284590</ARTG>
            </ARTGs>
            <MinimumBenefit>4351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW255</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Oncology Humeral Body -  Titanium</Description>
            <Size>40 - 140mm in 20mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5415</SubGroupID>
            <ARTGs>
                <ARTG>128450</ARTG>
                <ARTG>166620</ARTG>
            </ARTGs>
            <MinimumBenefit>3916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW202</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Wedge -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5416</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
            </ARTGs>
            <MinimumBenefit>200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW219</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humerus Connecting Screw -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5417</SubGroupID>
            <ARTGs>
                <ARTG>242316</ARTG>
            </ARTGs>
            <MinimumBenefit>620</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW220</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humerus Hex Socket Bolt -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5418</SubGroupID>
            <ARTGs>
                <ARTG>242316</ARTG>
            </ARTGs>
            <MinimumBenefit>537</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW200</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Plug Screw Axis -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5419</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
                <ARTG>248353</ARTG>
            </ARTGs>
            <MinimumBenefit>206</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW213</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Humeral Bearing -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5421</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW254</BillingCode>
            <Name>HMRS Oncology Humeral Head/Cap</Name>
            <Description>Cobalt Chromium</Description>
            <Size>40, 44mm, Cap</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5422</SubGroupID>
            <ARTGs>
                <ARTG>128450</ARTG>
            </ARTGs>
            <MinimumBenefit>4047</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH666</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO126</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Humerus Head</Name>
            <Description>MUTARS Humerus Head</Description>
            <Size>50mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5422</SubGroupID>
            <ARTGs>
                <ARTG>223513</ARTG>
                <ARTG>284244</ARTG>
            </ARTGs>
            <MinimumBenefit>4047</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH703</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO127</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Humerus cap</Name>
            <Description>MUTARS Humerus cap</Description>
            <Size>Small, medium and large. +5 and +10mm offset&#xD;
Standard / Inverse</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5422</SubGroupID>
            <ARTGs>
                <ARTG>227772</ARTG>
                <ARTG>234173</ARTG>
            </ARTGs>
            <MinimumBenefit>4047</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH346</BillingCode>
            <Name>Comprehesive Segmental Revision System (SRS)</Name>
            <Description>Comprehensive SRS Flange</Description>
            <Size>Small, large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5423</SubGroupID>
            <ARTGs>
                <ARTG>104347</ARTG>
            </ARTGs>
            <MinimumBenefit>4130</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW216</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Distal Humerus Cone -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5423</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
            </ARTGs>
            <MinimumBenefit>4130</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW217</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Distal Humerus Flange -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5423</SubGroupID>
            <ARTGs>
                <ARTG>242296</ARTG>
            </ARTGs>
            <MinimumBenefit>4130</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW643</BillingCode>
            <Name>METS Humeral Collar Round Smooth</Name>
            <Description>Titanium, smooth uncoated collar for a secure fit in the humeral canal</Description>
            <Size>20mm, 22mm, 24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5458</SubGroupID>
            <ARTGs>
                <ARTG>246505</ARTG>
            </ARTGs>
            <MinimumBenefit>2200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW619</BillingCode>
            <Name>METS Humeral Component for use with Hemi Head</Name>
            <Description>Titanium humeral component</Description>
            <Size>Small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5459</SubGroupID>
            <ARTGs>
                <ARTG>276014</ARTG>
            </ARTGs>
            <MinimumBenefit>6690</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW620</BillingCode>
            <Name>METS Humeral Head Fixation Screw</Name>
            <Description>Titanium screw which fixes the humeral component and the humeral head together</Description>
            <Size>Small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5460</SubGroupID>
            <ARTGs>
                <ARTG>246503</ARTG>
            </ARTGs>
            <MinimumBenefit>537</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW621</BillingCode>
            <Name>METS Humeral Component with Liner and re-attachment</Name>
            <Description>Titanium component with HA coated rails for tissue reattachment, HYMWPE liner with encased metal ring for use with contrained glenoid</Description>
            <Size>Mono-size, left and right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5461</SubGroupID>
            <ARTGs>
                <ARTG>277425</ARTG>
            </ARTGs>
            <MinimumBenefit>8541</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW622</BillingCode>
            <Name>METS Humeral Collar Round Coated</Name>
            <Description>Titanium colar with HAP coated stipples</Description>
            <Size>20mm, 22mm, 24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5462</SubGroupID>
            <ARTGs>
                <ARTG>246505</ARTG>
            </ARTGs>
            <MinimumBenefit>3916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW623</BillingCode>
            <Name>METS Humeal Stem</Name>
            <Description>Straight titanium stems, 7-11mm diameters</Description>
            <Size>Diameters 7-11mm,  Lengths 70-90mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5463</SubGroupID>
            <ARTGs>
                <ARTG>276068</ARTG>
            </ARTGs>
            <MinimumBenefit>2587</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW624</BillingCode>
            <Name>METS Humeral Shaft</Name>
            <Description>Titanium shafts in 15mm increments, reconstructs the humeral shaft where there is diseased or deficient bone</Description>
            <Size>Lengths 38-143mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5464</SubGroupID>
            <ARTGs>
                <ARTG>246504</ARTG>
            </ARTGs>
            <MinimumBenefit>3081</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW625</BillingCode>
            <Name>METS Humeral Integral Shaft &amp; Stem Coated</Name>
            <Description>Titanium, combined shaft, stem &amp; collar with HA coated stipples</Description>
            <Size>20mm shaft plateau with 8mm diameter stem, 24mm shaft plateau with 10mm diameter stem&#xD;
7945</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5465</SubGroupID>
            <ARTGs>
                <ARTG>276913</ARTG>
            </ARTGs>
            <MinimumBenefit>7548</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW626</BillingCode>
            <Name>METS Humeral Component with Liner</Name>
            <Description>Titanium component, UHMWPE liner with encased metal ring for use with constrained glenoid</Description>
            <Size>Mono-size, left and right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5467</SubGroupID>
            <ARTGs>
                <ARTG>277395</ARTG>
            </ARTGs>
            <MinimumBenefit>6729</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW627</BillingCode>
            <Name>METS Humeral Component with Reattachment for use with Hemi Head</Name>
            <Description>Titanium humeral component with HA coated rails for tissue reattachment</Description>
            <Size>Small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5468</SubGroupID>
            <ARTGs>
                <ARTG>276015</ARTG>
            </ARTGs>
            <MinimumBenefit>8875</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW628</BillingCode>
            <Name>METS Bayley Walker Glenoid Component</Name>
            <Description>Titanium HAP coated tapered screw with 22.2mm CoCr-Molybdenum head, for Glenoid fixation</Description>
            <Size>Extra small, small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5469</SubGroupID>
            <ARTGs>
                <ARTG>276250</ARTG>
            </ARTGs>
            <MinimumBenefit>7111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH665</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO125</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Glenosphere</Name>
            <Description>MUTARS glenosphere</Description>
            <Size>40mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5469</SubGroupID>
            <ARTGs>
                <ARTG>227771</ARTG>
            </ARTGs>
            <MinimumBenefit>7111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH674</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO135</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Glenoid</Name>
            <Description>MUTARS Glenoid</Description>
            <Size>1 size</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5469</SubGroupID>
            <ARTGs>
                <ARTG>227161</ARTG>
            </ARTGs>
            <MinimumBenefit>7111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW644</BillingCode>
            <Name>METS Humeral Hemi-head</Name>
            <Description>Titanium humeral hemi-head forming part of a modular system to replace diseased or damaged bone</Description>
            <Size>Diameters 43mm, 46mm, 52mm, 55mm, 58mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5470</SubGroupID>
            <ARTGs>
                <ARTG>276014</ARTG>
            </ARTGs>
            <MinimumBenefit>3218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH634</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO082</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Arthrodesis stems</Name>
            <Description>Arthrodesis tibial and femoral stems, cvd, straight, cemented/cementless</Description>
            <Size>11-20mm x 100 - 250mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5475</SubGroupID>
            <ARTGs>
                <ARTG>236019</ARTG>
            </ARTGs>
            <MinimumBenefit>3724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH659</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO119</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Arthrodesis Tibial component</Name>
            <Description>MUTARS - Arthrodesis Tibial component</Description>
            <Size>45mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5477</SubGroupID>
            <ARTGs>
                <ARTG>242292</ARTG>
                <ARTG>284589</ARTG>
            </ARTGs>
            <MinimumBenefit>6242</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH660</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO120</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Arthrodesis femoral component</Name>
            <Description>MUTARS - Arthrodesis femoral component</Description>
            <Size>45mm left and right</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>13</CategoryID>
            <SubCategoryID>123</SubCategoryID>
            <GroupID>1778</GroupID>
            <SubGroupID>5479</SubGroupID>
            <ARTGs>
                <ARTG>242292</ARTG>
                <ARTG>284584</ARTG>
            </ARTGs>
            <MinimumBenefit>6242</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HQ003</BillingCode>
            <Name>SURGITIME Titanium Mesh</Name>
            <Description>Titanium Surgitime is a non absorbable titanium mesh made of pure titanium (ASTM F-67). It comes in many different lengths, widths, thicknesses and hole diameters. It assist bone neoformation, acting as a barrier hindering the migration of epithelial cells and of the conjunctive tissues, thus avoiding competition with the bone graft.</Description>
            <Size>34x25mm- Thickness 0.04mm/Round hole 0,15mm  34x25mm- Thickness 0.04mm/Round hole 0,85mm  34x25mm- Thickness 0,08mm/Round hole 0,85mm</Size>
            <SupplierCode>HQ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4201</SubGroupID>
            <ARTGs>
                <ARTG>247013</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT027</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium</Description>
            <Size>&lt;0.2mm thick, 1 to 10cm² area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4201</SubGroupID>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT026</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium</Description>
            <Size>&lt;0.2mm, 51 to 100cm² area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4202</SubGroupID>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT034</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.2 to 0.49mm thick, 1 to 10cm² area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4203</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>707</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY577</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium contourable mesh; Orbital &amp; Pre-Shaped</Description>
            <Size>&lt;0.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4203</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>707</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT022</BillingCode>
            <Name>SCS Interlink Plate </Name>
            <Description>Titanium mesh plate - pre-shaped</Description>
            <Size>0.4mm thick, 1 - 10cm2</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4203</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>707</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB402</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial Fixation Mesh Plate</Description>
            <Size>28.8 - 48.8 mm x 14.5 - 16.2 mm  Thickness 0.4mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4203</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT031</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.2 to 0.49mm thick, 1 to 10cm² area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4203</SubGroupID>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO129</BillingCode>
            <Name>MODUS Mesh </Name>
            <Description>Pre-shaped, contourable Titanium Mesh, Sterile </Description>
            <Size>0.25-0.44mm thick, 11-50cm²</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW528</BillingCode>
            <Name>Stryker Neuro Mesh Plates</Name>
            <Description>Titanium malleable mesh plates for cranial reconstruction</Description>
            <Size>0.2-0.49mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>295882</ARTG>
                <ARTG>203105</ARTG>
                <ARTG>214470</ARTG>
                <ARTG>214471</ARTG>
                <ARTG>214472</ARTG>
            </ARTGs>
            <MinimumBenefit>769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT060</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.9-0.49mm thick, 11-50cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY578</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium contourable mesh; Mastoid, Cranial &amp; Pre-Shaped</Description>
            <Size>0.2mm-0.49mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT021</BillingCode>
            <Name>SCS Interlink Plate</Name>
            <Description>Titanium mesh plate - pre-shaped</Description>
            <Size>0.4mm thick, 11-50cm2</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB401</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial Fixation Mesh Plate</Description>
            <Size>40.2 - 42.2mm x 25.1 - 50.2mm  Thickness 0.3mm - 0.4mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI645</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Mesh panel, 1.5mm System Titanium</Description>
            <Size>(41-83) x (39-54mm) (0.3 or 0.2mm)</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ012</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis</Name>
            <Description>Mesh,0.2 -0.49mm thick, titanium.</Description>
            <Size>less than 50cm2 area</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Micro, Mini, Maxi</Description>
            <Size>0.2-0.49mm thick, 11-50cm²</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH508</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System Mesh thin 50cm2</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.2-0.49mm thick, 11-50cm2</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM217</BillingCode>
            <Name>Bioplate Biomesh System</Name>
            <Description>Titanium cranial biomesh</Description>
            <Size>0.3 to 0.45mm thickness, 32-60mm x 43-60mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>123206</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC889</BillingCode>
            <Name>TiMesh</Name>
            <Description>Square-rectangular Gridmesh Panel</Description>
            <Size>11 to 25 cm2 area</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC914</BillingCode>
            <Name>TiMesh Titanium Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>FlexMesh 1.5mm System. Composition: Titanium</Description>
            <Size>26 to 50 cm2 area; 0.3mm thick</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4204</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>628</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH024</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Pre-contoured Neuro Mesh, titanium</Description>
            <Size>163 x 115 x 0.3mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>119508</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO128</BillingCode>
            <Name>MODUS Mesh </Name>
            <Description>Titanium Mesh, Sterile </Description>
            <Size>0.2-0.49mm thick, 51-200cm²</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates</Description>
            <Size>0.2-0.49mm thick, 51-200cm²</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT047</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium &amp; 3D</Description>
            <Size>0.2-0.49mm thick, 51-200cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH512</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 3D Mesh 200cm2</Name>
            <Description>3D Mesh, Titanium</Description>
            <Size>0.2-0.49mm thick, 51-200cm2</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM218</BillingCode>
            <Name>Bioplate Biomesh System</Name>
            <Description>Titanium cranial biomesh</Description>
            <Size>0.45mm thickness, 85-132mm x 90-134mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>123206</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC524</BillingCode>
            <Name>TiMesh</Name>
            <Description>Isogrid Panel</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC525</BillingCode>
            <Name>TiMesh</Name>
            <Description>Sugar Mesh Panel / Grid</Description>
            <Size>11 x 7.5cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC887</BillingCode>
            <Name>TiMesh</Name>
            <Description>Titanium Mesh Panel</Description>
            <Size>51 to 100 cm2 area</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC890</BillingCode>
            <Name>TiMesh</Name>
            <Description>Square-rectangular Gridmesh Panel</Description>
            <Size>51 to 100 cm2 area</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI084</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>FlexMesh 1.0 - 1.5mm system. Composition: Titanium</Description>
            <Size>51 to 100cm² area, 0.3mm thickness</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK582</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Craniofacial Titanium Mesh System</Description>
            <Size>0.2 - 0.49mm thick, 51 - 200cm²</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY488</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium Contourable mesh plate</Description>
            <Size>&lt;0.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4205</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH018</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Sheet 1.5mm System. Titanium</Description>
            <Size>(203-206)mm x (123-127)mm x (0.2-0.3)mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4206</SubGroupID>
            <ARTGs>
                <ARTG>143959</ARTG>
            </ARTGs>
            <MinimumBenefit>1462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ441</BillingCode>
            <Name>Titanium Mesh</Name>
            <Description>Titanium Mesh Sterile</Description>
            <Size>0.2mm thickness, 15cm x 15cm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4206</SubGroupID>
            <ARTGs>
                <ARTG>143829</ARTG>
            </ARTGs>
            <MinimumBenefit>1462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ047</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates</Description>
            <Size>111 x 191mm Mesh Plate, Mesh &gt; 200cm2 area.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4206</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>1462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC387</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Square Grid Mesh</Description>
            <Size>Large</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4206</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY786</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium Contourable mesh, Cranial Neuro</Description>
            <Size>&lt;0.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4206</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT039</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh Titanium</Description>
            <Size>0.5-0.8mm thick, 1-10cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4207</SubGroupID>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC389</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Square Grid Mesh</Description>
            <Size>Small</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4207</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT023</BillingCode>
            <Name>SCS Interlink Plate</Name>
            <Description>Titanium mesh plate - pre-shaped</Description>
            <Size>0.6mm thick, 1 - 10cm2</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4207</SubGroupID>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH023</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Panel, Regular or Small Grid. Titanium</Description>
            <Size>(42-85) x (40-53)mm x 0.6mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>119508</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO131</BillingCode>
            <Name>MODUS Mesh</Name>
            <Description>Titanium Mesh, Sterile </Description>
            <Size>0.5-0.8mm thick, 11-50cm²</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates</Description>
            <Size>0.5-0.8mm thick, 11-50cm²</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT062</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.5-0.8mm thick, 11-50cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH509</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System Mesh 50cm2</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.5-0.8mm thick, 11-50cm2</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM219</BillingCode>
            <Name>Bioplate Biomesh System</Name>
            <Description>Titanium cranial biomesh</Description>
            <Size>0.6mm thickness, 36-65 x 52-65mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>123206</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC915</BillingCode>
            <Name>TiMesh Titanium Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>FlexMesh 1.5mm System. Composition: Titanium</Description>
            <Size>26 to 50 cm2 area; 0.6mm thick</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT024</BillingCode>
            <Name>SCS Interlink Plate</Name>
            <Description>Titanium mesh plate - pre-shaped</Description>
            <Size>0.6mm thick, 11-50cm2</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT031</BillingCode>
            <Name>SCS Titanium Mesh</Name>
            <Description>Titanium mesh</Description>
            <Size>0.6mm thick; 11-50cm2</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4208</SubGroupID>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB315</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.</Description>
            <Size>Plate Neuro, 65 x 90 mm, 68 x 91mm and 100 x 100mm, 0.3mm &amp; 0.6mm Mesh</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO130</BillingCode>
            <Name>MODUS Mesh </Name>
            <Description>Titanium Mesh, Sterile </Description>
            <Size>0.5-0.8mm thick, 51-200cm²</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ013</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis</Name>
            <Description>Mesh, 0.5-0.8mm thick, titanium</Description>
            <Size>51- 200 cm2 area</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates</Description>
            <Size>90 x 90mm Osteoform Mesh, Mesh 51 to 100cm2 area.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT023</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.50 to 0.80mm thick, 51 to 100cm² area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH510</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System Mesh 64cm2</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.5-0.8mm thick, 51-200cm2</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM220</BillingCode>
            <Name>BIOPLATE Biomesh</Name>
            <Description>Titanium cranial biomesh</Description>
            <Size>0.6mm thickness, 90-127 x 92-131mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>123206</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC877</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Mesh</Description>
            <Size>51 to 100 cm2 area, 0.6mm thickness</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI085</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>FlexMesh 1.0 - 2.2mm system. Composition : Titanium</Description>
            <Size>51 to 100cm² area, 0.6mm thickness</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN243</BillingCode>
            <Name>MatrixNEURO</Name>
            <Description>Preformed mesh</Description>
            <Size>0.6mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>313407</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST250</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Mesh: Micro, Dumbach, Dynamic</Description>
            <Size>Diameter 1.0mm - 2.3mm; Up to 90 x 90mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY579</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mesh</Description>
            <Size>0.5mm-0.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT030</BillingCode>
            <Name>SCS Titanium Mesh </Name>
            <Description>Titanium mesh</Description>
            <Size>0.6mm thick; 51-200cm2</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4209</SubGroupID>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>1146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB368</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable</Description>
            <Size>Plate Neuro, 132 x 158 mm, 150x 150 mm, 200 x 200 mm, 0.6mm Mesh</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH019</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Sheet 1.5mm System. Titanium</Description>
            <Size>206 x 123 x 0.6mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>143959</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates</Description>
            <Size>125 x 180mm Mesh Plate, 150 x 300mm Mesh Plate, Mesh &gt;200cm2 area.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH492</BillingCode>
            <Name>Standard Approach Mesh</Name>
            <Description>Pre-contoured titanium mesh implants for 11 standard approaches.</Description>
            <Size>0.6mm thick</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>202842</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH511</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System Mesh 200cm2</Name>
            <Description>Mesh, Titanium</Description>
            <Size>0.5-0.8mm thick, &gt;200cm2</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM221</BillingCode>
            <Name>BIOPLATE Biomesh</Name>
            <Description>Titanium cranial biomesh 3ME, packaged non-sterile</Description>
            <Size>20 x 20cm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>123206</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI083</BillingCode>
            <Name>TiMesh Titanium rigid Fixation Bone Grafting and Plating System</Name>
            <Description>FlexMesh 1.5mm - 2.2mm system. Composition: Titanium</Description>
            <Size>148 - 154mm x 148 - 154mm, 0.6mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY785</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium Contourable Mesh, Cranial Neuro</Description>
            <Size>0.5mm-0.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT032</BillingCode>
            <Name>SCS Titanium Mesh </Name>
            <Description>Titanium mesh: 2D, 3D, pre-moulded 2D, pre-moulded 3D</Description>
            <Size>0.6mm thick; &gt;200cm2</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1585</GroupID>
            <SubGroupID>4210</SubGroupID>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>2087</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ687</BillingCode>
            <Name>PDS Plates</Name>
            <Description>Absorbable synthetic (poly-p-dioxanone) plate/foil</Description>
            <Size>0.25 x 30 x 40mm&#xD;
0.5 x 30 x 40mm&#xD;
0.25 x 40 x 50mm&#xD;
0.5 x 40 x 50mm&#xD;
0.15 x 30 x 40mm&#xD;
0.15 x 40 x 50mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4220</SubGroupID>
            <ARTGs>
                <ARTG>165926</ARTG>
            </ARTGs>
            <MinimumBenefit>502</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT032</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; SonicWeld</Name>
            <Description>Mesh PDLLA (resorbable)</Description>
            <Size>0.20 to 0.49mm thick, 1 to 10 cm2 area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4221</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>433</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK019</BillingCode>
            <Name>Inion GTR Biodegradable System</Name>
            <Description>PLGA/TMC Copolymer: membrane &amp; tacks</Description>
            <Size>a) 30 x 40mm membrane kit; b) 6 tack kit and applicator</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4222</SubGroupID>
            <ARTGs>
                <ARTG>95697</ARTG>
            </ARTGs>
            <MinimumBenefit>654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT013</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name>
            <Description>Mesh, PDLLA (resorbable)</Description>
            <Size>0.20 to 0.49mm thick, 26 to 50cm² area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4223</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>1219</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT058</BillingCode>
            <Name>Martin Level One Fixation Resorb X &amp; SonicWeld RX</Name>
            <Description>Mesh, PDLLA (resorbable)</Description>
            <Size>0.50 to 0.80mm thick, 1 to 10cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4225</SubGroupID>
            <ARTGs>
                <ARTG>14336</ARTG>
            </ARTGs>
            <MinimumBenefit>577</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY544</BillingCode>
            <Name>PolyMax Rapid-Resorbable Fixation System</Name>
            <Description>Mesh Plate</Description>
            <Size>0.5-0.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4226</SubGroupID>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>908</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK023</BillingCode>
            <Name>CPS Bioabsorbable Fixation System</Name>
            <Description>CPS Systems and Baby System Plates.  Polylactic Acid Trimethylene Carbonate Copolymer</Description>
            <Size>1.5-2.5 mesh plate, 7 x 7 holes; 1.5mm baby mesh plate 7 x 7 holes</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4226</SubGroupID>
            <ARTGs>
                <ARTG>154546</ARTG>
            </ARTGs>
            <MinimumBenefit>908</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT046</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh PDLLA resorbable</Description>
            <Size>0.5-0.8mm thick, 26-50cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4227</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>1183</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY547</BillingCode>
            <Name>PolyMax Rapid-Resorbable Fixation System</Name>
            <Description>Mesh Plate</Description>
            <Size>0.5-0.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4228</SubGroupID>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>1866</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT048</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh PDLLA resorbable</Description>
            <Size>0.5-0.8mm thick, 101-200cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4229</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>2019</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC013</BillingCode>
            <Name>Osteomesh</Name>
            <Description>A scaffold bone void filler used to fill cranial defects.    </Description>
            <Size>Length (mm) 20-39  Height (mm) 1-5  Width (mm) 10-25</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4230</SubGroupID>
            <ARTGs>
                <ARTG>334285</ARTG>
            </ARTGs>
            <MinimumBenefit>570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC015</BillingCode>
            <Name>Osteoplug</Name>
            <Description>A bone void filler indicated for the repair of neurosurgical burr holes and other cranial defects. It is used to aid closure of post trephination burr hole defects.</Description>
            <Size>Inner Diameter (mm): 8-15  Outer Diameter (mm): 14-25  Height (mm): 5</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4230</SubGroupID>
            <ARTGs>
                <ARTG>334286</ARTG>
            </ARTGs>
            <MinimumBenefit>570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC016</BillingCode>
            <Name>Osteoplug-C</Name>
            <Description>A Bone void filler indicated for the repair of neurosurgical burr holes. </Description>
            <Size>Inner Diameter (mm): 8-15  Outer Diameter (mm): 14-25  Height (mm): 5</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4230</SubGroupID>
            <ARTGs>
                <ARTG>334287</ARTG>
            </ARTGs>
            <MinimumBenefit>570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT044</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh PDLLA resorbable</Description>
            <Size>&gt;0.8mm thick, 1-10cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4230</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WM001</BillingCode>
            <Name>Osteomesh</Name>
            <Description>A scaffold bone void filler used to fill cranial defects.</Description>
            <Size>Length (mm) 20-60 Height (mm) 1-5 Width (mm) 10-30  </Size>
            <SupplierCode>WM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4230</SubGroupID>
            <ARTGs>
                <ARTG>334285</ARTG>
            </ARTGs>
            <MinimumBenefit>570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WM004</BillingCode>
            <Name>Osteoplug</Name>
            <Description>A bone void filler indicated for the repair of neurosurgical burr holes and other cranial  defects. It is used to aid closure of post trephination burr hole defects.</Description>
            <Size> Length 8-100(mm): Width 2-10(mm) Height 4-5 (mm)</Size>
            <SupplierCode>WM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4230</SubGroupID>
            <ARTGs>
                <ARTG>334286</ARTG>
            </ARTGs>
            <MinimumBenefit>570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WM005</BillingCode>
            <Name>Osteoplug-C</Name>
            <Description>A Bone void filler indicated for the repair of neurosurgical burr holes.</Description>
            <Size>Length 8-15 (mm):  Width 8-15 (mm):Height 4-5 (mm)</Size>
            <SupplierCode>WM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4230</SubGroupID>
            <ARTGs>
                <ARTG>334287</ARTG>
            </ARTGs>
            <MinimumBenefit>570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC014</BillingCode>
            <Name>Osteomesh</Name>
            <Description>A scaffold bone void filler used to fill cranial defects.    </Description>
            <Size>Length (mm): 40-50  Height (mm): 1-5  Width (mm): 40-50</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4231</SubGroupID>
            <ARTGs>
                <ARTG>334285</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT015</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name>
            <Description>Mesh, PDLLA (resorbable)</Description>
            <Size>&gt;0.80mm thick, 11 to 25cm² area</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4231</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY545</BillingCode>
            <Name>PolyMax Rapid-Resorbable Fixation System</Name>
            <Description>Mesh Plate</Description>
            <Size>&gt;0.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4231</SubGroupID>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WM002</BillingCode>
            <Name>Osteomesh</Name>
            <Description>A scaffold bone void filler used to fill cranial defects</Description>
            <Size>Length (mm): 35-60 Height (mm): 1-5 Width (mm): 15-50</Size>
            <SupplierCode>WM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4231</SubGroupID>
            <ARTGs>
                <ARTG>334285</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT045</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh PDLLA resorbable</Description>
            <Size>&gt;0.8mm thick, 26-50cm²</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4232</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>987</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST516</BillingCode>
            <Name>Stryker Leibinger Resorbable Fixation System</Name>
            <Description>Resorbable plate: blank panel Tripolymer</Description>
            <Size>55x55mm </Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4232</SubGroupID>
            <ARTGs>
                <ARTG>151009</ARTG>
            </ARTGs>
            <MinimumBenefit>987</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WM003</BillingCode>
            <Name>Osteomesh</Name>
            <Description>A scaffold bone void filler used to fill cranial defects.</Description>
            <Size>Length (mm): 80-100 Height (mm): 1-5 Width (mm): 30-60</Size>
            <SupplierCode>WM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4232</SubGroupID>
            <ARTGs>
                <ARTG>334285</ARTG>
            </ARTGs>
            <MinimumBenefit>987</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY546</BillingCode>
            <Name>PolyMax Rapid-Resorbable Fixation System</Name>
            <Description>Mesh Plate</Description>
            <Size>&gt;0.8mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4233</SubGroupID>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>1130</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WM006</BillingCode>
            <Name>Osteomesh</Name>
            <Description>A scaffold bone void filler used to fill cranial defects</Description>
            <Size>Length 100 (mm): Height 1-5(mm):  Width 100(mm): </Size>
            <SupplierCode>WM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4233</SubGroupID>
            <ARTGs>
                <ARTG>334285</ARTG>
            </ARTGs>
            <MinimumBenefit>1130</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT049</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Mesh PDLLA resorbable</Description>
            <Size>&gt;0.8mm thick, 101-200cm2</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1586</GroupID>
            <SubGroupID>4496</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>1958</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY699</BillingCode>
            <Name>SynPOR</Name>
            <Description>Anatomical Porous Polyethylene with Titanium</Description>
            <Size>08.mm - 1.5mm thick</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1587</GroupID>
            <SubGroupID>4239</SubGroupID>
            <ARTGs>
                <ARTG>190454</ARTG>
            </ARTGs>
            <MinimumBenefit>816</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW444</BillingCode>
            <Name>E-POR Biomaterial/ Panel - Porous Polyethlene Titanium Mesh Composite</Name>
            <Description>Panel - Porous Polyethylene Titanium Mesh Composite</Description>
            <Size>0.5mm-0.8mm thick, 76mm x 50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1587</GroupID>
            <SubGroupID>4240</SubGroupID>
            <ARTGs>
                <ARTG>144994</ARTG>
            </ARTGs>
            <MinimumBenefit>885</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY697</BillingCode>
            <Name>SynPOR</Name>
            <Description>Porous Polyethylene with Titanium</Description>
            <Size>&gt; 08.mm thick</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1587</GroupID>
            <SubGroupID>4241</SubGroupID>
            <ARTGs>
                <ARTG>190454</ARTG>
            </ARTGs>
            <MinimumBenefit>1043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV011</BillingCode>
            <Name>Ossix Plus</Name>
            <Description>Ossix Plus is a resorbable collagen membrane intended for use during the process of guided bone regeneration (GBR) and guided tissue regeneration (GTR) as a biodegradable barrier.     </Description>
            <Size>15 x 25mm, 25 x 30mm, 30 x 40mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>380301</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV012</BillingCode>
            <Name>OSSIX Volumax</Name>
            <Description>A resorbable collagen membrane intended for use during the process of guided bone regeneration (GBR) and guided tissue regeneration (GTR) as a biodegradable barrier.</Description>
            <Size>10 x 12.5mm  15 x 25mm  25 x 30mm  10 x 40mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>380302</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI014</BillingCode>
            <Name>Geistlich Mucograft</Name>
            <Description>Collagen Matrix</Description>
            <Size>15mm x 20mm, 20mm x 30mm, diameter 8mm</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>229991</ARTG>
                <ARTG>229995</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI019</BillingCode>
            <Name>Geistlich Bio-Gide Perio / Geistlich Bio-Gide Compressed</Name>
            <Description>Geistlich Bio-Gide Perio and Geistlich Bio-Gide Compressed are collagen membranes containing porcine collagen in a bilayer structure. Geistlich Bio-Gide Perio is used for guided bone regeneration and is especially indicated for periodontal bone defects in oral and maxillofacial surgery.&#xD;
Geistlich Bio-Gide Compressed is intended to be used as a barrier membrane in the regeneration of bone defects.</Description>
            <Size>16 x 22 mm, 13 x 25 mm, 20 x 30 mm</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>230085</ARTG>
                <ARTG>294333</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI020</BillingCode>
            <Name>Geistlich Bio-Gide Shape</Name>
            <Description>Geistlich Bio-Gide Shape is intended to be used as a barrier membrane in the regeneration of bone defects and used after bone grafting procedures in extraction sockets.&#xD;
Because of its elasticity, Geistlich Bio-Gide Shape should be used in combination with void-filling bone graft materials such as autologous bone or bone substitutes (e.g. Geistlich Bio-Oss / Geistlich Bio-Oss Collagen) whenever possible.&#xD;
The porous surface, facing the bone, allows the ingrowth of bone-forming cells. The dense surface, facing the soft tissue, prevents the ingrowth of fibrous tissue into the bone defect.</Description>
            <Size>14 x 24 mm</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>287902</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI021</BillingCode>
            <Name>Geistlich Bio-Gide</Name>
            <Description>Geistlich Bio-Gide is a collagen membrane containing porcine collagen in a bilayer structure. It is used for guided bone regeneration and peridontal tissue regeneration in oral and maxillofacial surgery.</Description>
            <Size>13 x 25 mm, 25 x 25 mm, 30 x 40 mm</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>230084</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HD027</BillingCode>
            <Name>BioHorizons Mem-Lok Pliable </Name>
            <Description>Mem-Lok Pliable is a strong, conformable collagen barrier membrane manufactured from highly purified porcine tissue. Predictable resorption time is 12-16 weeks. Used for guided bone regeneration and periodontal tissue regeneration in oral and maxillofacial surgery.</Description>
            <Size>15mm x 20mm  20mm x 30mm  30mm x 40mm</Size>
            <SupplierCode>HD</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>300312</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HD029</BillingCode>
            <Name>BioHorions Mem-Lok RCM</Name>
            <Description>Mem-Lok Resorbable Collagen Matrix is engineered from highly purified, Type I bovine collagen to provide a predictable resorption period and ensure optimal bone regeneration in periodontal, implantology or maxillofacial surgery.</Description>
            <Size>15mm x 20mm  20mm x 30mm  30mm x 40mm</Size>
            <SupplierCode>HD</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>196055</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IC004</BillingCode>
            <Name>ZenGuard</Name>
            <Description>ZenGuard Resorbable Membrane is a conformable Collagen Membrane derived from purified porcine peritoneum to aid in wound healing</Description>
            <Size>15x 20mm&#xD;
20x 30mm&#xD;
30x 40mm</Size>
            <SupplierCode>IC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>300185</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IF003</BillingCode>
            <Name>Regaurde Resorbable Collagen Membrane</Name>
            <Description>Collagen dental regeneration membrane</Description>
            <Size>15x20mm, 20x30mm, 30x40mm</Size>
            <SupplierCode>IF</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>216324</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT033</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; SonicWeld</Name>
            <Description>Reconstruction sheet not mesh PDLLA (resorbable)</Description>
            <Size>25x25mm-0.1mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV020</BillingCode>
            <Name>BVital Form RCM </Name>
            <Description>Resorbable Collagen Dental Membrane</Description>
            <Size>(15-30)mm x (20-40)mm sheet</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>376528</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ013</BillingCode>
            <Name>NeoGen Collagen membrane</Name>
            <Description>NeoGen Collagen Flex is a bioresorbable, implantable collagen material that is intended for use in oral surgical procedures as a resorbable membrane material for use in simultaneous use of guided bine regeneration (GBR) - membrane and implants; augmentation around implants placed in immediate extraction sockets; augmentation around implants placed in delayed extraction sockets; localized ridge augmentation for later implantation; alveolar ridge reconstruction for prosthetic treatment; filling of bone defects after root resection, cystectomy or removal of retained teeth; guided bone regeneration in dehiscence defects and guided tissue regeneration procedures in periodontal defects</Description>
            <Size>Small 20mm x15mm  Medium 30mm x 20mm  Large 40mm x 30mm</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>372711</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR015</BillingCode>
            <Name>creos xenoprotect</Name>
            <Description>creos xenoprotect is a resorbable dental membrane. A resorbable collagen membrane is used for guided bone regeneration (GBR) and guided tissue regeneration (GTR) procedures.  It's composed of a network of interwoven, highly purified porcine collagen and elastin fibers, providing the membrane with high mechanical strength.</Description>
            <Size>15 x 20mm  25 x 30mm  30 x 40mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>297240</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW005</BillingCode>
            <Name>OsseoGuard Resorbable Collagen Membrane</Name>
            <Description>Dental Resorbable Collagen Membrane</Description>
            <Size>15mm x 20mm, 20mm x 30mm, 30mm x 40mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>154041</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW009</BillingCode>
            <Name>Biomend &amp; Biomend Extend Collagen Membrane</Name>
            <Description>Absorbable Collagen membrane</Description>
            <Size>15mm x 20mm&#xD;
20mm x 30mm&#xD;
30mm x 40mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>159199</ARTG>
                <ARTG>159200</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OK007</BillingCode>
            <Name>Neomem FLEXPLUS</Name>
            <Description>Resorbable Collagen Membrane</Description>
            <Size>15 x 20mm, 20 x 30mm, 30 x 40mm  </Size>
            <SupplierCode>OK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>317977</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB014</BillingCode>
            <Name>Jason membrane</Name>
            <Description>Resorbable collagen membrane for dental regeneration</Description>
            <Size>15 x 20mm, 20 x 30mm, 30 x 40mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>307644</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VQ001</BillingCode>
            <Name>CelGro Dental</Name>
            <Description>Resorbable collagen barrier membrane</Description>
            <Size>15mm x 20mm, 20 x 30mm, 30mm x 40mm, 40mm x 50mm</Size>
            <SupplierCode>VQ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4253</SubGroupID>
            <ARTGs>
                <ARTG>352137</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW416</BillingCode>
            <Name>Micro Thin Sheet</Name>
            <Description>Model/s 8438, 83020, 83022, 83029</Description>
            <Size>8438: 30 x 50 x 0.4mm,  83020: 38 x 50 x 0.25mm, 83022: 38 x 50 x 0.35mm, 83029: 38 x 50 x 0.45mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4254</SubGroupID>
            <ARTGs>
                <ARTG>152165</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW417</BillingCode>
            <Name>Sheet</Name>
            <Description>Porus Polyethylene. Models 6330, 6331, 8662, 9562. Micro single channel sheet, model 9528. Barrier microplate single channel sheet, model 9527 Medpor Titan Implant Sheets Plain, Barrier &amp; Double Barrier, and Medpor Titan Orbital floor and wall sheets 8102</Description>
            <Size>Sheets 6330: 38 x 50 x 1.5mm, 6331: 50 x 76 x 1.5mm, 8662: 76 x 127 x 1.5mm, 9862: 38 x 50 x 3mm. Microplate single channel Sheet 9528: 38 x 50 x 0.85mm. Barrier microplate single channel Sheet 9527: 38 x 50 x 0.85mm. Titan implant sheets 81020: 76 x 50 x</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4254</SubGroupID>
            <ARTGs>
                <ARTG>152165</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW418</BillingCode>
            <Name>Barrier Sheet: Barrier Sheet - Orbital Floor</Name>
            <Description>Porus Polyethylene. Barrier  sheet - Rectangle, models 8312 and 9312. Orbital floor implants, models 8305 and 9305</Description>
            <Size> Barrier  sheet - Rectangle: 50 x 76  x 1mm, 50 x 76 x 1.6mm: 50 x 76 x 1mm, 50 x 76 x 1.6mm.  Orbital Floor: 38 x 50 x 1mm, 38 x 50 x 1.6mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4254</SubGroupID>
            <ARTGs>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW672</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>HW426</PriorBillingCode>
                <PriorBillingCode>HW427</PriorBillingCode>
                <PriorBillingCode>SK513</PriorBillingCode>
                <PriorBillingCode>SK516</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ultra Thin Sheet</Name>
            <Description>Porus Polyethylene</Description>
            <Size>38-127 x 50-178 x 0.85mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4254</SubGroupID>
            <ARTGs>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK517</BillingCode>
            <Name>Sheet - Barrier Single Channel Sheet.</Name>
            <Description>Porus Polyethylene. Barrier Single Channel Sheet, Model 9527.</Description>
            <Size>Barrier Single Channel: 38 x 50 x 0.85mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4254</SubGroupID>
            <ARTGs>
                <ARTG>257016</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY696</BillingCode>
            <Name>SynPOR</Name>
            <Description>Porous Polyethylene</Description>
            <Size>0.45mm - 3.0mm thick</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4254</SubGroupID>
            <ARTGs>
                <ARTG>190454</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Ultra Thin, Membrane, Flor-Tec, Channel Sheet</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the craniofacial anatomy during reconstructive and plastic surgery procedures. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>2.5mm, 3.5mm. 4.0mm, 0.85mm, 1.5mm, 3.0mm</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4254</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW506</BillingCode>
            <Name>Stryker MEDPOR Implant</Name>
            <Description>Porous Polyethylene Mesh</Description>
            <Size>Block</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4255</SubGroupID>
            <ARTGs>
                <ARTG>152165</ARTG>
            </ARTGs>
            <MinimumBenefit>804</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Flexible Block</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the craniofacial anatomy during reconstructive and plastic surgery procedures. Made of high density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>13 x 38 x 3mm, 25 x 50 x 6mm, 13 x 38 x 9.5mm  25 x 50 x 3mm, 25 x 50 x 6mm, 25 x 50 x 9.5mm  38 x 63 x 3mm, 38 x 63 x 6mm, 38 x 63 x 9.5mm</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <SubGroupID>4255</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>804</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK515</BillingCode>
            <Name>Nasal Sheet (Strut).</Name>
            <Description>Nasal Sheet (Strut). Model 9536</Description>
            <Size>Nasal Sheet (Strut): 40 x 9 x 1.1mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1588</GroupID>
            <ARTGs>
                <ARTG>257016</ARTG>
            </ARTGs>
            <MinimumBenefit>178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Midface &amp; Mini</Description>
            <Size>Straight Plate - 2 Hole, Plate &lt; 4 holes.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4261</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM222</BillingCode>
            <Name>BIOPLATE Low Profile</Name>
            <Description>Low Profile 2-hole Straight Plate</Description>
            <Size>11mm - 14mm length</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4261</SubGroupID>
            <ARTGs>
                <ARTG>123205</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY561</BillingCode>
            <Name>Matrix</Name>
            <Description>Simple shaped plates</Description>
            <Size>&lt; 4 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4261</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT026</BillingCode>
            <Name>SCS Interlink Plate - 2-hole</Name>
            <Description>Titanium 2-hole plate</Description>
            <Size>0.4mm x 15mm, 0.4mm x 17mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4261</SubGroupID>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>63</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT010</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, titanium</Description>
            <Size>&lt;0.5mm thick, 4 to 7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4263</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH495</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, titanium</Description>
            <Size>&lt;0.5mm thick, 4 to 7 holes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4263</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM224</BillingCode>
            <Name>BIOPLATE Low Profile</Name>
            <Description>Low Profile Flex Contoured Burr Hole Cover</Description>
            <Size>Low profile 0.3mm, 1.5mm diam hole, 12 - 18mm diam plate</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4263</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>123205</ARTG>
            </ARTGs>
            <MinimumBenefit>169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN196</BillingCode>
            <Name>Matrix Plate</Name>
            <Description>Burr Hole Plates</Description>
            <Size>12 to 24mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4263</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT028</BillingCode>
            <Name>SCS Interlink Plate - Burr Hole/Drainage Burr Hole</Name>
            <Description>Titanium burr hole plate, drainage burr hole plate </Description>
            <Size>0.4mm thick; Diameter: 12mm, 16mm, 18mm, 22mm, </Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4263</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM223</BillingCode>
            <Name>Bioplate Plating System</Name>
            <Description>Plates of various shape</Description>
            <Size>4 to 7 holes</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4263</SubGroupID>
            <ARTGs>
                <ARTG>123205</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY562</BillingCode>
            <Name>Matrix</Name>
            <Description>Micro X, Frame plates</Description>
            <Size>4  - 7 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4263</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH504</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 8-15 hole plate</Name>
            <Description>Plate, Titanium</Description>
            <Size>&lt;0.5mm thick, 8-15 holes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4265</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM225</BillingCode>
            <Name>BIOPLATE Low Profile</Name>
            <Description>Low Profile 8-hole Boxcar Plate</Description>
            <Size>10 x 24mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4265</SubGroupID>
            <ARTGs>
                <ARTG>123205</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY563</BillingCode>
            <Name>Matrix</Name>
            <Description>Micor Orbital curved plate</Description>
            <Size>12 hole</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4265</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH506</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 16-32 hole plate</Name>
            <Description>Plate, Titanium</Description>
            <Size>&lt;0.5mm thick, 16-32 holes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4266</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>328</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY558</BillingCode>
            <Name>Matrix</Name>
            <Description>Micro Adaption, Strut Plates</Description>
            <Size>18-20 hole</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4266</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>328</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC867</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Plate</Description>
            <Size>Ohata Tristar 8.4 10mm, &lt; 4 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY580</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium adaption plate</Description>
            <Size>&lt;4 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY512</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>&lt;4 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>160</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT078</BillingCode>
            <Name>Anatomics Fixation Straight Plates</Name>
            <Description>Titanium fixation straight plates</Description>
            <Size>2 Holes&#xD;
Thickness - 0.6mm&#xD;
Length - 15mm</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB304</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates</Description>
            <Size>Plate Neuro, 2 hole, 11 - 16mm straight</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI677</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Neuro Straight, 1.5mm System, Titanium</Description>
            <Size>2 hole (medium or long)</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW497</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Fracture or reconstruction plates</Description>
            <Size>0.5 - 0.99mm thick, &amp;lt;4 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ003</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial  Osteosynthesis</Name>
            <Description>Plate,  0.5 - 0.99mm thick, titanium</Description>
            <Size>less than 4 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>370373</ARTG>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Midface &amp; Mini</Description>
            <Size>Straight Plate - 2 Hole, Plate &lt; 4 holes.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT024</BillingCode>
            <Name>Martin Micro Plate Osteosynthesis System</Name>
            <Description>1.5mm system Straight Plate Titanium</Description>
            <Size>2 hole, 0.6mm profile</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>96620</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH502</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 2 hole plate</Name>
            <Description>Plate, 0.6mm thick, titanium</Description>
            <Size>2-4 hole</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC872</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Straight Plate</Description>
            <Size>&lt; 4 holes</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC908</BillingCode>
            <Name>Timesh</Name>
            <Description>Rigid Straight Plates</Description>
            <Size>&lt; 4 holes</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT027</BillingCode>
            <Name>SCS Interlink Plate - 2-hole</Name>
            <Description>Titanium 2-hole plate</Description>
            <Size>0.6mm x 15mm, 0.6mm x 17mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4267</SubGroupID>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>84</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT080</BillingCode>
            <Name>Anatomics Burr Hole Plates</Name>
            <Description>Titanium burr hole plate</Description>
            <Size>Thickness - 0.6mm&#xD;
Diameter - 18-22mm</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ006</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis </Name>
            <Description>Plate, burr hole, with or without drainage tube slot, titanium</Description>
            <Size>0.5- 0.99mm thick, 4-7 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>337389</ARTG>
                <ARTG>370373</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Mini, Maxi</Description>
            <Size>Burr Hole Plates, Calvarium Plate - Small &amp; Large - Calvarium Plate, Plates 4 to 7 Holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH507</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System Burr hole plate</Name>
            <Description>Burr Hole Plate, Titanium</Description>
            <Size>0.6mm thick, 4-7 holes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC868</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Plate</Description>
            <Size>Fan Blade 11-18mm, Mesh 11-25mm, 4 - 7 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST141</BillingCode>
            <Name>Leibinger Titanium Implant System</Name>
            <Description>Leibinger Burr Hole Cover: curved  Titanium</Description>
            <Size>7, 10, 14mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY319</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Low profile neurosurgical plate, burr hole</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT029</BillingCode>
            <Name>SCS Interlink Plate - Burr Hole/Drainage Burr Hole</Name>
            <Description>Titanium burr hole plate, drainage burr hole plate </Description>
            <Size>0.6mm thick; Diameter: 12mm, 16mm, 18mm, 22mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA096</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BI353</PriorBillingCode>
                <PriorBillingCode>BI721</PriorBillingCode>
            </PriorBillingCodes>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Burr Hole, 1mm, 1.5mm, 2mm system  </Description>
            <Size>13mm-25mm  </Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>128458</ARTG>
                <ARTG>128460</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI591</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Chin Plates, Paulus, 2mm System, Titanium</Description>
            <Size>4 - 12mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO095</BillingCode>
            <Name>MODUS Orthognathics</Name>
            <Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description>
            <Size>1.5mm - 29mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
                <ARTG>181396</ARTG>
            </ARTGs>
            <MinimumBenefit>240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Mini, Maxi</Description>
            <Size>Gap Plates, Plates 4 to 7 holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT014</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, titanium</Description>
            <Size>0.5-0.99mm thick, 4-7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
                <ARTG>96620</ARTG>
            </ARTGs>
            <MinimumBenefit>240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY582</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium adaption plate</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>240</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Compression Plates - Micro, Mini &amp; Maxi</Description>
            <Size>Micro: 2 x 3 Hole Compression T Plate, Oblique Left &amp; Right Compression T Plate, 4 Hole Straight Compression Plate; 5 Hole Straight Plate, 13mm Left &amp; Right L Plate, 19mm T Plate, 2 x 3 Hole Quad Plate; Mini: 4 Hole Left &amp; Right L Plate, 4 Hole Left &amp; Rig</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY581</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium adaption plate</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ081</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate</Description>
            <Size>0.5-0.99mm thick, 4-7 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW500</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Craniofacial Fixation Plates ,Locking</Description>
            <Size>0.5 - 0.9mm thick, 4 -7 holes</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>190</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ063</BillingCode>
            <Name>Lyka Smith Jeil Le Forte Locking Plates 4-7 Holes</Name>
            <Description>Titanium locking plates of various shapes for reconstruction</Description>
            <Size>4-7 holes  Thickness - 0.5-0.99mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>310093</ARTG>
            </ARTGs>
            <MinimumBenefit>190</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW499</BillingCode>
            <Name>Delta Resorbable Fixation System</Name>
            <Description>Craniofacial Resorbable Fixation Plates</Description>
            <Size>0.5 -0.99mm thick, 4 - 7 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>151009</ARTG>
                <ARTG>72659</ARTG>
            </ARTGs>
            <MinimumBenefit>195</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY504</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>195</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT079</BillingCode>
            <Name>Anatomics Fixation Double-Y Plates</Name>
            <Description>Titanium craniofacial fixation plates</Description>
            <Size>6 Holes&#xD;
Thickness - 0.6mm&#xD;
Length - 17mm</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB305</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description>
            <Size>Plate Neuro, 4 - 7 hole, 14.3mm - 30.9mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB306</BillingCode>
            <Name>Aesculap CranioPlate System/ Plate Neuro, 4 hole square</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description>
            <Size>Plate Neuro, 4 hole 10mm square</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB307</BillingCode>
            <Name>Aesculap CranioPlate System/ Plate Neuro, 4 hole straight</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description>
            <Size>Plate Neuro, 4 hole 17 &amp; 20 mm straight</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB308</BillingCode>
            <Name>Aesculap CranioPlate System/ Plate Neuro, 6 hole double Y</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description>
            <Size>Plate Neuro, 6 hole 15 &amp; 17mm, double Y shape</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB309</BillingCode>
            <Name>Aesculap CranioPlate System/ Plate neuro, 5 hole Y</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates</Description>
            <Size>Plate Neuro, 5 hole 17mm, Y shape</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB313</BillingCode>
            <Name>Aesculap CranioPlate System/ Plate Neuro, Burr hole cover 12 &amp; 16mm</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description>
            <Size>Plate Neuro, 6 hole x 16 &amp; 20mm Burr hole cover</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH362</BillingCode>
            <Name>Lorenz Plating System</Name>
            <Description>Neuro Gap Plate, Titanium</Description>
            <Size>25mm - 45mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI348</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>L-Plate, 2mm System, Left or Right. Titanium</Description>
            <Size>2 x 2 hole, Mini or Low Profile</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>119508</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI605</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Matrix, 1.0 or 1.5mm System, Titanium</Description>
            <Size>6 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI617</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Straight, 1mm System. Titanium</Description>
            <Size>4 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI620</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Straight, low profile, 2.0mm System, Titanium</Description>
            <Size>4 - 8 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI621</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, L , 2.5mm or 2m system, Titanium</Description>
            <Size>2 x2 or 3x3 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI625</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Y, Double Y, X, 1.5mm System or 2.0mm System, Titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI627</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Straight, 1.5mm System, Titanium</Description>
            <Size>4 or 6 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI656</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Orbital, 1.5mm, 2.0mm System, Titanium</Description>
            <Size>6 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI728</BillingCode>
            <Name>W.Lorenz Osteosynthesis System</Name>
            <Description>Neuro Square or Rectangular Plate, titanium</Description>
            <Size>1.5mm system, 4 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>119508</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW498</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Craniofacial Fixation Plates</Description>
            <Size>0.5 - 0.99mm thick, 4 -7 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW677</BillingCode>
            <Name>Stryker Mini Plating System</Name>
            <Description>Craniomaxillofacial reconstruction fixation plates. </Description>
            <Size>0.5-0.99mm thick, 4-7 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ001</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial  Osteosynthesis  </Name>
            <Description>Plate, 0.5 - 0.99mm thick, titanium</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
                <ARTG>370373</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Midface, Mini, Maxi, BSSO, TR BSSO</Description>
            <Size>0.5-0.99mm thick, 4-7 holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT057</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate Titanium</Description>
            <Size>0.5 to 0.99mm thick, 4 - 7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH503</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 4-7 hole plate</Name>
            <Description>Plate, 0.6mm thick, Titanium</Description>
            <Size>4-7 hole</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC393</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Z Plate Left and Right</Description>
            <Size>4 hole - 5mm, 9.5mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC519</BillingCode>
            <Name>TiMesh</Name>
            <Description>Squareplate</Description>
            <Size>4 holes x 1mm - 4 holes x 2.2mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC520</BillingCode>
            <Name>TiMesh</Name>
            <Description>X Plate</Description>
            <Size>4 holes x 1mm - 4 holes x 2.2mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC576</BillingCode>
            <Name>Timesh</Name>
            <Description>Double Y Plates</Description>
            <Size>3 Hole - 2.5mm - 7mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC870</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Y Plate Double and Single</Description>
            <Size>4 - 7 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC875</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, T Plate</Description>
            <Size>4 - 7 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC883</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, L Plate (Left and right configurations)</Description>
            <Size>4 to 7 holes</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC885</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, H Plate</Description>
            <Size>4 - 7 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC909</BillingCode>
            <Name>Timesh</Name>
            <Description>Rigid Straight Plates</Description>
            <Size>4 - 7 holes</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ060</BillingCode>
            <Name>Lyka Smith Jeil Le Forte Plates 4-7 Holes</Name>
            <Description>Titanium plates in a variety of shapes for reconstruction</Description>
            <Size>Thickness - 0.5-0.8mm   4-7 Holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4271</SubGroupID>
            <ARTGs>
                <ARTG>310093</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Mini, Maxi</Description>
            <Size>Quad Plates, Medium 2 x 4 Hole Quad Plate, Plates 8 to 15 holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>205</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC869</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Plate</Description>
            <Size>Ohata Kerf Cover, 5 - 32 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>404</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK355</BillingCode>
            <Name>Universal Neuro Titanium Low Profile Plate</Name>
            <Description>Titanium Low Profile plates used for the fixation of cranial bone flaps</Description>
            <Size>Small, large, 20mm burr hole, 16 hole without bar</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Burr</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>404</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO096</BillingCode>
            <Name>MODUS Orthognathic</Name>
            <Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries. Le-Fort, Split, Grid, Bar plates, Sagittal split, X-Shaped, L-shaped, Z-shaped, T-shaped, Y-Shaped, straight plates, square, rectangular </Description>
            <Size>0.5-0.7mm Thick, 8-32 Holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT037</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate Titanium</Description>
            <Size>0.5-0.99mm thick, 8-32 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK345</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal CMF Plate</Name>
            <Description>Le Fort 1 Plate, Right/Left</Description>
            <Size>11hole, Advancement 2 - 10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY585</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium adaption plate</Description>
            <Size>8-32 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ082</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate, Complex shape</Description>
            <Size>0.5-0.99mm thick, 8-32 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>273</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY583</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium adaption plate</Description>
            <Size>8-32 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>195</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ083</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate</Description>
            <Size>0.5-0.99mm thick, 8-32 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>195</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO127</BillingCode>
            <Name>MODUS Intermaxillary Fixation System </Name>
            <Description>Titanium Arch Bar </Description>
            <Size>One size </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>350314</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW486</BillingCode>
            <Name>Stryker Leibinger Hybrid MMF Plate</Name>
            <Description>SMARTLOCK Hybrid MMF Plate, Locking  System - Universal SMARTLOCK Hybrid MMF  Component - MMF Plate</Description>
            <Size>One size - 9 Hole Straight Plate, for maxilla and Mandible</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW504</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Craniofacial Locking Fixation Plates</Description>
            <Size>0.5 - 0.99mm thick, 8 -32 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI923</BillingCode>
            <Name>OmniMax Arch Bar</Name>
            <Description>Arch Bar</Description>
            <Size>One size</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>211079</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ061</BillingCode>
            <Name>Lyka Smith Jeil Le Forte Locking Plates 8-32 holes</Name>
            <Description>Titanium locking plates for craniofacial reconstruction</Description>
            <Size>Thickness - 0.8mm  Holes - 8-32</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>310093</ARTG>
            </ARTGs>
            <MinimumBenefit>279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW503</BillingCode>
            <Name>Delta Resorbable fixation System</Name>
            <Description>Craniofacial Resorbable Fixation Plates</Description>
            <Size>0.5 - 0.99mm thick, 8 -32 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>151009</ARTG>
                <ARTG>72659</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY397</BillingCode>
            <Name>PolyMax Resorbable Fixation System</Name>
            <Description>1.5 Burr Hole Cover</Description>
            <Size>8 Hole</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY584</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>8-32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB310</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description>
            <Size>Plate Neuro, 8 - 32 hole, 28 mm - 90 mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB317</BillingCode>
            <Name>Aesculap CranioPlate System/ Plate Neuro, 16 hole straight</Name>
            <Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description>
            <Size>Plate Neuro, 16 hole 63mm straight</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI641</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Matrix.  1mm System, 1.5mm System. Titanium</Description>
            <Size>2 x 4 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI658</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Plate, Orbital. 1.5mm System, 2mm System. Titanium</Description>
            <Size>8-10 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI719</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Neuro Sub-Temporal Plate, Titanium</Description>
            <Size>medium</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI773</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Neuro sub-temporal plate, 1.5 system, titanium</Description>
            <Size>Small</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW502</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Craniofacial Fixation Plates</Description>
            <Size>0.5 - 0.99mm thick, 8 -32 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>262485</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ002</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial  Osteosynthesis</Name>
            <Description>Plate,  0.5 - 0.99mm thick, titanium</Description>
            <Size> 8-32 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Midface, Mini, Maxi</Description>
            <Size>0.5-0.99mm thick, 8-32 holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH505</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 8-32 hole plate</Name>
            <Description>Plate, 0.6mm thick, Titanium</Description>
            <Size>8-32 hole</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC678</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Universal Plate</Description>
            <Size>12h</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC871</BillingCode>
            <Name>Ti Mesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium ,Straight Plate</Description>
            <Size>8 - 32 holes</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC876</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, T Plate</Description>
            <Size>8 - 15 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC884</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, L Plate (Left and right configurations)</Description>
            <Size>8 - 15 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC886</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, H Plate</Description>
            <Size>8-15 hole</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI091</BillingCode>
            <Name>TiMesh</Name>
            <Description>Rigid Straight Plate</Description>
            <Size>8 -32 holes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA079</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BI985</PriorBillingCode>
                <PriorBillingCode>BI989</PriorBillingCode>
            </PriorBillingCodes>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>straight plates</Description>
            <Size>8-32 holes</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ062</BillingCode>
            <Name>Lyka Smith Jeil Le Forte Plates 8-32 Holes</Name>
            <Description>Titanium plates in a variety of shapes for reconstruction</Description>
            <Size>Thickness 0.5 - 0.8mm  8-20 Holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4277</SubGroupID>
            <ARTGs>
                <ARTG>310093</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY514</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>&gt;32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4284</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ010</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis</Name>
            <Description>Plate, 0.5-0.99mm thick, titanium</Description>
            <Size>more than 32 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4284</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>277</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Mini</Description>
            <Size>40 Hole Straight Plate, Mesh 18 row, Plate &gt;32 holes.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4284</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>277</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM231</BillingCode>
            <Name>BIOPLATE Biomesh</Name>
            <Description>Titanium, lattice, 48 hole, packaged non-sterile</Description>
            <Size>32 x 44mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4284</SubGroupID>
            <ARTGs>
                <ARTG>123205</ARTG>
            </ARTGs>
            <MinimumBenefit>277</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY466</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium adaption plates</Description>
            <Size>&gt;32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4284</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>277</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY506</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>&lt;4 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4286</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>204</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK026</BillingCode>
            <Name>CPS Bioabsorbable Fixation System</Name>
            <Description>CPS Systems and Baby System Plates.  Polylactic Acid Trimethylene Carbonate Copolymer</Description>
            <Size>1.5-2.5mm plates:- 2-10 hole plates and extended, c-plate &amp; x-plate 7 hole, H-plate 8 hole, orthognathic hole and L-plate L &amp; R 7 hole</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4286</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>154544</ARTG>
            </ARTGs>
            <MinimumBenefit>204</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ011</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis</Name>
            <Description>Plate, 1-1.99mm thick, titanium</Description>
            <Size>less than 4 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4286</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>107</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT009</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, titanium</Description>
            <Size>1 to 1.99mm thick, &lt;4 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4286</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>107</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY317</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium Plate - straight</Description>
            <Size>1.6mm Profile, 2-4 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4286</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>107</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ084</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate</Description>
            <Size>1.0-1.99mm thick, &amp;lt;4 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4286</SubGroupID>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>107</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO097</BillingCode>
            <Name>MODUS Orthognathics</Name>
            <Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description>
            <Size>1.0-1.99mm, 4-7 Holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Midface, Mini &amp; Maxi</Description>
            <Size>Chin Plate 2, 3, 4, 6, 8, 10 &amp; 12mm, Plates 4 to 7 holes.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK131</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Fracture Plate</Name>
            <Description>Items used for reconstruction and fixation of mandibular fractures and tumour resection.</Description>
            <Size>Universal Mandible Fracture Plate, C-shaped, 4 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK132</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Fracture Plate</Name>
            <Description>Items used for reconstruction and fixation of mandibular fractures and tumour resection.</Description>
            <Size>Universal Mandible Fracture Plate, Angled Shaped, 6 holes, 115-140 deg</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ085</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate, S-shape</Description>
            <Size>1.0-1.99mm thick, 4-7 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates - Fracture</Description>
            <Size>1.0-1.99mm thick, 4-7 holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY498</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Mandible plate</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ086</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate</Description>
            <Size>1.0-1.99mm thick, 4-7 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW493</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Mandible Locking Fixation Plates</Description>
            <Size>1.0 -1.9mm thick, 4 - 7 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>403</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates - Fracture</Description>
            <Size>8 Hole Fracture Plate, 4 &amp; 6 hole locking fracture plate, 4 to 7 hole locking plate.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>403</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT043</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate Titanium locking</Description>
            <Size>1.0 to 1.99 mm thick, 4 - 7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>403</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY587</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible locking plate, complex shape</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>403</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ087</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate, Locking</Description>
            <Size>1.0-1.99mm thick, 4-7 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>403</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT012</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name>
            <Description>Mesh, PDLLA (resorbable)</Description>
            <Size>1.0 to 1.99mm thick, 4 to 7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY507</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK025</BillingCode>
            <Name>CPS Bioabsorbable Fixation System</Name>
            <Description>CPS Systems and Baby System Plates.  Polylactic Acid Trimethylene Carbonate Copolymer</Description>
            <Size>1.5mm plates:- 20 holes, c-plate &amp; x-plate 7 hole, L-plate 7 hole L &amp; R. burrhole</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>154544</ARTG>
            </ARTGs>
            <MinimumBenefit>246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ007</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis</Name>
            <Description>Plate, 1-1.99mm thick, titanium</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT059</BillingCode>
            <Name>Martin Level  One Fixation Plate</Name>
            <Description>Martin Level One Fixation</Description>
            <Size>1.0-1.99mm thick, 4-7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH513</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System Mesh 1mm 4-7 hole plate</Name>
            <Description>Plate, Titanium</Description>
            <Size>1.0-1.99mm thick, 4-7 holes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC517</BillingCode>
            <Name>TiMesh</Name>
            <Description>Mandibular "J" Plate</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA009</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>plates, various shapes</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4288</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
                <ARTG>211079</ARTG>
            </ARTGs>
            <MinimumBenefit>147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO098</BillingCode>
            <Name>MODUS Orthognathics</Name>
            <Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description>
            <Size>1.3-1.99 Thickness, 8-15 Holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW494</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Mandible Fixation Plates</Description>
            <Size>1.0 - 1.99mm thick, 8 -15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Mandible Locking plates</Description>
            <Size>8-15 Hole Plates, 1.0-1.99 mm thick</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY588</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible locking plate, complex shape</Description>
            <Size>8-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ088</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate, Locking</Description>
            <Size>1.0-1.99mm thick, 8-15 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT036</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; Sonic Weld</Name>
            <Description>Plate PDLLA (resorbable)</Description>
            <Size>1.0 to 1.99mm thick, 8 to 15 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY508</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>8-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK022</BillingCode>
            <Name>CPS Bioabsorbable Fixation System</Name>
            <Description>OTPS fixation system: PLGA/TMC copolymer</Description>
            <Size>Plates 6 &amp; 8 hole</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>154544</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO099</BillingCode>
            <Name>MODUS Orthognathics</Name>
            <Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description>
            <Size>2.0mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW508</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Mandible Locking Fixation Plates</Description>
            <Size>1.0 - 1.99mm thick, 8 - 15 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>11565</ARTG>
                <ARTG>124319</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ008</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis</Name>
            <Description>Plate, 1-1.99mm thick, titanium </Description>
            <Size>8-15 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Mini &amp; Maxi</Description>
            <Size>12 Hole Straight Plate 1.0 mm thick, 8 Hole Straight Plate 1.0 mm thick, Plates 8 to 15 holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT056</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate ,Titanium</Description>
            <Size>1.0 to 1.99mm thick, 8 -15 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>99619</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH514</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 1mm 8-15 hole plate</Name>
            <Description>Plate, Titanium</Description>
            <Size>1.0-1.99mm thick, 8-15 holes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC522</BillingCode>
            <Name>TiMesh</Name>
            <Description>Curved Plate:  Standard, Rigid, Left, Right</Description>
            <Size>1mm x 12 holes</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI970</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>Mandibular fracture plates</Description>
            <Size>8-15 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ089</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate</Description>
            <Size>1.0-1.99mm thick, 8-15 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4293</SubGroupID>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT029</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, titanium</Description>
            <Size>1.0 to 1.99mm thick, 16 to 32 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>3D</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>798</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO121</BillingCode>
            <Name>MODUS Mandible </Name>
            <Description>Titanium Mandibular locking plates, complex shape</Description>
            <Size>16-20 holes, 1.3-1.5mm thickness. </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY493</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium Mandibular locking plate, complex shape</Description>
            <Size>16-32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1113</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO119</BillingCode>
            <Name>MODUS Mandible </Name>
            <Description>Mandible Locking Plates </Description>
            <Size>16-21 Hole, 1.0-1.99 thickness</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>798</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW496</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Mandible Fixation Plates</Description>
            <Size>1.0 -1.9mm thick, 16 - 32 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>798</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ028</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Mandible Locking Plates</Description>
            <Size>16-32 Hole Plates, 1.0-1.99 mm thick</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>798</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT028</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name>
            <Description>Plate, PDLLA (resorbable)</Description>
            <Size>1.0 to 1.99mm thick, 16 to 32 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>143326</ARTG>
            </ARTGs>
            <MinimumBenefit>394</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY589</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>16-32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>394</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK024</BillingCode>
            <Name>CPS Bioabsorbable Fixation System</Name>
            <Description>CPS Systems and Baby System Plates.  Polylactic Acid Trimethylene Carbonate Copolymer</Description>
            <Size>1.5mm baby plates:- 20 hole, c-plate &amp; x-plate 7 hole, 2 hole</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>154544</ARTG>
            </ARTGs>
            <MinimumBenefit>394</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI762</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>Plates, 2.4 Mandibular Fracture System, Titanium</Description>
            <Size>16 - 24 Hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO118</BillingCode>
            <Name>MODUS Mandible </Name>
            <Description>Indication-specific solutions for mandibular orthognatic surgeries   </Description>
            <Size>1.0-1.99 thickness, 16-32 Holes </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW495</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Mandible Fixation Plates</Description>
            <Size>1.0 - 1.9mm thick, 16- 32 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ009</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis</Name>
            <Description>Plate 1-1.99mm thick, titanium</Description>
            <Size>more than 16 holes</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Mini, Maxi</Description>
            <Size>16 Hole Straight Plate, 1.0mm thick, Plate 15 to 32 holes</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT030</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate Titanium</Description>
            <Size>1.0 to 1.99mm thick, 16 to 32 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH515</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System 1mm 16-32 hole plate</Name>
            <Description>Plate, Titanium</Description>
            <Size>1.0-1.99mm thick, 16-32 holes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4296</SubGroupID>
            <ARTGs>
                <ARTG>202851</ARTG>
            </ARTGs>
            <MinimumBenefit>199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY700</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium Mandibular locking plate, complex shape</Description>
            <Size>&gt;32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4300</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY511</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Rapid resorbable reconstruction plate</Description>
            <Size>&gt;32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4300</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW674</BillingCode>
            <Name>Stryker Mini Plating System</Name>
            <Description>Craniomaxillofacial reconstruction fixation plates. </Description>
            <Size>2.0-2.99mm thick, 4-7 holes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4301</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>702</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY499</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible plate</Description>
            <Size>4-7 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4301</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>702</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK030</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed  Plating &amp; Fixation System</Name>
            <Description>Mandible locking plates</Description>
            <Size>4-7 Holes, 2.0-2.99 mm thick</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4301</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>604</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT066</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, Titanium</Description>
            <Size>2.0-2.99m thick, 4-7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4301</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>604</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ090</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate</Description>
            <Size>2.0-2.99mm thick, 4-7 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4301</SubGroupID>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>604</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY497</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible plate</Description>
            <Size>8-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4303</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>761</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK140</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Reconstruction Plate</Name>
            <Description>Items used for reconstruction and fixation of mandibular fractures and tumour resection.</Description>
            <Size>Universal Mandible Reconstruction Plate, 8 - 15 holes, straight with template</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4303</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>926</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY599</BillingCode>
            <Name>AO/ASIF Plates</Name>
            <Description>Titanium mandible locking plate</Description>
            <Size>8-15 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4303</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>926</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ091</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate, Locking</Description>
            <Size>2.0-2.99mm thick, 8-15 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4303</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>926</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT067</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, Titanium</Description>
            <Size>2.0-2.99m thick, 8-15 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4303</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>459</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO132</BillingCode>
            <Name>MODUS Mandible </Name>
            <Description>Anatomical contoured Complex, pre-formed locking plates intended for orthognathic reconstruction, inclusive of C-shaped adaption plates.</Description>
            <Size>16-32 holes, 2.0 thickness</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Complex, Locking</Suffix>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>1287</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT069</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>KT055</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Plating System</Name>
            <Description>Preshaped reconstruction plates, in left and right options, Complex, locking</Description>
            <Size>2.0mm to 2.5mm thickness with 26 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Complex, Locking</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>1287</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV013</BillingCode>
            <Name>Complex Locking plate</Name>
            <Description>Preshaped reconstruction plates, in left and right options, Complex, locking</Description>
            <Size>Small  Medium  Large</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Complex, Locking</Suffix>
            <ARTGs>
                <ARTG>366767</ARTG>
            </ARTGs>
            <MinimumBenefit>1287</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY780</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Anatomical Preformed Complex Locking Reconstruction Plates</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Complex, Locking</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1287</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY500</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible plate</Description>
            <Size>15-32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK031</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates - Fracture</Description>
            <Size>Rigid Comminuted Fracture Plate</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT068</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>KT055</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KLS Martin Plating System</Name>
            <Description>Locking, Preshaped reconstruction plates, in left and right options</Description>
            <Size>2.0mm to 2.5mm thickness with 26 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK138</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Reconstruction Plate</Name>
            <Description>Items used for reconstruction and fixation of mandibular fractures and tumour resection.</Description>
            <Size>Universal Mandible Reconstruction Plate, (Full), 16 - 32 holes, with template</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>295882</ARTG>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK141</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Reconstruction Plate</Name>
            <Description>Items used for reconstruction and fixation of mandibular fractures and tumour resection</Description>
            <Size>Universal Mandible Reconstruction Plate, (Hemi), Right and Left, 6 + 17 holes with template</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>295882</ARTG>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK142</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Reconstruction Plate</Name>
            <Description>Items used for reconstruction and fixation of mandibular fractures and tumour resection</Description>
            <Size>Universal Mandible Reconstruction Plate, (Full), 6 + 17 + 6 holes, with template</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY600</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible locking plate</Description>
            <Size>16-32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI938</BillingCode>
            <Name>Lorenz Locking Reconstruction System</Name>
            <Description>Locking plates</Description>
            <Size>2.0 and 2.4 mm, 16-32 holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ092</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate, Locking</Description>
            <Size>2.0-2.99mm thick, 16-32 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4307</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>1073</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY472</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible locking plate, complex shape</Description>
            <Size>&gt;32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4310</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1414</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ093</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Plates</Name>
            <Description>Titanium plate, Locking, Complex Shape</Description>
            <Size>2.0-2.99mm thick, &gt;32 holes</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4310</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>1414</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF027</BillingCode>
            <Name>Sternal Fixation Device</Name>
            <Description>A patented complex sternal fixation system for thoracotomy</Description>
            <Size>20-70mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4311</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>308885</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY550</BillingCode>
            <Name>Titanium Sternal Fixation System</Name>
            <Description>Locking Plate - Star</Description>
            <Size>Star: 6 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4311</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1354</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY551</BillingCode>
            <Name>Titanium Sternal Fixation System</Name>
            <Description>Locking Plate - Straight , H or Star</Description>
            <Size>Straight: 12holes, H: small &amp; large, Star: 12 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4312</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1443</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT007</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, titanium</Description>
            <Size>=&gt;3mm thick, 8 to 15 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4312</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>96620</ARTG>
            </ARTGs>
            <MinimumBenefit>578</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY347</BillingCode>
            <Name>Titanium Sternal Fixation System</Name>
            <Description>Locking Plate - straight</Description>
            <Size>20 or 30 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4314</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>1662</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY501</BillingCode>
            <Name>AO/ASIF Plate</Name>
            <Description>Titanium mandible plate</Description>
            <Size>16-32 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4314</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1246</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT061</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Plate, Titanium</Description>
            <Size>≥3mm thick, 16 to 32 Holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1589</GroupID>
            <SubGroupID>4314</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>968</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK032</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Lag Screws - Micro, Mini</Description>
            <Size>1.2mm x (6 - 16)mm; 1.6mm x (10-12)mm; 2.0mm x (8 - 22)mm;</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>78</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO124</BillingCode>
            <Name>MODUS Orthognathics Screw</Name>
            <Description>Cortical Screw and Sliders </Description>
            <Size>2-14mm</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>350272</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW511</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Micro Screws</Description>
            <Size>1.0 - 1.2mm diameter, 3 - 15mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>251654</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ004</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis </Name>
            <Description>Screw, titanium</Description>
            <Size>diameter less than 1.25mm </Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK033</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Screws</Name>
            <Description>Micro, Maxi &amp; Self Drilling</Description>
            <Size>"Size 1.2mm self-drilling screws, 1.2mm x (2 - 14)mm, Screws diameter &lt; 1.24mm"</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT025</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Screw Titanium</Description>
            <Size>diameter &lt;1.24mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC574</BillingCode>
            <Name>Timesh</Name>
            <Description>X-Drive Screws</Description>
            <Size>2 - 15mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>128524</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC879</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Screw - Cruciate Head, 12 point Flat Head</Description>
            <Size>Diameter &lt;1.24mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>128524</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY559</BillingCode>
            <Name>AO/ASIF Screw</Name>
            <Description>CMF screw; cortex, cortical, emergency, self-tapping,self-drilling</Description>
            <Size>1.0mm-1.20mm various lengths</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4321</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV014</BillingCode>
            <Name>CMF Screw</Name>
            <Description>Self tapping and self drilling screws</Description>
            <Size>Diameter 1.5 - 2.4mm</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>366767</ARTG>
            </ARTGs>
            <MinimumBenefit>116</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY591</BillingCode>
            <Name>External Midface Distractor System</Name>
            <Description>Fixation; Set - Screws</Description>
            <Size>1.25-3.24mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Distractor</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>83</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI457</BillingCode>
            <Name>Lorenz 2 - 2.4mm Locking Reconstruction System</Name>
            <Description>Screw, Locking Reconstruction Modular. Titanium</Description>
            <Size>2 - 2.4 x (6-18)mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO125</BillingCode>
            <Name>MODUS Orthognathic Screw</Name>
            <Description>Cortical screw, TriLock locking Screw, TriLock Speed-Tip screw, Self-Tapping screw Screw </Description>
            <Size>1.5-2.5 Diameter,  5-23mm lengths</Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>350272</ARTG>
                <ARTG>350350</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW487</BillingCode>
            <Name>Stryker Leibinger Hybrid MMF Screws</Name>
            <Description>SMARTLock Hybrid MMF Screws, Locking  System - Universal SMARTLock Hybrid MMF  Component - MMF Screws</Description>
            <Size>Two Sizes -   2.0mm Diameter, 6mm Length  2.0mm Diameter, 8mm Length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>251654</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK034</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Locking Screws</Description>
            <Size>Diameter 1.25-3.24mm</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT035</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Screw, titanium</Description>
            <Size>Diameter 2.25 - 2.74mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV015</BillingCode>
            <Name>CMF Locking Screw</Name>
            <Description>Locking Screw, Self tapping</Description>
            <Size>Diameter 1.5-2.4 mm</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>366767</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY592</BillingCode>
            <Name>AO/ASIF Screw</Name>
            <Description>Cortex, Cortical, Emergency, Self-tapping, Self-drilling; Locking Screws</Description>
            <Size>1.25-3.24mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI925</BillingCode>
            <Name>OmniMax Screws</Name>
            <Description>MMF Screws</Description>
            <Size>2.0 diameter, 7mm-11mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ059</BillingCode>
            <Name>Lyka Smith Jeil Le Fort Locking Screws</Name>
            <Description>Titanium Locking Screws</Description>
            <Size>Diameter 2-2.4mm  Length 4-20mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>310093</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ094</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Screws</Name>
            <Description>Titanium Screw, Locking</Description>
            <Size>Diameter 1.25-3.24mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>88</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW510</BillingCode>
            <Name>Delta Resorbable Fixation System</Name>
            <Description>Resorbable Screws</Description>
            <Size>1.7mm diameter, 3 -6mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>151008</ARTG>
                <ARTG>72659</ARTG>
            </ARTGs>
            <MinimumBenefit>118</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT040</BillingCode>
            <Name>Martin Level One Fixation Resorb x &amp; Sonic Weld</Name>
            <Description>Sonic Pin PDDLA (resorbable)</Description>
            <Size>Diameter 1.25 - 3.24mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>143327</ARTG>
            </ARTGs>
            <MinimumBenefit>118</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY593</BillingCode>
            <Name>PolyMax Rapid-Resorbable Fixation System</Name>
            <Description>Polyactide Resorbable Screw/Tack</Description>
            <Size>1.25-3.24mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>118</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VK018</BillingCode>
            <Name>CPS Bioabsorbable Fixation System</Name>
            <Description>OTPS fixation system: PLGA/TMC copolymer</Description>
            <Size>Screws 1.5 - 2.5mm dia x 5-8mm long</Size>
            <SupplierCode>VK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>154541</ARTG>
            </ARTGs>
            <MinimumBenefit>118</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT077</BillingCode>
            <Name>Anatomics Bone Screws</Name>
            <Description>Titanium bone screws for patient specific implants</Description>
            <Size>Diameter - 1.6-2.0 mm&#xD;
Length - 5mm</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB314</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial fixation system</Description>
            <Size>Screws Neuro, Emergency, self tapping, magazine of 8, 1.8mm x 3 &amp; 5mm lengths and magazine of 6, 1.8mm x 4 &amp; 6mm lengths</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB316</BillingCode>
            <Name>Aesculap Neuro Plating System</Name>
            <Description>Cranial fixation system</Description>
            <Size>screws neuro, self drilling, magazine of 8 and magazine of 6, 1.5mm x 3, 4 &amp; 5mm lengths  </Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>140600</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH020</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Bone Screw, Cross Drive or Centre Drive. Titanium</Description>
            <Size>1.5mm dia x (3.5 - 17)mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>143957</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH021</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Bone Screw, Cross Drive or Centre Drive. Titanium</Description>
            <Size>1.8mm dia x (3.5 - 17)mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI360</BillingCode>
            <Name>W Lorenz Osteosynthesis System</Name>
            <Description>Bone Screw, Cross or Centre Drive, Std or Self Drilling; Titanium</Description>
            <Size>2.0mm x (4 - 7) mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI723</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>Screw, High Torque 2.0/2.4 Mandibular Fracture, Titanium</Description>
            <Size>2.7 x (6-20)mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI726</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>Screw, High Torque (HT), Emergency, 2.0/2.4 Mandibular Fracture System, Titanium</Description>
            <Size>Dia 2.3mm x 4.0, 5.0, 7.0, 9.0, 11.0, 13.0, 15.0mm  Lengths</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI733</BillingCode>
            <Name>W.Lorenz Osteosynthesis System</Name>
            <Description>Bone Screw, Self Drilling, Cross Drive, Titanium</Description>
            <Size>1.5 mm (dia) x 6.0, 7.0mm [lengths]</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI734</BillingCode>
            <Name>W.Lorenz Osteosynthesis System</Name>
            <Description>Bone Screw, Self Drilling, Cross Drive, Titanium</Description>
            <Size>1.5 mm (dia) x 3.5, 4.0, 5.0mm, [lengths]</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI744</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>Screw, High Torque 2.0/2.4 Mandibular Fracture, Titanium</Description>
            <Size>2.0 x (9-17)mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI748</BillingCode>
            <Name>Mandibular Fracture System</Name>
            <Description>Screw, High Torque (HT), 2.0/2.4 Mandibular Fracture System, Titanium</Description>
            <Size>Dia 2.4 x 6.0mm, 8.0, 10.0, 12.0, 14.0, 16.0, 18.0mm Lengths</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HQ001</BillingCode>
            <Name>Bionnovation Fixation Screws</Name>
            <Description>Craniofacial Bone Screw, non-biodegradable    These are bone screws that are intended to be used to be surgically inserted for the use in bone graft surgery, fixation of grafts and membranes in the maxilla and mandible. </Description>
            <Size>Diameter 1.2mm, Length 4,6,8,10,12,14mm   Diameter 1.4mm, Length 4,6,8,10,12,14mm  Diameter 1.6mm, Length 4,6,8,10,12, 14mm  Diameter 1.8mm, Length 4,6,8,10,12,14mm  </Size>
            <SupplierCode>HQ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>247012</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW491</BillingCode>
            <Name>Stryker Leibinger Plating System</Name>
            <Description>Craniofacial Fixation Screws</Description>
            <Size>1.5 - 2.7mm diameter, 3 - 20mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>251654</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ005</BillingCode>
            <Name>Rebstock Cranio-Maxillofacial Osteosynthesis </Name>
            <Description>Screw, titanium</Description>
            <Size>Diam 1.25-3.24mm </Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>337389</ARTG>
                <ARTG>370373</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK035</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Screws</Name>
            <Description>Micro, Maxi &amp; Self Drilling</Description>
            <Size>Diameter 1.25-3.24mm</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT038</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Screw Titanium</Description>
            <Size>Diameter 1.25 to 3.24mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>96620</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH516</BillingCode>
            <Name>Martin Osteosynthesis 1.5mm System Screw</Name>
            <Description>Self retaining, Titanium</Description>
            <Size>3-7mm length, 1.5-1.8mm diam</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>212844</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM232</BillingCode>
            <Name>Bioplate Plating System</Name>
            <Description>Titanium Screws</Description>
            <Size>1.25 to 3.24mm Diameter</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>123204</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC571</BillingCode>
            <Name>Timesh</Name>
            <Description>12 Point Screws</Description>
            <Size>3 - 20mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128524</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC880</BillingCode>
            <Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name>
            <Description>Titanium, Screw - Cruciate Head, 12 point Flat Head</Description>
            <Size>Diameter 1.25 - 1.74mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128524</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI092</BillingCode>
            <Name>TiMesh</Name>
            <Description>Internal Drive Screws</Description>
            <Size>Diameter: 1.5 - 1.8mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128524</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI093</BillingCode>
            <Name>TiMesh</Name>
            <Description>Rescue Screws</Description>
            <Size>Diameter: 1.8 - 2.4mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128524</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV020</BillingCode>
            <Name>CMF Screw</Name>
            <Description>Self tapping and self drilling screws</Description>
            <Size>Diameter 1.5 - 2.4mm</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>330190</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF127</BillingCode>
            <Name>Melbourne TMJ Prosthesis</Name>
            <Description>TMJ Mandibular Component - Screws</Description>
            <Size>(2.7-3.2mm Diameter) x (8-12mm Length)</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY590</BillingCode>
            <Name>AO/ASIF Screw</Name>
            <Description>Cortex, Cortical, Emergency, Self-tapping, Self-drilling; Low Profile, Pure Titanium; Matrix Plating System Titanium Alloy, </Description>
            <Size>1.25-3.24mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
                <ARTG>297881</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT025</BillingCode>
            <Name>SCS Interlink Screw</Name>
            <Description>Titanum screw, self-drilling</Description>
            <Size>Diameter 1.5mm, 2.0mm  </Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>339424</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA080</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BH016</PriorBillingCode>
                <PriorBillingCode>BH017</PriorBillingCode>
                <PriorBillingCode>BI742</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TMJ System</Name>
            <Description>Screw, Cross Drive, Titanium  </Description>
            <Size>2.0-3.2mm diameter</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
                <ARTG>145265</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI924</BillingCode>
            <Name>OmniMax Screws</Name>
            <Description>IMF screws</Description>
            <Size>2.0 diameter, 7-11mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>128459</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ058</BillingCode>
            <Name>Lyka Smith Jeil LeForte System Screws</Name>
            <Description>Self tapping and self drilling screws</Description>
            <Size>Diameter- 1.3 - 2.7mm  Length 2-20mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>310093</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ095</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Standard+ Solutions - Screws</Name>
            <Description>Titanium Screw</Description>
            <Size>Diameter 1.25-3.24mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1590</GroupID>
            <SubGroupID>4323</SubGroupID>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>42</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY345</BillingCode>
            <Name>Titanium Sternal Fixation System</Name>
            <Description>Titanium Emergency Release Pin</Description>
            <Size>One Size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4332</SubGroupID>
            <ARTGs>
                <ARTG>157069</ARTG>
            </ARTGs>
            <MinimumBenefit>93</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK146</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Biconcave Washer</Name>
            <Description>Items used for reconstruction and fixation of mandibular fractures and tumour resection</Description>
            <Size>Universal Mandible Bi-concave Washer</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4334</SubGroupID>
            <ARTGs>
                <ARTG>142141</ARTG>
            </ARTGs>
            <MinimumBenefit>29</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW435</BillingCode>
            <Name>E-POR Biomaterial/ Craniotomy Gap Wedge Porous Polyethylene</Name>
            <Description>Craniotomy Gap Wedge Porous Polyethylene</Description>
            <Size>One Size - V and T shape</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4335</SubGroupID>
            <ARTGs>
                <ARTG>144944</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK036</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Screws</Description>
            <Size>MMF / Anchorage Screws 1.2/1.6/2.0mm Anchor, Bone</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4336</SubGroupID>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB289</BillingCode>
            <Name>CranioFix Absorbable</Name>
            <Description>Double sided Cranial clamp, absorbable polyester</Description>
            <Size>11mm, 16mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4337</SubGroupID>
            <ARTGs>
                <ARTG>125104</ARTG>
            </ARTGs>
            <MinimumBenefit>93</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB384</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BB072</PriorBillingCode>
                <PriorBillingCode>BB073</PriorBillingCode>
                <PriorBillingCode>BB168</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CranioFix</Name>
            <Description>Titanium Skull Fixation Clamp</Description>
            <Size>11mm - 20mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4337</SubGroupID>
            <ARTGs>
                <ARTG>138311</ARTG>
            </ARTGs>
            <MinimumBenefit>93</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY252</BillingCode>
            <Name>AO/ASIF Facio-Maxillary Plates</Name>
            <Description>Flapfix - Plates for fixation of cranial bone flaps</Description>
            <Size>10 - 20mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4337</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>93</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK037</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Screws</Description>
            <Size>Locking Screw Inserts, Other ancillary</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4338</SubGroupID>
            <ARTGs>
                <ARTG>130509</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY784</BillingCode>
            <Name>SynPOR</Name>
            <Description>Chin Connector</Description>
            <Size>One Size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4338</SubGroupID>
            <ARTGs>
                <ARTG>190454</ARTG>
            </ARTGs>
            <MinimumBenefit>137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC264</BillingCode>
            <Name>SYSTEM-  Doppler Blood Flow Monitoring System. COMPONENT - Cook-Swartz Implantable Doppler Flow Probe</Name>
            <Description>The Cook-Swartz Implantable Doppler Flow Probe is an implantable 20MHz Probe with epoxy-coated Crystal and patented Silicone Cuff which provides continuous direct vessel monitoring of microvascular anastomoses. A 30cm wire with external Retention Tabs is attached to the 1mm diameter Crystal.</Description>
            <Size>Cuff Lengths: 17.4 and 32mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1591</GroupID>
            <SubGroupID>4340</SubGroupID>
            <ARTGs>
                <ARTG>187643</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HQ002</BillingCode>
            <Name>SURGITIME PTFE</Name>
            <Description>Surgitime PTFE is a synthetic non-absorbable membrane that is 100% biocompatible and not derived from animal source. This Membrane is considered to be a barrier for tissue regeneration. polytetraflouroethylene membranes or mechanical barriers for guided bone regeneration are used to prevent migration of cells from epithelial and connective tissues, thus providing a proper space for the formation of a natural fibrin structure which is the bone tissue precursor. Surgitime PTFE  are a high-density sheet with a surface structure and porosity suitable to prevent intergration and passage of bacteria within the interstices of the material, and simultaneously facilitate adhesion of the host cells and the material.</Description>
            <Size>30x20mm- Thickness 0,10mm  30x20mm- Thickness 0,25mm</Size>
            <SupplierCode>HQ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1901</GroupID>
            <SubGroupID>6201</SubGroupID>
            <ARTGs>
                <ARTG>247014</ARTG>
            </ARTGs>
            <MinimumBenefit>168</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ010</BillingCode>
            <Name>Neoss Ti Reinforced Membrane - S I, Neoss Ti Reinforced Membrane - M I, Neoss Non- Reinforced Membra</Name>
            <Description>Neoss Ti Reinforced membrane NeoGen is an implantable temporary non-resorbable device (membrane) for use as a spacer creation barrier in the treatment of local defects in the oral cavity in conjunction with tissue regeneration or augmentation. Neoss membranes are intended to be submerged and clinically implanted more than 30 days with an expected duration of implantation up of 6 months.</Description>
            <Size>28.7mm x 18mm, 0.3mm thick (Reinforced S I)&#xD;
30.4mm x 19.4mm, 0.3 thick (Reinforced M I)&#xD;
29mm x 14mm, 0.3mm thick (Non-reinforced)</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1901</GroupID>
            <SubGroupID>6201</SubGroupID>
            <ARTGs>
                <ARTG>235233</ARTG>
            </ARTGs>
            <MinimumBenefit>168</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ011</BillingCode>
            <Name>Neoss Ti Reinforced Membrane - L I, Neoss Ti Reinforced Membrane - M</Name>
            <Description>Neoss Ti Reinforced membrane NeoGen is an implantable temporary non-resorbable device (membrane) for use as a spacer creation barrier in the treatment of local defects in the oral cavity in conjunction with tissue regeneration or augmentation. Neoss membranes are intended to be submerged and clinically implanted more than 30 days with an expected duration of implantation up of 6 months.</Description>
            <Size>35.9mm x 21.2mm, 0.3mm thick (L I) &#xD;
32.2mm x 22mm, 0.3mm thick (M)</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1901</GroupID>
            <SubGroupID>6202</SubGroupID>
            <ARTGs>
                <ARTG>235233</ARTG>
            </ARTGs>
            <MinimumBenefit>227</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ012</BillingCode>
            <Name>Neoss Non-Reinforced Membrane, Neoss Ti Reinforced Membrane - L, XL</Name>
            <Description>Neoss Ti Reinforced membrane NeoGen is an implantable temporary non-resorbable device (membrane) for use as a spacer creation barrier in the treatment of local defects in the oral cavity in conjunction with tissue regeneration or augmentation. Neoss membranes are intended to be submerged and clinically implanted more than 30 days with an expected duration of implantation up of 6 months.</Description>
            <Size>34mm x 25mm, 0.3mm thick and 46mm  x 32mm, 0.3mm thick</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>199</SubCategoryID>
            <GroupID>1901</GroupID>
            <SubGroupID>6203</SubGroupID>
            <ARTGs>
                <ARTG>235233</ARTG>
            </ARTGs>
            <MinimumBenefit>300</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY782</BillingCode>
            <Name>SynPOR</Name>
            <Description>Porous Polyethylene Chin Implant</Description>
            <Size>4-9mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1592</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>190454</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Chin Two Piece Anatomical contour.</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the chin. Made of high density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>3mm, 5mm, 7mm, 9mm</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1592</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW412</BillingCode>
            <Name>Chins</Name>
            <Description>Extended chin implants: Round RZ (Models 8313 - 8315) and extended square RZ (Models 8316, 8318). Two piece chin design (Models 8320 - 8322). Single piece chin design, contoured (Models 7520 - 7522). Additional chin shapes (Models 6341 - 6344) Contoured t</Description>
            <Size>Extended chin Implants design RZ round small: 45 x 47 x 3mm, medium 45 x 47 x 5mm, large 45 x 47 x 7mm; Extneded Chin Implants square small 45 x 47 x3mm; Medium 45 x 47 x 5mm; Large 45 x 47 x 7mm; Two piece design small 46 x 33 x 5mm; Medium 56 x 36 x 7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1592</GroupID>
            <ARTGs>
                <ARTG>257033</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT074</BillingCode>
            <Name>Anatomics Cranial Patient Specific Implant - One Piece</Name>
            <Description>Cranial patient specific implant constructed of Titanium, Acrylic or Porous Polyethylene</Description>
            <Size>Custom</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW547</BillingCode>
            <Name>Stryker Biomodelled Patient Specific Implant</Name>
            <Description>Biomodelled Patient Specific Craniofacial Implant</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>225792</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT003</BillingCode>
            <Name>IPS Implants® Cranium</Name>
            <Description>IPS Implants® Cranium</Description>
            <Size>Custom - Patient Specific</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
                <ARTG>96620</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC528</BillingCode>
            <Name>TiMesh</Name>
            <Description>Cranial Custom Mesh</Description>
            <Size>121mm x 72mm - 152  x 152mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY772</BillingCode>
            <Name>PSI</Name>
            <Description>Biomodelled Patient Specific Craniofacial implant, PEEK Titanium</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY834</BillingCode>
            <Name>OBL PorousiTi® Patient Specific Implant - Cranium</Name>
            <Description>Patient specific implant for the cranium constructed of PourousTi®</Description>
            <Size>The implant is custom made so the size is variable</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT033</BillingCode>
            <Name>SCS Biomodelled Mesh, 1-piece</Name>
            <Description>Titanium mesh, 1-piece: 2D, 3D</Description>
            <Size>Custom </Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ096</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise PorousiTi - Cranium</Name>
            <Description>Patient specific Titanium 3D printed implant for cranial reconstruction</Description>
            <Size>Personalized so the size is variable</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY774</BillingCode>
            <Name>PSI</Name>
            <Description>Biomodelled Patient Specific Craniofacial implant, PEEK Titanium, 3 Piece</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled Three Piece</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>10657</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT035</BillingCode>
            <Name>SCS Biomodelled Mesh, 3-piece</Name>
            <Description>Titanium mesh, 3-piece: 2D, 3D</Description>
            <Size>Custom</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled Three Piece</Suffix>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>10657</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT075</BillingCode>
            <Name>Anatomics Cranial Patient Specific Implant - Two Piece</Name>
            <Description>Patient Specific Cranial Implant constructed of Titanium, Acrylic or Porous Polyethylene</Description>
            <Size>Custom</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled Two Piece</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>10169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY773</BillingCode>
            <Name>PSI</Name>
            <Description>Biomodelled Patient Specific Craniofacial Implant, Titanium, 2 Piece</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled Two Piece</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>10169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY826</BillingCode>
            <Name>OBL PorousiTi® Cranial Patient Specific Implant – Two piece</Name>
            <Description>Patient specific two piece implant for the cranium constructed of PourousTi®</Description>
            <Size>The implant is custom made so the size is variable</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled Two Piece</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>10169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT034</BillingCode>
            <Name>SCS Biomodelled Mesh, 2-piece</Name>
            <Description>Titanium mesh, 2-piece: 2D, 3D</Description>
            <Size>Custom</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled Two Piece</Suffix>
            <ARTGs>
                <ARTG>339425</ARTG>
            </ARTGs>
            <MinimumBenefit>10169</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC625</BillingCode>
            <Name>Modified Dual TiMesh</Name>
            <Description>TiMesh Surgical Mesh Modified, includes two cranial plates. Composition: Titanium</Description>
            <Size>121mm x 77mm - 152mm x 152mm.</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4343</SubGroupID>
            <Suffix>Biomodelled, Dual Mesh</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>10237</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Custom Made Implant</Name>
            <Description>An implantable device made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is custom made/biomodelled from individual patient's CT scan, on doctors prescription, used for correction and reconstruction of any facial, head or any non-weight bearing bone structure.</Description>
            <Size>Custom designed and biomodelled from patient's CT scan image.</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4346</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>9682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW437</BillingCode>
            <Name>E-POR Biomaterial/ Mastoid, Pterional, Contourable Porous Polyethylene</Name>
            <Description>Mastoid, Pterional, Contourable Porous Polyethylene</Description>
            <Size>Left, Right, 43mm - 57mm x 0.6mm, 1.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4346</SubGroupID>
            <ARTGs>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL012</BillingCode>
            <Name>Su-Por Pterional, Mastoid, Temporal</Name>
            <Description>Mastoid, Pterional, Contourable Porous Polyethylene.</Description>
            <Size>Various sizes, left, right</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4346</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>1267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK038</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates</Description>
            <Size>90 x 90mm, 95 x 165mm, &amp; Large Pre-formed Osteoform Mesh, Cranium.</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>4348</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>2535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT081</BillingCode>
            <Name>Anatomics Surgical Guide</Name>
            <Description>Biomodelled surgical guides to support surgical decision making both pre and intra-operatively</Description>
            <Size>The device is custom made so the size will vary</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>5496</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>1950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY777</BillingCode>
            <Name>ProPlan</Name>
            <Description>Patient Specific Cranical Surgical Guides, Implants</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>5496</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>1950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY825</BillingCode>
            <Name>Surgical Guide for OBL PSI System - Cranium</Name>
            <Description>Patient specific surgical guide for cranial implant</Description>
            <Size>The device is custom made so sizes will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1593</GroupID>
            <SubGroupID>5496</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>1950</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW420</BillingCode>
            <Name>Ear Reconstruction</Name>
            <Description>Porus Polyethylene. Helical rim, models 8328 and 8329</Description>
            <Size>Helical rim: 37 x 62mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1594</GroupID>
            <SubGroupID>4349</SubGroupID>
            <ARTGs>
                <ARTG>152165</ARTG>
            </ARTGs>
            <MinimumBenefit>342</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW432</BillingCode>
            <Name>Ear Reconstruction</Name>
            <Description>Porus Polyethylene. Ear base left and right, models 7542 and 7525  - 7527. Ear base extended left and right, models 8330 and 8331.</Description>
            <Size>Ear base: 29 x 55 x 13mm, 32 x 65 x 16mm. Ear base extended: 30 x 60mm.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1594</GroupID>
            <SubGroupID>4350</SubGroupID>
            <ARTGs>
                <ARTG>187187</ARTG>
                <ARTG>257034</ARTG>
            </ARTGs>
            <MinimumBenefit>489</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW434</BillingCode>
            <Name>E-POR Biomaterial/ Midface Contour Porous Polyethylene</Name>
            <Description>Midface Contour Porous Polyethylene</Description>
            <Size>One size</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1595</GroupID>
            <SubGroupID>4351</SubGroupID>
            <ARTGs>
                <ARTG>257037</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW438</BillingCode>
            <Name>E-POR Biomaterial/ Temporal Fossa Implant Porous Polyethylene</Name>
            <Description>Temporal Fossa Implant Porous Polyethylene</Description>
            <Size>61mm - 105mm x 18mm - 20mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1595</GroupID>
            <SubGroupID>4351</SubGroupID>
            <ARTGs>
                <ARTG>187178</ARTG>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY783</BillingCode>
            <Name>SynPOR</Name>
            <Description>Porous Polyethylene Malar Implant</Description>
            <Size>3-5 mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1595</GroupID>
            <SubGroupID>4351</SubGroupID>
            <ARTGs>
                <ARTG>190454</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Malar, Paranasal, Midface Implant</Name>
            <Description>An implantable device intended to support, contour and provide structure for the face including the cheeks and eye sockets. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>Left and Right (47mm x 24mm x 4mm)</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1595</GroupID>
            <SubGroupID>4351</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT083</BillingCode>
            <Name>Anatomics Patient Specific Malar Implant</Name>
            <Description>A customised patient specific implant constucted of porous polyethelene</Description>
            <Size>The device is customised so sizes will vary</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1595</GroupID>
            <SubGroupID>4352</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW436</BillingCode>
            <Name>E-POR Biomaterial/ Transsphenoidal Sellar Contourable Porous Polyethylene</Name>
            <Description>Transphenoidal Sellar Contourable Porous Polyethylene</Description>
            <Size>2.5mm x 20mm - 40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1595</GroupID>
            <SubGroupID>4352</SubGroupID>
            <ARTGs>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK512</BillingCode>
            <Name>Malar Shape</Name>
            <Description>Porus Polyethylene. Design RZ malar shapes, super petite and petite, left and right (Models 9501 - 9504). Design M malar shapes, left and right (Models 9507 - 9512). Additional malar shapes, extended contoured left and right (Models 9513 - 9518) Contoured</Description>
            <Size>Design RZ malar shapes: super petite left and right 50 x 19 x 3mm, Design RZ malar shapes petite left and right 50 x 19 x 5mm. Design malar shapes: small left and right  64 x 19 x 3mm, left and right medium 64 x 19 x 4.5mm, Left and right large 64 x 19 x </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1595</GroupID>
            <ARTGs>
                <ARTG>187184</ARTG>
                <ARTG>257037</ARTG>
            </ARTGs>
            <MinimumBenefit>322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY824</BillingCode>
            <Name>OBL PorousiTi Patient Specific Implant - Mandible</Name>
            <Description>Patient specific implant for mandible constructed of PourousiTi</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4353</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>6682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ097</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise PorousiTi - Mandible</Name>
            <Description>Patient specific Titanium 3D printed implant for mandible</Description>
            <Size>Personalized so the size is variable</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4353</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>6682</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO120</BillingCode>
            <Name>MODUS Mandible </Name>
            <Description>Locking Plates - Mandibular Reconstruction </Description>
            <Size>6+19+6 Hole, Full Mandible Plate </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4353</SubGroupID>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>1195</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK039</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Osteo Plating &amp; Fixation System</Name>
            <Description>Plates - Reconstruction</Description>
            <Size>5 x 20 x 5 Hole Full Mandible Plate; 5 x 16 x 5 Hole Full Mandible Plate; Mandible, Full</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4353</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>1195</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC513</BillingCode>
            <Name>TiMesh</Name>
            <Description>Full Mandible</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4353</SubGroupID>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1195</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI569</BillingCode>
            <Name>TMJ System</Name>
            <Description>Fossa Component, Left or Right; Titanium, UHMWPE</Description>
            <Size>Small, Medium Large</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4354</SubGroupID>
            <ARTGs>
                <ARTG>145265</ARTG>
            </ARTGs>
            <MinimumBenefit>4891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OG003</BillingCode>
            <Name>OMX Solutions Melbourne TMJ Glenoid Fossa Component</Name>
            <Description>Universal glenoid fossa component constructed of UHMWP</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>OG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4354</SubGroupID>
            <ARTGs>
                <ARTG>276176</ARTG>
            </ARTGs>
            <MinimumBenefit>4891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF131</BillingCode>
            <Name>Melbourne TMJ Prosthesis</Name>
            <Description>TMJ Fossa component</Description>
            <Size>One Size</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4354</SubGroupID>
            <ARTGs>
                <ARTG>268455</ARTG>
            </ARTGs>
            <MinimumBenefit>4891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ044</BillingCode>
            <Name>OrthoTin TMJ Fossa Component</Name>
            <Description>Titanium fossa component with UHMWPE bearing surface</Description>
            <Size>The device is custom made so the size will vary</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4354</SubGroupID>
            <ARTGs>
                <ARTG>293845</ARTG>
            </ARTGs>
            <MinimumBenefit>4891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK040</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Mini, Maxi</Description>
            <Size>Angled EDC Plate, Angled Long EDC Plate, 40mm 6 Hole Fracture Plate, 6 Hole Curved EDC Plate, 33mm &amp; 38mm 4 Hole EDC Plate, 48mm 6 Hole EDC Plate, Mandible, Mandible/Reduction, Mandible Angle</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4355</SubGroupID>
            <Suffix>Compression</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW422</BillingCode>
            <Name>Mandibular angle</Name>
            <Description>Porus Polyethylene. RZ mandibular angles left and right (Models 9955 - 9960); Porus Polyethylene. Contoured mandibular angles left and right (Models 88037 - 88038)</Description>
            <Size>RZ mandibular angles: 65 x 35 x 3 x 6.5 x 3 x 3mm, 65 x 35 x 7 x 6.5 x 3 x 3mm, 65 x 35 x 11 x 6.5 x 3 x 3mm. Contoured mandibular angles left and right:59 x 29 x 7 x 11mm.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4355</SubGroupID>
            <Suffix>Polymer</Suffix>
            <ARTGs>
                <ARTG>187186</ARTG>
                <ARTG>257036</ARTG>
            </ARTGs>
            <MinimumBenefit>1448</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Mandible (Left / Right)</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the mandible. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>74 x 33 x5mm</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4355</SubGroupID>
            <Suffix>Polymer</Suffix>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>1448</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY695</BillingCode>
            <Name>Condylar Head Add-On System</Name>
            <Description>Fixation Plate 0-6mm positions</Description>
            <Size>2 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4357</SubGroupID>
            <Suffix>Fixation Plate</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO123</BillingCode>
            <Name>MODUS Mandible </Name>
            <Description>MODUS Mandible - Complete Condylar Device system (Left and Right), inclusive of carrier element and connecting screws for Condylar Head Prosthesis. </Description>
            <Size>Mandible Condylar Device, Left and Right   </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4357</SubGroupID>
            <ARTGs>
                <ARTG>350311</ARTG>
            </ARTGs>
            <MinimumBenefit>1506</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT008</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Temporary condylar impant, titanium</Description>
            <Size>5cm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4357</SubGroupID>
            <ARTGs>
                <ARTG>304394</ARTG>
            </ARTGs>
            <MinimumBenefit>1506</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK218</BillingCode>
            <Name>Leibinger Titanium Implant System - Universal Mandible Condylar Device</Name>
            <Description>Items used for reconstruction following trauma or tumor resection of the mandible. Included are 2x cross pin fixation screw.</Description>
            <Size>Universal Mandible Condylar Device Left and Right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4357</SubGroupID>
            <ARTGs>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>1506</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY694</BillingCode>
            <Name>Condylar Head Add-On System</Name>
            <Description>Condylar Head - Left, Right</Description>
            <Size>One Size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4357</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1506</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ097</BillingCode>
            <Name>Patient Specific Biomodelled Plate</Name>
            <Description>Patient Specific Biomodelled Plate</Description>
            <Size>Patient Specific</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>366767</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI030</BillingCode>
            <Name>Yxoss CBR</Name>
            <Description>Yxoss CBR is a customized 3-D printed pure titanium or titanium alloys (certified medical grade 4) scaffold for use in craniofacial surgery, to regenerate complex alveolar bone in craniofacial bone rejuvenation and augmentation (Attachments 1 &amp; 2).</Description>
            <Size>Patient specific - size matches individual patient.</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>280805</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW545</BillingCode>
            <Name>Stryker Biomodelled Patient Specific Mandible Reconstruction Plate</Name>
            <Description>Biomodelled Patient Specific Mandible Complex Locking Reconstruction Plate</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>218563</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW668</BillingCode>
            <Name>Facial iD</Name>
            <Description>Patient specific implants</Description>
            <Size>These plates are patient specific - size will vary</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>331521</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT002</BillingCode>
            <Name>UNIQOS custom Threadlock TS Mandible Reconstruction Plates</Name>
            <Description>UNIQOS Custom Threadlock TS Mandible Reconstruction Plates</Description>
            <Size>Custom-Patient Specific</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OG005</BillingCode>
            <Name>Custom Plate</Name>
            <Description>A titanium plate designed to be attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as the bone heals. The device is used for fixation of maxillofacial, mandibular fractures and reconstructions.</Description>
            <Size>Customised to patients</Size>
            <SupplierCode>OG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>330150</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RV016</BillingCode>
            <Name>Patient Specific Implant</Name>
            <Description>Patient Specific Implant</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>RV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>366767</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY776</BillingCode>
            <Name>ProPlan</Name>
            <Description>Biomodelled Patient specific Mandible Complex Locking Reconstruction Plate</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY832</BillingCode>
            <Name>SynpliciTi System - Plates</Name>
            <Description>Patient specific plates for the mandible, maxilla and TMJ</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY836</BillingCode>
            <Name>Custom made plates (including Megaplates)</Name>
            <Description>Patient specific plates for the mandible and maxilla</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ048</BillingCode>
            <Name>Lyka Smith Patient Specific Plate</Name>
            <Description>3D printed custom plate</Description>
            <Size>The device is custom so the size will vary</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>293845</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ098</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Titanium 3D Printed Plates</Name>
            <Description>Patient specific Titanium 3D printed plates for maxillofacial applications</Description>
            <Size>Personalized so the size is variable</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>3510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK041</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ045</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Plating &amp; Fixation System</Name>
            <Description>Plates - Reconstruction</Description>
            <Size>5 x 16 Hole plate Right &amp; Left</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Hemimandible</Suffix>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>539</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC515</BillingCode>
            <Name>TiMesh</Name>
            <Description>Hemimandible, Left/Right</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Hemimandible</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>539</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC512</BillingCode>
            <Name>TiMesh</Name>
            <Description>Maxillary Prosthesis</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Maxilla</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1774</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC516</BillingCode>
            <Name>TiMesh</Name>
            <Description>Mandibular Symphysis</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <Suffix>Symphsis</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>1081</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI559</BillingCode>
            <Name>TMJ System</Name>
            <Description>Mandibular Component, Left or Right, Titanium</Description>
            <Size>(40 - 60mm), 5-13 hole</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <ARTGs>
                <ARTG>145265</ARTG>
            </ARTGs>
            <MinimumBenefit>5700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OG002</BillingCode>
            <Name>OMX Solutions Melbourne TMJ Mandibular Ramus</Name>
            <Description>Custom 3D printed mandible component constructed of titanium alloy</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>OG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <ARTGs>
                <ARTG>276176</ARTG>
            </ARTGs>
            <MinimumBenefit>5700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF128</BillingCode>
            <Name>Melbourne TMJ Prosthesis</Name>
            <Description>TMJ Mandibular Component</Description>
            <Size>S, M, L (Left &amp; Right)</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <ARTGs>
                <ARTG>268455</ARTG>
            </ARTGs>
            <MinimumBenefit>5700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ045</BillingCode>
            <Name>OrthoTin TMJ Ramus Component</Name>
            <Description>TiN coated titanium mandibular ramus</Description>
            <Size>The device is custom made so the size will vary</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4358</SubGroupID>
            <ARTGs>
                <ARTG>293845</ARTG>
            </ARTGs>
            <MinimumBenefit>5700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY594</BillingCode>
            <Name>Mandible External Fixator</Name>
            <Description>Hemi, 3/4, Full and Ramus</Description>
            <Size>Various</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>4504</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>1423</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT085</BillingCode>
            <Name>Anatomics Patient Specifc Surgical Guide</Name>
            <Description>Patient specific surgical guide created from patient CT scan data, used to assist surgeons to implant the device by assisting in clinical decision making both pre- and intraoperatively</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HI001</BillingCode>
            <Name>DDN Guide</Name>
            <Description>Custom made patient specific guide for use with the Neoss Implant System (NJ001)</Description>
            <Size>The device is custom made so the size will vary</Size>
            <SupplierCode>HI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>336209</ARTG>
            </ARTGs>
            <MinimumBenefit>1163</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW650</BillingCode>
            <Name>VSP Orthognathics Bundle (Surgical Guide and Implants)</Name>
            <Description>VSP Orthognathic Bundle (Surgical Guide and Implants - Plates and Screws)</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW653</BillingCode>
            <Name>VSP Reconstruction Mandibular/Maxillary Case Bundle</Name>
            <Description>VSP Reconstruction Mandibular/Maxillary Case Bundle (With Metal Inserts) Customized Bundle</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT005</BillingCode>
            <Name>UNIQOS Patient Specific Surgical guides</Name>
            <Description>UNIQOS Patient Specific Surgical guides</Description>
            <Size>Custom - Patient specific</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>200232</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV007</BillingCode>
            <Name>MGuide</Name>
            <Description>3D printed surgical template</Description>
            <Size>Custom-made, patient specific so size will vary</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>348196</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OG001</BillingCode>
            <Name>OMX Solutions patient Optimized Guide system</Name>
            <Description>CT Based Patient Specific Surgical Guide</Description>
            <Size>The device is patient specific so size will vary</Size>
            <SupplierCode>OG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276176</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY778</BillingCode>
            <Name>ProPlan</Name>
            <Description>Pateint specific Maxillofacial Surgical Guides, Implants</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY827</BillingCode>
            <Name>SynpliciTi System – Surgical Guides</Name>
            <Description>Patient specific surgical guides for the mandible, maxilla and TMJ</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY829</BillingCode>
            <Name>Custom made plates (including Megaplates) – Surgical Guides</Name>
            <Description>Surgical Guides for patient specific plates for the mandible and maxilla</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY835</BillingCode>
            <Name>Surgical Guide for OBL PorousiTi® PSI System – Mandible &amp; Maxilla</Name>
            <Description>Patient specific surgical guide for mandible and maxilla</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UI001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RQ082</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsGuide</Name>
            <Description>A non-sterile, custom-made surgical guide manufactured by 3-D printing  and CAD/CAM techniques</Description>
            <Size>Custom-made. Patient specific</Size>
            <SupplierCode>UI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>292759</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UI003</BillingCode>
            <Name>DGUIDE</Name>
            <Description>A custom made patient-specific and single-use aid, intended to be used in dental and craniomaxillofacial surgical procedures.</Description>
            <Size>Patient specific</Size>
            <SupplierCode>UI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>322576</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ047</BillingCode>
            <Name>OrthoTin Surgical Guide</Name>
            <Description>Patient specific surgical guide</Description>
            <Size>The device is custom so the size may vary</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>293845</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ049</BillingCode>
            <Name>Lyka Smith Patient Specific Guides</Name>
            <Description>Patient specific surgical guide</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5498</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>293845</ARTG>
            </ARTGs>
            <MinimumBenefit>2011</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY828</BillingCode>
            <Name>OBL PorousiTi Patient Specific Implant - Maxilla</Name>
            <Description>Patient specific implant for maxilla constructed of PorousiTi</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5782</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>6337</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ099</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise PorousiTi - Maxilla</Name>
            <Description>Patient specific Titanium 3D printed implant for maxilla</Description>
            <Size>Personalized so the size is variable</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>5782</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>6337</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT084</BillingCode>
            <Name>Anatomics Patient Specific Mandible</Name>
            <Description>Custom mandible implant constructed of porous polyethylene</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1596</GroupID>
            <SubGroupID>6741</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>4559</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW423</BillingCode>
            <Name>Nasal Shape. Petite Nasal Dorsum.</Name>
            <Description>Porus Polyethylene. Petite Nasal Dorsum ( Models 84000 - 84004).</Description>
            <Size>Petite Nasal Dorsum: 4 x 4 x 45mm, 4 x 4 x 55mm, 5 x 5 x 45mm, 5 x 5 x 55mm, 6 x 9 x 55mm.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>4360</SubGroupID>
            <ARTGs>
                <ARTG>257016</ARTG>
            </ARTGs>
            <MinimumBenefit>272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biopore Nasal Dorsum Shape</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the nose and zygoma. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>53 x 5mm, 66 x 6 mm, 76 x 15mm, 40 x 9mm</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>4360</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>272</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW415</BillingCode>
            <Name>Nasal Shape or Rhinoplasty Shape</Name>
            <Description>Porus Polyethylene. Nasal Arch shapes, nasal arch and nasal sheet (Models 9533 - 9536). Nasal dorsum shapes, design A and design B (Models 7516 - 7518). Nasal valve support, lateral nasal valve support and ext.</Description>
            <Size>Nasal arch shapes: small 70 x 13 x 2mm, medium 70 x 15 x 2mm, large 70 x 15 x 2mm, sheet 40 x 9 x 1.1mm. Nasal dorsum shapes: design A small 53 x 5mm, design A large 66 x 8mm, design B 67 x 6.5mm. Nasal valve support: lateral nasal valve 13 x 0.85 x 3.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>4361</SubGroupID>
            <ARTGs>
                <ARTG>152165</ARTG>
            </ARTGs>
            <MinimumBenefit>341</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW425</BillingCode>
            <Name>Nasal Shell Shapes.</Name>
            <Description>Nasal Shell Shapes, Regular and Large with Inserts Small and Large (included). Models 9553 - 9554. Thin Nasal Shell 84006</Description>
            <Size>Regular: 38 x 21 x 17mm, Insert Small 30 x 4 x 9mm, Insert Large 38 x 2.5 x 9mm. Large: 40 x 20 x 18mm, Insert Small 32 x 4 x 9mm, Insert Large 41 x 3 x 9mm. Thin Nasal Dorsal Shell 42.7mm x 16.4mm x 21.8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>4362</SubGroupID>
            <ARTGs>
                <ARTG>257016</ARTG>
            </ARTGs>
            <MinimumBenefit>478</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW424</BillingCode>
            <Name>Nasal Valve Support.</Name>
            <Description>Lateral Nasal Valve, Model 7545. External Nasal Valve Batten, Model 7546. External Nasal Valve Batten - Thin, Model 7167</Description>
            <Size>Lateral Nasal Valve:13 x 3.5 x 0.85mm, External Nasal Valve Batten: 25 x 11 x 0.85mm, External Nasal Valve Batten - Thin: 24 x 11.5 x 0.6mm.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>4363</SubGroupID>
            <ARTGs>
                <ARTG>257016</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC521</BillingCode>
            <Name>TiMesh</Name>
            <Description>Naso-Orbital-Ethmoid </Description>
            <Size>1mm - 2.2mm;  Complex 1, Complex 2, Complex 3</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>4364</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>128523</ARTG>
            </ARTGs>
            <MinimumBenefit>527</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY823</BillingCode>
            <Name>SynpliciTi System – Surgical Guides</Name>
            <Description>Surgical Guide for the zygoma</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>6024</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>2584</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY831</BillingCode>
            <Name>SynpliciTi System - Plates</Name>
            <Description>Patient specific plates for zygoma</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>5783</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ100</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise Titanium 3D Printed Plates - Zygoma</Name>
            <Description>Patient specific Titanium 3D printed plates for zygoma reconstruction</Description>
            <Size>Personalized so the size is variable</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1597</GroupID>
            <SubGroupID>5783</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW411</BillingCode>
            <Name>Complete Orbital Shape</Name>
            <Description>Porus Polyethylene. Complete and 2 / 3 orbit shapes. Inferior 2 / 3 left and right. Models 9567, 9568</Description>
            <Size>Inferior: 83 x 78mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4366</SubGroupID>
            <ARTGs>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>1892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL011</BillingCode>
            <Name>Su-Por Inferior 2/3 Orbit, Complete Orbit, 3D Orbital Floor</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the face including the cheeks and eye socket. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. Includes Inferior 2/3 Orbit (left, right); left complete orbit (left, right)</Description>
            <Size>various sizes, left, right</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4366</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>1892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT087</BillingCode>
            <Name>Anatomics Patient Specific Orbital Floor Implant</Name>
            <Description>A custom, patient specific implant intended for the reconstruction of the patient's orbital floor manufactured with titanium or porous polyethylene.</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT001</BillingCode>
            <Name>UNIQOS Biomodelled Customised Orbital Floor Mesh</Name>
            <Description>UNIQOS Biomodelled Customised Orbital Floor Mesh</Description>
            <Size>Customised - patient specific</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>109878</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN355</BillingCode>
            <Name>TRUMATCH® CMF Orbital</Name>
            <Description>Patient matched, orbital floor reconstruction implants, Titanium  </Description>
            <Size>Custom sized</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY833</BillingCode>
            <Name>OBL PorousiTi® Patient Specific Implant – Orbital Floor</Name>
            <Description>Patient specific implant for the orbital floor constructed of PourousTi®</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ101</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>WH006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Materialise PorousiTi - Orbital</Name>
            <Description>Patient specific Titanium 3D printed implant for orbital reconstruction</Description>
            <Size>Personalized so the size is variable</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>377044</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW433</BillingCode>
            <Name>E-POR Biomaterial/ Orbital Wall and Floor Porous Polyethylene Titanium Mesh Composite (large)</Name>
            <Description>Orbital Wall and Floor Porous Polyethylene Titanium Mesh Composite</Description>
            <Size>41 x 42 x 0.6-1.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <Suffix>Coated</Suffix>
            <ARTGs>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>960</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH363</BillingCode>
            <Name>Lorenz Plating System</Name>
            <Description>Orbital Floor Plate, Titanium</Description>
            <Size>Small to Large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>128458</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EO122</BillingCode>
            <Name>MODUS Orbital Plating System</Name>
            <Description>Orbital Floor Plate </Description>
            <Size>Small - Large </Size>
            <SupplierCode>EO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>350270</ARTG>
                <ARTG>350271</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW522</BillingCode>
            <Name>Stryker Leibinger 3D Orbital Floor Plate</Name>
            <Description>Stryker Leibinger 3D Orbital Floor Plate</Description>
            <Size>Small, Right  Small, Left  Large, Right  Large, Left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>257032</ARTG>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK042</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Plates</Name>
            <Description>Micro, Mini</Description>
            <Size>Orbital Plate, Orbital Plate Large</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK043</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ049</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OsteoMed Orbital Floor Plates</Name>
            <Description>Preformed titanium mesh orbital floor plates</Description>
            <Size>Small Left,  Small Right,  Large Left,  Large Right</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>130508</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY391</BillingCode>
            <Name>Orbital Fixation System</Name>
            <Description>Orbital Floor Plate</Description>
            <Size>S, M, L</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>167547</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY698</BillingCode>
            <Name>SynPOR</Name>
            <Description>Anatomical Porous Polyethylene</Description>
            <Size>0.8mm - 1.5mm thick</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>190454</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL010</BillingCode>
            <Name>Su-Por Orbital Floor</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the face including the cheeks and eye socket. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various size and can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>24mm, 30mm, 34mm, 35mm, 40mm</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4367</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>868</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT082</BillingCode>
            <Name>Anatomics Patient Specific Orbital Rim</Name>
            <Description>Custom, 3D-printed orbital rim constructed of porous polyethylene.</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4370</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>4095</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK511</BillingCode>
            <Name>Orbital Rim</Name>
            <Description>Orbital rims, left and right extended. Models 9539, 9540 Orbital Rim Onlay Implants 81001, 81002</Description>
            <Size>Left &amp; right extended models 47 x 40mm Oribtal Rim Onlay Implants left &amp; right 40 x 40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4370</SubGroupID>
            <ARTGs>
                <ARTG>257035</ARTG>
                <ARTG>257037</ARTG>
            </ARTGs>
            <MinimumBenefit>385</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RJ008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Su-Por Orbital Rim, Extended</Name>
            <Description>An implantable device intended to support, contour, and provide structure for the face including the cheeks and eye socket. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description>
            <Size>Left and Right (44mm x 38mm)</Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4370</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>385</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW410</BillingCode>
            <Name>Enophthalmos Wedge</Name>
            <Description>Regular left and right. Large left and right. (Models 9541 - 9544)</Description>
            <Size>Regular: 22 x 31 x 7mm. Large: 28 x 40 x 7.5mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4371</SubGroupID>
            <ARTGs>
                <ARTG>257032</ARTG>
            </ARTGs>
            <MinimumBenefit>385</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VL013</BillingCode>
            <Name>Su-Por Enophthalmos Wedge</Name>
            <Description>The Su-Por Enophthalmos Wedge is contoured in the shape of the orbital floor and provides volume to restore the orbit to its normal shape and size. </Description>
            <Size>24mm x 33.5mm x 7mm (left,right)  28mm x 40mm x 7.5mm (left, right)    </Size>
            <SupplierCode>VL</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>4371</SubGroupID>
            <ARTGs>
                <ARTG>335454</ARTG>
            </ARTGs>
            <MinimumBenefit>385</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT088</BillingCode>
            <Name>Anatomics Patient Specific Surgical Guide</Name>
            <Description>The Surgical Guide component of the system is created from the patient's CT scan data to assist the surgeon with pre- and intraoperative planning.</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>6023</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>2584</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY830</BillingCode>
            <Name>Surgical Guide for OBL PorousiTi® PSI System – Orbital Floor</Name>
            <Description>Patient specific surgical guide for orbital floor implant</Description>
            <Size>The model is custom made so size will vary</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1598</GroupID>
            <SubGroupID>6023</SubGroupID>
            <Suffix>Biomodelled</Suffix>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>2584</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-09-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO058</BillingCode>
            <Name>Cochlear Vistafix 3 VXI300 Implants</Name>
            <Description>Titanium implant with TiOblast™ for Vistafix one-stage or two-stage surgery</Description>
            <Size>3 mm and 4 mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4373</SubGroupID>
            <Suffix>Concave</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>1055</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO042</BillingCode>
            <Name>Vistafix™ Fixture ST</Name>
            <Description>Titanium self-tapping fixtures for the retention of midface and orbital prostheses.</Description>
            <Size>3mm and 4mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4373</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO037</BillingCode>
            <Name>Face to Face</Name>
            <Description>Console Abutment Unigrip - Titanium</Description>
            <Size>30, 60, 90, 110 Degrees</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4374</SubGroupID>
            <Suffix>Angled/Offset</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>873</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO061</BillingCode>
            <Name>Cochlear Vistafix 3 VXA300 Abutments</Name>
            <Description>Titanium  abutment for Vistafix one-stage and two-stage surgery. VXA Abutments are only compatible with VXI300 Implants</Description>
            <Size>3.5 mm, 4.5 mm, 6 mm, 7.5 mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4374</SubGroupID>
            <Suffix>Concave</Suffix>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>913</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO036</BillingCode>
            <Name>Standard Abutments</Name>
            <Description>Abutment Complete - Titanium</Description>
            <Size>3.0mm - 90780, 4.0mm - 90778, 5.5mm - 90776, 7.0mm - 90774</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4374</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO038</BillingCode>
            <Name>Face to Face</Name>
            <Description>Healing Abutment Unigrip - Titanium</Description>
            <Size>7mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4376</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>278</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO059</BillingCode>
            <Name>Cochlear Vistafix 3 VXA300 Healing Abutment</Name>
            <Description>Titanium healing abutment can be used during healing to avoid having to select the abutment length during surgery. The markings can be used to indicate thickness of the soft tissue. The healing abutment is mounted on the implant and is only compatible with theVXI300 implants</Description>
            <Size>9 mm</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4376</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>278</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO035</BillingCode>
            <Name>Face to Face</Name>
            <Description>Cover Screw with Internal Hexagon</Description>
            <Size>One Size Only</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4377</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>138</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CO060</BillingCode>
            <Name>Cochlear Vistafix 3 Cover screw conical</Name>
            <Description>Cover screw conical for Vistafix VXI300 implant. The Cover screw is only compatible with VXI300 implants</Description>
            <Size>One size</Size>
            <SupplierCode>CO</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1599</GroupID>
            <SubGroupID>4377</SubGroupID>
            <ARTGs>
                <ARTG>123984</ARTG>
            </ARTGs>
            <MinimumBenefit>138</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AT076</BillingCode>
            <Name>Anatomics Biomodel</Name>
            <Description>A patient-specific, 3D printed  biomodel intended to assist the surgeon during pre- and intraoperative procedural planning.</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>AT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>288564</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HI002</BillingCode>
            <Name>DDN Biomodel</Name>
            <Description>Custom made biomodel for use with the Neoss Implant System (NJ001)</Description>
            <Size>The device is custom made so the size will vary.</Size>
            <SupplierCode>HI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>336209</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW544</BillingCode>
            <Name>Stryker Anatomical Biomodel for Mandible</Name>
            <Description>Patient Specific Craniofacial Anatomical Biomodel</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>218563</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW546</BillingCode>
            <Name>Stryker Anatomical Biomodel for PEEK</Name>
            <Description>Patient Specific Craniofacial Anatomical Biomodel</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>225792</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW651</BillingCode>
            <Name>VSP Orthognathics Bundle (Custom Biomodel and Implants)</Name>
            <Description>VSP Orthognathics Bundle (Custom Biomodel and Implants - Plates and Screws)</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW652</BillingCode>
            <Name>VSP Reconstruction Maxillofacial Case Bundle</Name>
            <Description>VSP Reconstruction Maxillofacial Case Bundle (Includes Skull Model)</Description>
            <Size>Custom</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT004</BillingCode>
            <Name>UNIQOS Patient Specific Anatomical Biomodel</Name>
            <Description>Patient specific antomical biomodel</Description>
            <Size>Custom-Patient Specific</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>200232</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OG004</BillingCode>
            <Name>The OMX Solutions Biomodel</Name>
            <Description>CT Based Patient Specific Anatomical Biomodel</Description>
            <Size>The device is patient specific so size will vary</Size>
            <SupplierCode>OG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>276753</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY775</BillingCode>
            <Name>PSI</Name>
            <Description>Patient specific Craniofacial Anatomical Biomodel</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY779</BillingCode>
            <Name>ProPlan</Name>
            <Description>Patient Specific Craniofacial Anatomical Biomodel</Description>
            <Size>Custom</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>276733</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UI002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RQ083</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BIOMODEL</Name>
            <Description>3D CT Based Patient Specific biomodels generated from Patient’s CT scan to   replicate patient particular anatomical contours</Description>
            <Size>Custom - made. Patient specific</Size>
            <SupplierCode>UI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>292561</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UI004</BillingCode>
            <Name>OMF Model</Name>
            <Description>A custom made patient-specific and single-use aid, intended to be used in dental and craniomaxillofacial surgical procedures</Description>
            <Size>Patient specific</Size>
            <SupplierCode>UI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>322576</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ046</BillingCode>
            <Name>OrthoTin Anatomic Biomodel</Name>
            <Description>Anatomic Biomodel</Description>
            <Size>The device is custom so the size will vary</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>293845</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ050</BillingCode>
            <Name>Lyka-Smith Anatomical Biomodel</Name>
            <Description>Three-dimensional anatomical biomodel</Description>
            <Size>The device is custom made so the size will vary</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>200</SubCategoryID>
            <GroupID>1807</GroupID>
            <ARTGs>
                <ARTG>293845</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER415</BillingCode>
            <Name>Bicon Dental Implant System-Abutment, Permanent</Name>
            <Description>Bicon Dental Implant System permanent abutment, universal, Ti, various profiles</Description>
            <Size>diameter (4-7.5mm) (post (2-3mm), angle 0˚ and 15˚, height (1-12mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>158187</ARTG>
                <ARTG>160010</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV007</BillingCode>
            <Name>Ankylos / DS EV Permanent Abutments</Name>
            <Description>Permanent Abutments</Description>
            <Size>Diameter range: 3.3mm - 5.7mm, height range: 7.5mm - 11.1mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>153161</ARTG>
                <ARTG>224096</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GZ003</BillingCode>
            <Name>JD Permanent Abutments</Name>
            <Description>Titanium Abutments</Description>
            <Size>1.5mm to 6.0mm (height)</Size>
            <SupplierCode>GZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>334161</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HD026</BillingCode>
            <Name>BioHorizons Multi-unit Abutments</Name>
            <Description>Titanium abutments used for multiple-unit restorations. Includes straight, 17 and 30 degree abutments. Laser-lok technology optional. Comes with a cover cap. </Description>
            <Size>Collar height: 1.0 - 5.0mm  Platforms: 3.0, 3.5, 4.5, 5.7mm  Angles: Straight,  17 and 30 degrees  </Size>
            <SupplierCode>HD</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>133898</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IC003</BillingCode>
            <Name>Southern Implants Abutments</Name>
            <Description>Final Abutments (multiple units)</Description>
            <Size>3.0 - 6mm Diameter&#xD;
1.0 - 5.5mm Height</Size>
            <SupplierCode>IC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>146306</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JN003</BillingCode>
            <Name>ARDS Abutments</Name>
            <Description>Permanent - ball,  conical,  straight, angled, anatomic</Description>
            <Size>(4.2 - 6)mm width x (2.5 - 1)mm height</Size>
            <SupplierCode>JN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>375050</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV005</BillingCode>
            <Name>MIS Abutments</Name>
            <Description>Abutments</Description>
            <Size>Height: 1mm - 5mm, Crown height: 4 - 11mm, Platform: Narrow, Standard or Wide</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>115006</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV014</BillingCode>
            <Name>MIS Abutments</Name>
            <Description>Abutments</Description>
            <Size>Height: 1mm - 5mm, Crown height: 4 - 11mm, Platform: Narrow or Standard</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>115006</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV017</BillingCode>
            <Name>MIS Abutments</Name>
            <Description>Abutments</Description>
            <Size>Height: 1mm - 5mm, Crown height: 4 - 11mm, Platform: Narrow, Standard or Wide</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>115006</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ003</BillingCode>
            <Name>Neoss Titanium Abutment</Name>
            <Description>Neoss Abutment Titanium</Description>
            <Size>Universal</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>120228</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ004</BillingCode>
            <Name>Neoss Gold Abutment</Name>
            <Description>Neoss Abutment Gold </Description>
            <Size>Universal</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>120228</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR001</BillingCode>
            <Name>Nobel Biocare Abutments</Name>
            <Description>Final Abutments (Multi-Units)</Description>
            <Size>NP, RP, WP</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>127964</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW001</BillingCode>
            <Name>3i Abutment Complete</Name>
            <Description>Titanium</Description>
            <Size>3.25 - 6mm diameter</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>120288</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB010</BillingCode>
            <Name>Neodent GM Abutment (Mini Conical, Exact Mini Conical)</Name>
            <Description>Titanium abutment</Description>
            <Size>GM Mini Conical  - Diameter: 0.8mm - 5.5mm  GM Exact Mini Conical - Diameter: 1.5mm - 3.5mm; Angle: 17º, 30º</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>286940</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB019</BillingCode>
            <Name>BLX Screw-Retained Abutment</Name>
            <Description>Screw-retained abutment, straight or angled</Description>
            <Size>Diameter: 4.6mm  Gingiva height: 1.5mm, 2.5mm, 3.5mm, 4.5mm, 5.5mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>212172</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB025</BillingCode>
            <Name>Straumann Zygomatic Screw-retained Abutment</Name>
            <Description>Titanium screw-retained abutments, straight</Description>
            <Size>4.6mm diameter, 1.5mm - 4.5mm height</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>330841</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB027</BillingCode>
            <Name>BL/BLT Screw-retained Abutment</Name>
            <Description>Screw-retained abutment, straight or angled</Description>
            <Size>Diameter: 3.5mm, 4.6mm  Gingiva height: 1.5mm, 2.5mm, 3.5mm, 4.5mm, 5.5mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>212172</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB033</BillingCode>
            <Name>TLX Screw-Retained Abutment</Name>
            <Description>Titanium abutment</Description>
            <Size>AH 3.5 mm   Narrow base  </Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4385</SubGroupID>
            <ARTGs>
                <ARTG>212172</ARTG>
            </ARTGs>
            <MinimumBenefit>171</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER414</BillingCode>
            <Name>Bicon Dental Implant System-Abutment (temporary)</Name>
            <Description>Bicon Dental Implant System temporary abutments</Description>
            <Size>dia (4-7.5mm) x length (2.5-6.5mm) x post (2-3mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>158187</ARTG>
                <ARTG>160010</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV003</BillingCode>
            <Name>Astra Tech Implant System/ DS EV Healing Abutments</Name>
            <Description>Healing Abutments</Description>
            <Size>Healing Abutment  Diameter: Range 3.5 - 7.5 mm,  Height Range from 2.0 - 10mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>212101</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV004</BillingCode>
            <Name>Astra Tech Implant System / DS EV Abutments</Name>
            <Description>Temporary Abutment</Description>
            <Size>Diameter range: 3.3 - 7.0 mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>212101</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DH006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ankylos Temporary Abutments</Name>
            <Description>Temporary and healing abutments</Description>
            <Size>Diameter 3.3mm - 7mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>212101</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GZ004</BillingCode>
            <Name>JD Temporary Abutments</Name>
            <Description>Titanium Abutments</Description>
            <Size>3.2mm to 7.5mm (diameter), 3.0mm to 9.0mm (height)</Size>
            <SupplierCode>GZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>334161</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HD025</BillingCode>
            <Name>BioHorizons Healing Abutment</Name>
            <Description>Titanium healing abutment with or without laser-lok technology</Description>
            <Size>Emergence profiles: Narrow - Wide     Diameter - 4.0-8.0mm     Height: 1.0 - 5.0mm   </Size>
            <SupplierCode>HD</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>133898</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ009</BillingCode>
            <Name>Neoss Implant System</Name>
            <Description>Healing / Provisional Abutment with Screw</Description>
            <Size>Universal</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>120227</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR004</BillingCode>
            <Name>Nobel Biocare Abutments</Name>
            <Description>Abutment, temporary or healing, complete</Description>
            <Size>NP, RP, WP, 6.0mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>127913</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW010</BillingCode>
            <Name>Zimmer Tapered Screw-Vent Healing Abutment </Name>
            <Description>Temporary or healing abutment </Description>
            <Size>2.9mm  3.5mm  4.5mm  5.7mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>338406</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW012</BillingCode>
            <Name>T3 Healing abutment</Name>
            <Description>Abutment, temporary or healing, complete</Description>
            <Size>3.25 - 6mm diameter    </Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>120289</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB004</BillingCode>
            <Name>Straumann Bone Level Implant Healing Abutment</Name>
            <Description>Straumann Healing Abutment NC/RC/SC</Description>
            <Size>Heights 0.0 mm – 6.5mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>200750</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB013</BillingCode>
            <Name>Neodent GM Healing Abutment</Name>
            <Description>Titanium healing abutment</Description>
            <Size>Diameter: 3.3mm, 4.5mm  Profile: 0.8mm - 5.5mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>303678</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB017</BillingCode>
            <Name>BLX Healing Abutment</Name>
            <Description>Titanium healing abutment</Description>
            <Size>Diameter: 4mm, 5mm, 6mm, 6.5mm, 7.5mm  Abutment height: 2mm, 4mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>200750</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB032</BillingCode>
            <Name>TLX Healing Caps/Abutments</Name>
            <Description>Titanium healing abutment</Description>
            <Size>Diameter: 4mm, 5.5mm, 7.2mm narrow, regular or wide base  Length: 2mm 3mm, 4.5mm  </Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4386</SubGroupID>
            <ARTGs>
                <ARTG>200750</ARTG>
            </ARTGs>
            <MinimumBenefit>68</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV001</BillingCode>
            <Name>Astra Tech Implant System/ DS EV Cover Screws &amp; healing cap</Name>
            <Description>Cover Screw and healing cap</Description>
            <Size>Diameter range 3.0 - 5.4</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>153161</ARTG>
                <ARTG>212100</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JN002</BillingCode>
            <Name>ARDS Cover Screws and Healing Caps</Name>
            <Description>Cover Screws and Healing Caps </Description>
            <Size>(4-6.3)mm diameter  x (2 - 5)mm height,</Size>
            <SupplierCode>JN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>375050</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV006</BillingCode>
            <Name>MIS Cover Screws and Healing Caps</Name>
            <Description>Cover screws and healing caps (Biocom, Seven, Mistral)</Description>
            <Size>1.5mm - 6mm height, 4mm - 6.3mm diameter</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>115006</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV016</BillingCode>
            <Name>MIS Cover Screws and Healing Caps</Name>
            <Description>Cover screws and healing caps (V3)</Description>
            <Size>1.5mm - 8mm height, 3.3mm - 5.8mm diameter</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>115006</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV019</BillingCode>
            <Name>MIS Cover Screws and Healing Caps</Name>
            <Description>Cover screws and healing caps (C1)</Description>
            <Size>1.5mm - 8mm height, 3.3mm - 6.3mm diameter</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>115006</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR002</BillingCode>
            <Name>Nobel Biocare Cover Screws</Name>
            <Description>Cover screw</Description>
            <Size>NP, RP, WP, 6.0mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>97382</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB002</BillingCode>
            <Name>Straumann Pty Ltd</Name>
            <Description>Straumann Closure Cap / Healing Cap NNC / RN / WN /  RC / NC / SC</Description>
            <Size>Height 0.0 - 4.5 mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB011</BillingCode>
            <Name>Neodent GM Cover Screw</Name>
            <Description>Cover screw</Description>
            <Size>Height: 0mm, 2mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>303678</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB016</BillingCode>
            <Name>BLX Cover Cap</Name>
            <Description>Closure cap/protective cap</Description>
            <Size>Closure cap height: 0.4mm, 0.5mm; regular or wide base                        Protective cap height: 5.1mm, 6.6mm, 8.1mm; diameter: 4.6mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>196612</ARTG>
                <ARTG>200750</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB026</BillingCode>
            <Name>Straumann Zygomatic Cover-Screw/Protective Cap</Name>
            <Description>Cover screw for implant; protective cap for screw-retained abutment</Description>
            <Size>Cover screw: 4mm diameter.  Protective cap: 4.6mm diameter, 4.5 - 8.1mm height</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>200750</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB028</BillingCode>
            <Name>BL/BLT Protective Cap</Name>
            <Description>Protective cap for screw-retained abutment</Description>
            <Size>Height: 5mm, 6.5mm, 8mm  Diameter: 3.5mm, 4.6mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>196612</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB031</BillingCode>
            <Name>TLX Cover Cap </Name>
            <Description>Closure cap/protective cap</Description>
            <Size>Closure cap height: 0mm, 1.5mm narrow, regular or wide base  Diameter: 4mm, 5.5mm, 2.7mm  </Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1600</GroupID>
            <SubGroupID>4387</SubGroupID>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>48</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GZ001</BillingCode>
            <Name>JD Zygoma Dental Implants</Name>
            <Description>Titanium Dental Implants</Description>
            <Size>3.9mm to 4.3mm (diameter), 30mm to 60mm (height)</Size>
            <SupplierCode>GZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1601</GroupID>
            <ARTGs>
                <ARTG>334160</ARTG>
            </ARTGs>
            <MinimumBenefit>780</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IC002</BillingCode>
            <Name>Southern Zygomatic and Oncology Implants</Name>
            <Description>Zygomatic Titanium dental implants with 45 or 55 degree angulation</Description>
            <Size>4 to 6mm diameter, 27 to 52.5mm length</Size>
            <SupplierCode>IC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1601</GroupID>
            <ARTGs>
                <ARTG>146307</ARTG>
            </ARTGs>
            <MinimumBenefit>780</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR007</BillingCode>
            <Name>Branemark Titanium Fixture</Name>
            <Description>Zygomaticus Fixture</Description>
            <Size>30, 35, 37.5, 40, 42.5, 45, 47.5, 50, 52.5mm Length</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1601</GroupID>
            <ARTGs>
                <ARTG>97382</ARTG>
            </ARTGs>
            <MinimumBenefit>780</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB024</BillingCode>
            <Name>Straumann Zygomatic Implant, ZAGA Round and ZAGA Flat</Name>
            <Description>Titanium zygomatic implant, round or flat</Description>
            <Size>4.3mm diameter, 30mm - 60mm length</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1601</GroupID>
            <ARTGs>
                <ARTG>330842</ARTG>
            </ARTGs>
            <MinimumBenefit>780</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI018</BillingCode>
            <Name>Master Pin</Name>
            <Description>Pins used in dental surgery for the fixation of membranes (absorbable, non-absorbable and titanium membranes) in order to avoid micro-mobility of the graft. With sharp tips and the stable construction, the pins can be precisely inserted into cortical bones. The pins have an additional minithread and are a hybrid composed of a screw and pin. The thread makes easy and safe removal possible after a healing period has taken place. This thread enlarges the surface of the shaft at the same time and therefore offers more stability.</Description>
            <Size>3.5mm</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4389</SubGroupID>
            <ARTGs>
                <ARTG>280879</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT064</BillingCode>
            <Name>Martin Level 1 Fixation</Name>
            <Description>Orthodontic Screw</Description>
            <Size>1.5 - 2.0mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4389</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK422</BillingCode>
            <Name>Orthodontic Skeletal Anchor Screw</Name>
            <Description>Anchor Screw for Mandibular Maxillary Fixation Screw, Self-Drilling</Description>
            <Size>1.7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4389</SubGroupID>
            <ARTGs>
                <ARTG>251654</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK423</BillingCode>
            <Name>Orthodontic Skeletal Anchor Screw</Name>
            <Description>Anchor Screw for Mandibular Maxillary Fixation Screw, Self-Drilling</Description>
            <Size>2.0mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4389</SubGroupID>
            <ARTGs>
                <ARTG>200615</ARTG>
                <ARTG>251654</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK421</BillingCode>
            <Name>Orthodontic Skeletal Anchor Plate</Name>
            <Description>Orthodontic Skeletal Anchor Plate Locking</Description>
            <Size>1.7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4390</SubGroupID>
            <Suffix>Locking</Suffix>
            <ARTGs>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>312</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT063</BillingCode>
            <Name>Martin Level One Fixation</Name>
            <Description>Orthodontic skeletal anchorage plate</Description>
            <Size>0.5 to 0.99mm thick, 2 to 7 holes</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4390</SubGroupID>
            <ARTGs>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK420</BillingCode>
            <Name>Orthodontic Skeletal Anchor Plate</Name>
            <Description>Orthodontic Skeletal Anchor Plate, Standard</Description>
            <Size>1.7mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4390</SubGroupID>
            <ARTGs>
                <ARTG>295882</ARTG>
            </ARTGs>
            <MinimumBenefit>220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY749</BillingCode>
            <Name>Orthodontic Bone Anchor System</Name>
            <Description>Anchor Plate, Various Designs</Description>
            <Size>4-5 Holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4390</SubGroupID>
            <ARTGs>
                <ARTG>192707</ARTG>
            </ARTGs>
            <MinimumBenefit>220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NJ001</BillingCode>
            <Name>NEOSS IMPLANT SYSTEM</Name>
            <Description>TITANIUM DENTAL IMPLANT</Description>
            <Size>DIAMETERS  3.25; 3.5; 4.0; 4.5; 5.0; 5.5; 6.0 and 6.5 mm in Lengths: 7, 9, 11, 13, 15, and 17mm</Size>
            <SupplierCode>NJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <Suffix>Hydrophilic Coating</Suffix>
            <ARTGs>
                <ARTG>119452</ARTG>
            </ARTGs>
            <MinimumBenefit>409</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB009</BillingCode>
            <Name>Straumann SLActive</Name>
            <Description>Straumann Bone Level Implants with SLActive Hydrophillic Surface</Description>
            <Size>2.9mm-4.8mm diameter, 4mm-18mm height</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <Suffix>Hydrophilic Coating</Suffix>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>409</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB015</BillingCode>
            <Name>BLX Roxolid SLActive Implant</Name>
            <Description>Bone level implant with SLActive hydrophilic surface</Description>
            <Size>Diameter: 3.5mm, 3.75mm, 4.0mm, 4.5mm, 5.0mm, 5.5mm, 6.5mm            Length: 6mm - 18mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <Suffix>Hydrophilic Coating</Suffix>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>409</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB023</BillingCode>
            <Name>Neodent Helix GM Acqua Implant</Name>
            <Description>Titanium dental implant, Acqua hydrophilic surface</Description>
            <Size>Diameter: 3.5mm - 7.0mm    Length: 8.0mm - 18.0mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <Suffix>Hydrophilic Coating</Suffix>
            <ARTGs>
                <ARTG>329014</ARTG>
            </ARTGs>
            <MinimumBenefit>409</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB029</BillingCode>
            <Name>TLX Roxolid SLActive Implant </Name>
            <Description>Tissue Level implant with SLActive hydrophilic surface</Description>
            <Size>Diameter: 3.75 mm, 4.5 mm, 5.5 mm, 6.5 mm  Length: 6 mm, 8 mm, 10 mm, 12 mm, 14 mm, 16 mm, 18 mm  narrow, regular or wide base  </Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <Suffix>Hydrophilic Coating</Suffix>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>409</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER413</BillingCode>
            <Name>Bicon Dental Implant System-Implant</Name>
            <Description>Bicon Dental Implants for mandible or maxilla, endosseous, hydroxyapatite coated, with well</Description>
            <Size>Dia (3-6mm) x length (5-11mm); well (2-3mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>158187</ARTG>
                <ARTG>160010</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV002</BillingCode>
            <Name>Astra Tech Implant System Fixtures Tx/EV, Prime Taper EV</Name>
            <Description>Titanium fixture with microthreaded cervical neck</Description>
            <Size>Diameter 3.0 - 5.4mm, Length 6-17mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>212688</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DH005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ankylos C/X Implants</Name>
            <Description>Screw implant with cover screw (included) and pre-mounted placement head</Description>
            <Size>Diameter range 3.5 - 7.0 mm, Length 8-17mm</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>212688</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GZ002</BillingCode>
            <Name>JD Evolution Dental Implants</Name>
            <Description>Titanium Dental Implants</Description>
            <Size>2.75mm to 6.0mm (diameter), 6 to 26 mm (height)</Size>
            <SupplierCode>GZ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>334160</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HD024</BillingCode>
            <Name>BioHorizons Tapered Pro</Name>
            <Description>Bone level tapered implant with Laser-Lok collar for immediate placement. Colour-coded internal hex conical connection. Cover screw included.</Description>
            <Size>Body diameter: 3.8-5.2mm   Platform diameter: 3-4.5mm   Body length: 9-18mm  </Size>
            <SupplierCode>HD</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>126233</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IC001</BillingCode>
            <Name>Southern Dental Implants</Name>
            <Description>Titanium dental implants in External-Hex, Tri-Nex or Internal Octagon (IT) connection</Description>
            <Size>3.25 to 6.0mm diameter, 6.0 to 52.5mm length</Size>
            <SupplierCode>IC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>146307</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IF001</BillingCode>
            <Name>Implant Direct Oceania Implant Systems (InterActive, Legacy, Swish)</Name>
            <Description>Dental implants, endosseous</Description>
            <Size>Diameter 3.2 - 7.0mm; Length 6.0 - 16.0mm</Size>
            <SupplierCode>IF</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>238870</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JN001</BillingCode>
            <Name>ARDS Implants</Name>
            <Description>Titanium implants (SMART, CIT)  </Description>
            <Size>(3 - 6)mm diameter x (8-13)mm length</Size>
            <SupplierCode>JN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>375050</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV004</BillingCode>
            <Name>MIS Implants</Name>
            <Description>Titanium implants (Biocom, Seven, Mistral)</Description>
            <Size>3mm - 6mm Diameter, 6mm - 16mm length</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>104449</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV015</BillingCode>
            <Name>MIS Implants</Name>
            <Description>Titanium implants (V3)</Description>
            <Size>3.30mm, 3.90mm, 4.30mm, 5mm Diameter.   8mm, 10mm, 11.50mm, 13mm, 16mm Length.</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>104449</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV018</BillingCode>
            <Name>MIS Implants</Name>
            <Description>Titanium implants (C1)</Description>
            <Size>3.30mm, 3.75mm, 4.2mm, 5mm Diameter. 8mm, 10mm, 11.5mm, 13mm, 16mm Length.</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>104449</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR003</BillingCode>
            <Name>Branemark System</Name>
            <Description>Dental Implants, endosseous</Description>
            <Size>Diameter: 3.3mm - 5.0mm&#xD;
Length: 10mm - 15mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>97382</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR010</BillingCode>
            <Name>Replace Implant (NobelReplace Conical Connection, NobelReplace Conical Connection PMC)</Name>
            <Description>Dental Implant Endosseous, Titanium</Description>
            <Size>Diameter: 3.5mm- 5.0mm&#xD;
Length : 8.0mm - 16.00mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>97382</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR012</BillingCode>
            <Name>Groovy Implants (NobelReplace Tapered Groovy, Branemark System Mk III Groovy, NobelSpeedy Groovy)</Name>
            <Description>Dental Implants, endosseous</Description>
            <Size>Diameter 3.3 - 6.0mm; Length 7.0 - 25.0mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>97382</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR013</BillingCode>
            <Name>NobelActive implants</Name>
            <Description>Dental implants, endosseous</Description>
            <Size>Diameter 3.5 - 5.5mm; Length 7.0 - 18.0mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>97382</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NR014</BillingCode>
            <Name>NobelParallel Conical Connection</Name>
            <Description>Dental implants</Description>
            <Size>Diameter: 3.75mm - 5.5mm&#xD;
Length : 7.0mm - 18mm</Size>
            <SupplierCode>NR</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>97382</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW002</BillingCode>
            <Name>T3 Implant System</Name>
            <Description>Dental Implant</Description>
            <Size>3.25 - 6mm diameter</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>100482</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW011</BillingCode>
            <Name>Zimmer Tapered Screw-Vent Implant </Name>
            <Description>Dental Implant Endosseous</Description>
            <Size>3.1mm  3.7mm  4.1mm  4.7mm  6.0mm  </Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>282252</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB008</BillingCode>
            <Name>Straumann Dental Implant</Name>
            <Description>Straumann Dental Implant</Description>
            <Size>6 - 18mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB012</BillingCode>
            <Name>Neodent Helix GM Implant</Name>
            <Description>Titanium dental implant</Description>
            <Size>Diameter: 3.5mm - 6mm  Length: 8.0mm - 18.0mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>286940</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB018</BillingCode>
            <Name>BLX Roxolid SLA Implant</Name>
            <Description>Bone level implant</Description>
            <Size>Diameter: 3.5mm, 3.75mm, 4.0mm, 4.5mm, 5.0mm, 5.5mm, 6.5mm            Length: 6mm- 18mm</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB030</BillingCode>
            <Name>TLX Roxolid SLA Implant</Name>
            <Description>Tissue Level Implant </Description>
            <Size>Diameter: 3.75 mm, 4.5 mm, 5.5 mm, 6.5 mm      narrow, regular or wide base  Length: 6 mm, 8 mm, 10 mm, 12 mm, 14 mm, 16 mm, 18 mm  </Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4392</SubGroupID>
            <ARTGs>
                <ARTG>119306</ARTG>
            </ARTGs>
            <MinimumBenefit>351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER377</BillingCode>
            <Name>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.25 g</Name>
            <Description>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.25 g, synthetic</Description>
            <Size>0.25 g, granule size 50-500μm or 500-1000μm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4393</SubGroupID>
            <ARTGs>
                <ARTG>230860</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB005</BillingCode>
            <Name>Straumann Bone Ceramic</Name>
            <Description>070.198 Straumann Bone Ceramic 400 -700</Description>
            <Size>Straumann Bone Ceramic 400 -700, Granule size 400 - 700 microns, Unit size 0.25 g, Volume: approx 0.3 ml</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4393</SubGroupID>
            <ARTGs>
                <ARTG>194429</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER378</BillingCode>
            <Name>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.5 g</Name>
            <Description>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.5 gram, synthetic</Description>
            <Size>0.5 gram; granule size 50-500μm or 500-1000μm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>230860</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FV013</BillingCode>
            <Name>OSSIX Bone</Name>
            <Description>OSSIX Bone is an osteoconductive bone grafting material aimed to fill, augment, or reconstruct periodontal and bony defects of the maxillo-facial complex.</Description>
            <Size>5 x 10 x 10mm (0.5 cc)</Size>
            <SupplierCode>FV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>380303</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI007</BillingCode>
            <Name>Bio-Oss Pen</Name>
            <Description>Pen applicator with natural bone mineral derived from bovine bone</Description>
            <Size>0.25 to 1mm; 0.25g (0.5125cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>229990</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HD023</BillingCode>
            <Name>BioHorizons MinerOss XP</Name>
            <Description>MinerOss XP is a highly porous anorganic porcine bone mineral matrix designed for hard tissue grafting applications. Xenograft for filling of bone defects in maxillofacial surgery, implantology, and periodontology.</Description>
            <Size>Particle size ranges from 250-1000μm   Volume: 0.5cc,  Jar or Syringe applicator</Size>
            <SupplierCode>HD</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>299220</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IF002</BillingCode>
            <Name>Bioresorb Macro Pore</Name>
            <Description>ß-Tricalcium Phosphate Bone Regeneration Material with Advanced Porosity</Description>
            <Size>200 – 500 μm at 0.5 ml, 500 – 1000 μm at 0.5 ml, 500 – 1000 μm at 1.0 ml </Size>
            <SupplierCode>IF</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>136546</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV021</BillingCode>
            <Name>BVital GENOSS Granules </Name>
            <Description>Anorganic Bone Mineral Granules , vial or preloaded applicator </Description>
            <Size>&lt;1.0 cc</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>376530</ARTG>
                <ARTG>376529</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW006</BillingCode>
            <Name>Endobon Xenograft Granules</Name>
            <Description>Hydroxyapatite granules, 0.5-1mm diameter</Description>
            <Size>0.5ml</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>171507</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB006</BillingCode>
            <Name>Straumann Bone Ceramic</Name>
            <Description>070.199 Straumann Bone Ceramic 500 -1000</Description>
            <Size>Straumann Bone Ceramic 500 -1000, Granule size: 500 -1000 microns, Unit size: 0.5 g, Volume: approx 0.95 ml</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>194429</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB021</BillingCode>
            <Name>cerabone</Name>
            <Description>Bone grafting material derived from bovine bone</Description>
            <Size>Granule size 0.5 - 1.0mm; 0.5ml.  Granule size 1.0 - 2.0mm; 0.5ml. </Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4394</SubGroupID>
            <ARTGs>
                <ARTG>329433</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER379</BillingCode>
            <Name>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 1-2 g</Name>
            <Description>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 1-2 gram, synthetic</Description>
            <Size>1 and 2 grams, granule size 50-500μm and  500-1000μm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>230860</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER534</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NW008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NovaBone Dental Putty</Name>
            <Description>NovaBone® Dental Putty is 100% synthetic and fully resorbable.</Description>
            <Size>CARTRIDGES 2 UNITS X 0.5CC  CARTRIDGES 4 UNITS X 0.25CC  CARTRIDGES 4 UNITS X 0.5CC  SYRINGE, 1 UNIT X  0.5CC</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>242772</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI006</BillingCode>
            <Name>Bio-Oss</Name>
            <Description>Natural bone mineral derived from bovine bone</Description>
            <Size>1 to 2mm: 0.5g (1.5cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>229987</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI008</BillingCode>
            <Name>Bio-Oss Pen</Name>
            <Description>Pen applicator with natural bone mineral derived from bovine bone</Description>
            <Size>0.25 to 1mm; 0.5g (1.025cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>229990</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GI009</BillingCode>
            <Name>Bio-Oss Pen</Name>
            <Description>Pen applicator with natural bone mineral derived from bovine bone</Description>
            <Size>1 to 2mm; 0.5g (1.5cc)</Size>
            <SupplierCode>GI</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>229990</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HD028</BillingCode>
            <Name>BioHorizons MinerOss XP</Name>
            <Description>MinerOss XP is a highly porous anorganic porcine bone mineral matrix designed for hard tissue grafting applications. Xenograft for filling of bone defects in maxillofacial surgery,implantology, and periodontology.</Description>
            <Size>Particle size ranges from 250-1000μm or 1000-2000μm Volume: 1.0cc, 2.0cc, and 4.0cc Jar or Syringe applicator</Size>
            <SupplierCode>HD</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>299220</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IC005</BillingCode>
            <Name>Zen Gro</Name>
            <Description>Dental Bone Matrix Implant, animal derived</Description>
            <Size>Particle size 0.25-1mm 0.5 cc&#xD;
Particle Sze  0.25-1mm 1.0 cc&#xD;
Particle Size 0.25-1mm 2.0 cc&#xD;
Particle Size 0.25-1mm 4.0 cc&#xD;
Particle size 1.0-2.0mm  1.0cc&#xD;
Particle size 1.0-2.0mm  2.0cc</Size>
            <SupplierCode>IC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>299165</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MV022</BillingCode>
            <Name>BVital GENOSS Granules </Name>
            <Description>Anorganic Bone Mineral Granules , vial </Description>
            <Size> (1 -2) cc</Size>
            <SupplierCode>MV</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>376529</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW007</BillingCode>
            <Name>Endobon Xenograft Granules</Name>
            <Description>Hydroxyapatite granules, 0.5-1mm diameter or 1-2mm diameter</Description>
            <Size>2 - 8ml</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>171507</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB007</BillingCode>
            <Name>Straumann Bone Ceramic</Name>
            <Description>070.200 Straumann Bone Ceramic 500 -1000</Description>
            <Size>Straumann Bone Ceramic 500 -1000, Granule size: 500 -1000 microns, Unit Size 1g, Volume approx 1.9 ml</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>194429</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB020</BillingCode>
            <Name>cerabone</Name>
            <Description>Bone grafting material derived from bovine bone</Description>
            <Size>Granule size 0.5 - 1.0ml; 2cc(ml), 5cc(ml).   Granule size 1.0 - 2.0mm; 2cc(ml), 5cc(ml).</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>329433</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SB022</BillingCode>
            <Name>cerabone</Name>
            <Description>Bone grafting material derived from bovine bone</Description>
            <Size>Granule size: 0.5 - 1.0mm; 1ml.  Granule size: 1.0 - 2.0mm; 1ml.</Size>
            <SupplierCode>SB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>329433</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WB001</BillingCode>
            <Name>Ethoss</Name>
            <Description>EthOss TCP is intended to fill, augment, or reconstruct periodontal or bony defects of the oral and maxillofacial region. </Description>
            <Size>65% beta tri-calcium phosphate (ß-TCP) and 35% medical grade calcium sulfate (CaSO4) in 0.5cc syringes or 1.0cc syringes.</Size>
            <SupplierCode>WB</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>201</SubCategoryID>
            <GroupID>1602</GroupID>
            <SubGroupID>4395</SubGroupID>
            <ARTGs>
                <ARTG>299917</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT018</BillingCode>
            <Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name>
            <Description>Distractor System, Complete, External, Midface, Aluminium, Carbon Fibre</Description>
            <Size>one size only</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4396</SubGroupID>
            <Suffix>Multivector</Suffix>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>7897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY401</BillingCode>
            <Name>External Midface Distractor System</Name>
            <Description>Head Frame Assembly, Carbon Fibre Rods</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4396</SubGroupID>
            <Suffix>Multivector</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>7897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT016</BillingCode>
            <Name>Martin Distraction Osteogenesis</Name>
            <Description>Distractor System, Complete, other, titanium</Description>
            <Size>1.5mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4396</SubGroupID>
            <Suffix>Single Vector</Suffix>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>5501</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY349</BillingCode>
            <Name>Multi Vector Distractor Set</Name>
            <Description>Titanium Multi Vector Distractor</Description>
            <Size>MVD Arms:15mm-85mm. Pin holding clamps-ramus,body,universal,limited bone stock ramus and body. Assembly left &amp; right 35mm. K wires 2.0mm 150mm length. Connecting bar 4.0mm 100mm-200mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4398</SubGroupID>
            <ARTGs>
                <ARTG>157706</ARTG>
            </ARTGs>
            <MinimumBenefit>1906</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK044</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ041</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Logic Distraction System</Name>
            <Description>Distractor, spacers &amp; activation set</Description>
            <Size>Straight, Curved 18-52mm</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4399</SubGroupID>
            <Suffix>Multivector</Suffix>
            <ARTGs>
                <ARTG>130510</ARTG>
            </ARTGs>
            <MinimumBenefit>2788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT019</BillingCode>
            <Name>Martin Distraction Osteogenesis</Name>
            <Description>Distractor System, Complete, other, titanium</Description>
            <Size>15-60 mm distraction length</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4399</SubGroupID>
            <Suffix>Multivector</Suffix>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>2788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT065</BillingCode>
            <Name>IPS Custom Distractor</Name>
            <Description>Internal distractor with patient specific 3D Printed plates and/or standard implant parts that have been adjusted to patients anatomical structures and needs.</Description>
            <Size>1mm – 2mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4399</SubGroupID>
            <Suffix>Multivector</Suffix>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>2788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK183</BillingCode>
            <Name>Leibinger Intraoral Distractor (Multiguide II)</Name>
            <Description>Manufactured from stainless steel, allows gradual, independent, and simultaneous distraction of the mandible in 3 planes.</Description>
            <Size>Frame 20mm - 35mm, 2.0mm diameter, 50 - 90 mm length Auto - Pilot Pins</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4399</SubGroupID>
            <Suffix>Multivector</Suffix>
            <ARTGs>
                <ARTG>200615</ARTG>
            </ARTGs>
            <MinimumBenefit>2788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY753</BillingCode>
            <Name>Curvilinear Distraction System</Name>
            <Description>Curvilinear Distraction, Right Left</Description>
            <Size>30mm - 100mm radius</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4399</SubGroupID>
            <Suffix>Multivector</Suffix>
            <ARTGs>
                <ARTG>183673</ARTG>
            </ARTGs>
            <MinimumBenefit>2788</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT011</BillingCode>
            <Name>Martin Distraction Osteogenesis</Name>
            <Description>Distractor System, Complete, internal/intraoral, titanium</Description>
            <Size>10 to 20 mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4399</SubGroupID>
            <Suffix>Single Vector</Suffix>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>1906</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY399</BillingCode>
            <Name>Alveolar Distractor</Name>
            <Description>Vertical mandibular, maxilla alveolar ridge distractor</Description>
            <Size>8-16mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1603</GroupID>
            <SubGroupID>4399</SubGroupID>
            <Suffix>Single Vector</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>1906</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT053</BillingCode>
            <Name>KLS Martin Distractor</Name>
            <Description>Zurich II distractor bodies</Description>
            <Size>15mm - 30mm distraction length</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4402</SubGroupID>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>2145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY515</BillingCode>
            <Name>CMF Distraction System</Name>
            <Description>Distractor System, Distractor Body</Description>
            <Size>10-40mm distraction length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4402</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
                <ARTG>183673</ARTG>
            </ARTGs>
            <MinimumBenefit>2145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT006</BillingCode>
            <Name>Zurich II Modular Distractors</Name>
            <Description>Distractor System, Component, Dual fixation plates, pair</Description>
            <Size>Mesh-large and small design; Cloverleaf design</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4403</SubGroupID>
            <Suffix>Dual Plate</Suffix>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY595</BillingCode>
            <Name>Midface, CMF Distractor System</Name>
            <Description>Distractor Footplate</Description>
            <Size>Various</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4403</SubGroupID>
            <Suffix>Dual Plate</Suffix>
            <ARTGs>
                <ARTG>155806</ARTG>
                <ARTG>183673</ARTG>
            </ARTGs>
            <MinimumBenefit>1279</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT021</BillingCode>
            <Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name>
            <Description>Distractor System, Component, Footplate, titanium</Description>
            <Size>1.5mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4403</SubGroupID>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY406</BillingCode>
            <Name>External Midface Distractor System</Name>
            <Description>Titanium Zygomatic, Maxxilary Footplate</Description>
            <Size>3 holes, 40mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4403</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT022</BillingCode>
            <Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name>
            <Description>Distractor System, Component, Cross Bar, aluminium.carbon fibre</Description>
            <Size>one size only</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4406</SubGroupID>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>965</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY402</BillingCode>
            <Name>External Midface Distractor System</Name>
            <Description>Horizontal Rod Assembly</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4406</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>965</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT017</BillingCode>
            <Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name>
            <Description>Distractor System, Component, Screws/Pins (other than bone screws), titanium</Description>
            <Size>45-55mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4408</SubGroupID>
            <ARTGs>
                <ARTG>113786</ARTG>
                <ARTG>96619</ARTG>
            </ARTGs>
            <MinimumBenefit>144</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY517</BillingCode>
            <Name>Midface Distractor System</Name>
            <Description>Distractor System, Screw</Description>
            <Size>4-10mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4409</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
            </ARTGs>
            <MinimumBenefit>73</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT020</BillingCode>
            <Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name>
            <Description>Distractor System, Component, Other, titanium, aluminium</Description>
            <Size>1.5-1.58mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4410</SubGroupID>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>1424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KT054</BillingCode>
            <Name>KLS Martin Distractors</Name>
            <Description>Zurich II remote release activators</Description>
            <Size>20mm - 50mm</Size>
            <SupplierCode>KT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4411</SubGroupID>
            <ARTGs>
                <ARTG>113786</ARTG>
            </ARTGs>
            <MinimumBenefit>487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY518</BillingCode>
            <Name>Midface, CMF Distractor System</Name>
            <Description>Distractor System , Body extensions</Description>
            <Size>20-60 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>202</SubCategoryID>
            <GroupID>1604</GroupID>
            <SubGroupID>4411</SubGroupID>
            <ARTGs>
                <ARTG>155806</ARTG>
                <ARTG>213820</ARTG>
            </ARTGs>
            <MinimumBenefit>487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RJ001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PR007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ContourFlex Calf Implant</Name>
            <Description>Calf implant</Description>
            <Size>70-170cc</Size>
            <SupplierCode>RJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1605</GroupID>
            <SubGroupID>4412</SubGroupID>
            <ARTGs>
                <ARTG>139493</ARTG>
            </ARTGs>
            <MinimumBenefit>504</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RJ002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PR008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ContourFlex Gluteal Implant</Name>
            <Description>Gluteal Implant</Description>
            <Size>280-460cc, Round and Anatomical</Size>
            <SupplierCode>RJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1605</GroupID>
            <SubGroupID>4413</SubGroupID>
            <ARTGs>
                <ARTG>139493</ARTG>
            </ARTGs>
            <MinimumBenefit>604</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RJ003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PR009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PowerFlex Pectoralis Implant</Name>
            <Description>Pectoralis Implant</Description>
            <Size>Length: 14.2-17.6cm, Width: 9.0-13.5cm, Depth: 1.6-3.2cm,Shape: Symetrical or Asymetrical.</Size>
            <SupplierCode>RJ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1605</GroupID>
            <SubGroupID>5510</SubGroupID>
            <ARTGs>
                <ARTG>139493</ARTG>
            </ARTGs>
            <MinimumBenefit>926</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN013</BillingCode>
            <Name>Mentor Siltex Becker Expander/Mammary Implant</Name>
            <Description>Textured Becker Expander/Mammary Implant</Description>
            <Size>145 to 800cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <Suffix>Expander Implant</Suffix>
            <ARTGs>
                <ARTG>119809</ARTG>
            </ARTGs>
            <MinimumBenefit>1989</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK045</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ048</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PMT Tissue Expander (Integra/Accuspan)</Name>
            <Description>Smooth tissue expander with remote or internal port</Description>
            <Size>Volume 5cc to 1600cc</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>337350</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JT005</BillingCode>
            <Name>Polytech Smooth Tissue Expander with integrated or remote magnetic valve</Name>
            <Description>Smooth with integrated or remote valve</Description>
            <Size>The  tissue expanders vary in maximum volume from 100 - 960mls</Size>
            <SupplierCode>JT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>168188</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JT006</BillingCode>
            <Name>Polytech Textured Mammary or  Tissue Expander with integrated or remote magnetic valve</Name>
            <Description>Textured with integrated or remote valve.</Description>
            <Size>The tissue expanders vary in maximum volume from 100 - 960mls</Size>
            <SupplierCode>JT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>168188</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JT007</BillingCode>
            <Name>Polytech Textured Mammary Expander with integrated or remote magnetic valve</Name>
            <Description>Textured  with integrated or remote magnetic valve. Anatomically shaped with reinforced inner base</Description>
            <Size>The mammary expanders vary in maximum volume from 200 - 960mls</Size>
            <SupplierCode>JT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>168188</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN001</BillingCode>
            <Name>Mentor Radovan Tissue Expander</Name>
            <Description>Tissue Expander</Description>
            <Size>Volume 25cc - 1000cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>125097</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN176</BillingCode>
            <Name>Mentor Siltex Contour Profile Breast Tissue Expander</Name>
            <Description>Siltex Contour Profile Breast Tissue Expander (CPX4)</Description>
            <Size>250-850cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>226977</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN177</BillingCode>
            <Name>Mentor Siltex Contour Profile Breast Tissue Expander</Name>
            <Description>Siltex Contour Profile Breast Tissue Expander (CPX4) with suture tabs</Description>
            <Size>250-850cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>226977</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UQ042</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SP010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Nagor Tissue Expander</Name>
            <Description>Two Stage, Valved</Description>
            <Size>10 to 2000cc</Size>
            <SupplierCode>UQ</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1606</GroupID>
            <SubGroupID>4414</SubGroupID>
            <ARTGs>
                <ARTG>137351</ARTG>
            </ARTGs>
            <MinimumBenefit>653</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC018</BillingCode>
            <Name>MatriDerm Dermal Matrix</Name>
            <Description>Dermal Matrix Scaffold for tissue regeneration and modulation of scar tissue formation.</Description>
            <Size>Width (mm) 37-52 (mm) Length (mm) 52-74 (mm) Thickness 1(mm)</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4419</SubGroupID>
            <ARTGs>
                <ARTG>370020</ARTG>
            </ARTGs>
            <MinimumBenefit>877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG034</BillingCode>
            <Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name>
            <Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description>
            <Size>5cm x 5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4419</SubGroupID>
            <ARTGs>
                <ARTG>158795</ARTG>
            </ARTGs>
            <MinimumBenefit>877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PW003</BillingCode>
            <Name>NovoSorb® BTM 5cm x 5cm</Name>
            <Description>NovoSorb® BTM is a synthetic biocompatible and biodegradable temporary skin substitute and scaffold, intended to temporise dermal injuries and facilitate dermal repair.</Description>
            <Size>5cm x 5cm</Size>
            <SupplierCode>PW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4419</SubGroupID>
            <ARTGs>
                <ARTG>308217</ARTG>
            </ARTGs>
            <MinimumBenefit>877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG035</BillingCode>
            <Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name>
            <Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description>
            <Size>10cm x 12.5cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4420</SubGroupID>
            <ARTGs>
                <ARTG>158795</ARTG>
            </ARTGs>
            <MinimumBenefit>1112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PW002</BillingCode>
            <Name>NovoSorb® BTM 10cm x 10cm</Name>
            <Description>NovoSorb® BTM is a synthetic biocompatible and biodegradable temporary skin substitute and scaffold, intended to temporise dermal injuries and facilitate dermal repair.</Description>
            <Size>10cm x 10cm</Size>
            <SupplierCode>PW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4420</SubGroupID>
            <ARTGs>
                <ARTG>308217</ARTG>
            </ARTGs>
            <MinimumBenefit>1112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC017</BillingCode>
            <Name>MatriDerm Dermal Matrix</Name>
            <Description>Dermal Matrix Scaffold for tissue regeneration and modulation of scar tissue formation. </Description>
            <Size>Width (mm) 148 (mm)  Length (mm) 105 (mm)  Thickness 1 -2(mm)</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4421</SubGroupID>
            <ARTGs>
                <ARTG>370020</ARTG>
            </ARTGs>
            <MinimumBenefit>1697</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG036</BillingCode>
            <Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name>
            <Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description>
            <Size>10cm x 25cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4421</SubGroupID>
            <ARTGs>
                <ARTG>158795</ARTG>
            </ARTGs>
            <MinimumBenefit>1697</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PW001</BillingCode>
            <Name>NovoSorb® BTM 10cm x 20cm</Name>
            <Description>NovoSorb® BTM is a synthetic biocompatible and biodegradable temporary skin substitute and scaffold, intended to temporise dermal injuries and facilitate dermal repair.</Description>
            <Size>10cm x 20cm</Size>
            <SupplierCode>PW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4421</SubGroupID>
            <ARTGs>
                <ARTG>308217</ARTG>
            </ARTGs>
            <MinimumBenefit>1697</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC019</BillingCode>
            <Name>MatriDerm Dermal Matrix</Name>
            <Description>Dermal Matrix Scaffold for tissue regeneration and modulation of scar tissue formation</Description>
            <Size>Width (mm) 210 (mm) Length (mm) 297 (mm) Thickness 1-2 (mm)</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4422</SubGroupID>
            <ARTGs>
                <ARTG>370020</ARTG>
            </ARTGs>
            <MinimumBenefit>3296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG037</BillingCode>
            <Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name>
            <Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description>
            <Size>20cm x 25cm</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4422</SubGroupID>
            <ARTGs>
                <ARTG>158795</ARTG>
            </ARTGs>
            <MinimumBenefit>3296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PW004</BillingCode>
            <Name>NovoSorb® BTM 20cm x 25cm</Name>
            <Description>NovoSorb® BTM is a synthetic biocompatible and biodegradable temporary skin substitute and scaffold, intended to temporise dermal injuries and facilitate dermal repair.</Description>
            <Size>20cm x 25cm</Size>
            <SupplierCode>PW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1607</GroupID>
            <SubGroupID>4422</SubGroupID>
            <ARTGs>
                <ARTG>308217</ARTG>
            </ARTGs>
            <MinimumBenefit>3296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM274</BillingCode>
            <Name>FlowCOUPLER</Name>
            <Description>High Density polyethylene (ring); Stainless Steel (pins) with preattached probe</Description>
            <Size>2.0mm, 2.5mm, 3.0mm, 3.5mm, 4.0mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1608</GroupID>
            <Suffix>with Doppler probe</Suffix>
            <ARTGs>
                <ARTG>243832</ARTG>
            </ARTGs>
            <MinimumBenefit>990</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM030</BillingCode>
            <Name>Synovis Coupler</Name>
            <Description>High Density polyethylene (ring); Stainless Steel (pins)</Description>
            <Size>Diameter 1-4mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>203</SubCategoryID>
            <GroupID>1608</GroupID>
            <ARTGs>
                <ARTG>95596</ARTG>
            </ARTGs>
            <MinimumBenefit>609</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN118</BillingCode>
            <Name>Mentor Smooth Round Saline Implant</Name>
            <Description>Smooth Round implant with Anterior Diaphragm Valve</Description>
            <Size>&lt;500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1609</GroupID>
            <SubGroupID>4423</SubGroupID>
            <Suffix>Valved</Suffix>
            <ARTGs>
                <ARTG>119646</ARTG>
            </ARTGs>
            <MinimumBenefit>697</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN119</BillingCode>
            <Name>Mentor Smooth Round Saline Implant</Name>
            <Description>Smooth Round implant with Anterior Diaphragm Valve</Description>
            <Size>≥500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1609</GroupID>
            <SubGroupID>4426</SubGroupID>
            <Suffix>Valved</Suffix>
            <ARTGs>
                <ARTG>119646</ARTG>
            </ARTGs>
            <MinimumBenefit>624</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JT003</BillingCode>
            <Name>Sublime Line Mammary Implant</Name>
            <Description>Smooth, Microthane or textured surface. Round or oval based with anatomical or central projection.</Description>
            <Size>Low Profile, Moderate Profile, High Profile and Extra High Profile. Sizes 45-495cc.</Size>
            <SupplierCode>JT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>171783</ARTG>
            </ARTGs>
            <MinimumBenefit>975</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH725</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Motiva Ergonomix Implant Matrix, SilkSurface with Qid</Name>
            <Description>Sterile Silicone Breast Implants Motiva Implant  Matrix Ergonomix, SilkSurface with Qid - Prosthesis, internal,  mammary, gel filled</Description>
            <Size>105cc to 500cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>282777</ARTG>
            </ARTGs>
            <MinimumBenefit>975</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH729</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MOTIVA IMPLANTS ANATOMICAL TRUEFIXATION</Name>
            <Description>Sterile Silicone Breast Implants. Gel filled, pre-shaped. </Description>
            <Size>250- 495 cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>373251</ARTG>
            </ARTGs>
            <MinimumBenefit>975</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN126</BillingCode>
            <Name>Mentor Contour Profile Gel Implant</Name>
            <Description>Textured, Contour Profile, Cohesive lll, Gel implant</Description>
            <Size>&lt;500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>130678</ARTG>
            </ARTGs>
            <MinimumBenefit>975</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AW008</BillingCode>
            <Name>Natrelle® INSPIRA® TruForm™ Smooth Mammary Implant</Name>
            <Description>Round implants with smooth surface. Available in four projections: low, moderate, full and extra-full; and two cohesive gel types: TruForm™ 1 Responsive Gel and TruForm™ 2 Soft-Touch™ Gel.</Description>
            <Size>110 - 800 grams</Size>
            <SupplierCode>AW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>175421</ARTG>
                <ARTG>175426</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AW019</BillingCode>
            <Name>BRST Round MICROCELL™ Micotextured cohesive gel filled mammary implant</Name>
            <Description>Round-shaped implants with MICROCELL™ microtextured surface, silicone elastomer barrier layer and cohesive silicone gel.   Available in three profiles:  moderate, high and extra high.</Description>
            <Size>175 - 700 g</Size>
            <SupplierCode>AW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>220900</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG027</BillingCode>
            <Name>Sebbin Mammary Implants</Name>
            <Description>Sterile Silicone Breast Implants less than 500cc</Description>
            <Size>Volume less than 500cc</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>309616</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JK046</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>UQ043</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Gel Filled Mammary Prosthesis Models RGI-D, RGI-DH and RGI-DEH</Name>
            <Description>Smooth Round</Description>
            <Size>80 to 800ml</Size>
            <SupplierCode>JK</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>277759</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH724</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Motiva, Matrix Silk Surface PLUS</Name>
            <Description>Sterile Silicone Breast Implants, Motiva Matrix SilkSurface PLUS - Prosthesis, internal, mammary, gel filled</Description>
            <Size>105cc to 500cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>282778</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH728</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Motiva, Matrix Silk Surface PLUS with QID</Name>
            <Description>Sterile Silicone Breast Implants Motiva Implant Matrix SilkSurface PLUS with Qid - Prosthesis, internal, mammary,gel filled</Description>
            <Size>105cc to 500cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>282776</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN122</BillingCode>
            <Name>Mentor Smooth Round Gel Implant</Name>
            <Description>Smooth, Round, Cohesive l Gel Implant</Description>
            <Size>less than 500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>110587</ARTG>
                <ARTG>319150</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN124</BillingCode>
            <Name>Mentor Siltex Round Gel Implant</Name>
            <Description>Textured, Round Cohesive l Gel implant</Description>
            <Size>less than 500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>110588</ARTG>
                <ARTG>326144</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN130</BillingCode>
            <Name>Mentor Siltex Round Gel Implant</Name>
            <Description>Textured, Round Cohesive Gel ll Implant</Description>
            <Size>&lt;500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>110589</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZW002</BillingCode>
            <Name>Eurosilicone Breast Implants</Name>
            <Description>Round Cohesive Gel Breast Implants for Plastic and Reconstructive Surgery</Description>
            <Size>100cc to 900cc</Size>
            <SupplierCode>ZW</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4429</SubGroupID>
            <ARTGs>
                <ARTG>132036</ARTG>
            </ARTGs>
            <MinimumBenefit>595</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JT004</BillingCode>
            <Name>Sublime Line Mammary Implant</Name>
            <Description>Smooth, Microthane or textured surface. Round or oval based with anatomical or central projection</Description>
            <Size>Low Profile, Moderate Profile, High Profile and Extra High Profile. Sizes 500-1035cc.</Size>
            <SupplierCode>JT</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>171783</ARTG>
            </ARTGs>
            <MinimumBenefit>1170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH727</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Motiva Ergonomix Implant Matrix, SilkSurface with QID</Name>
            <Description>Sterile Silicone Breast Implants, Motiva Ergonomix Matrix, SilkSurface PLUS with QID  - prostheses, Internal, Mammary, gel filled</Description>
            <Size>500cc TO 775cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>282777</ARTG>
            </ARTGs>
            <MinimumBenefit>1170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH730</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MOTIVA IMPLANTS ANATOMICAL TRUEFIXATION</Name>
            <Description>Sterile Silicone Breast Implants. Gel filled, pre-shaped. </Description>
            <Size>500-600 cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>373251</ARTG>
            </ARTGs>
            <MinimumBenefit>1170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN127</BillingCode>
            <Name>Mentor Contour Profile Gel Implant</Name>
            <Description>Textured, Contour Profile, Cohesive lll, Gel implant</Description>
            <Size>≥500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <Suffix>Pre-shaped</Suffix>
            <ARTGs>
                <ARTG>130678</ARTG>
            </ARTGs>
            <MinimumBenefit>1170</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EG025</BillingCode>
            <Name>Sebbin Mammary Implants </Name>
            <Description>Sterile Silicone Breast Implants greater than 500cc</Description>
            <Size>Greater Than 500cc</Size>
            <SupplierCode>EG</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <ARTGs>
                <ARTG>309616</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH726</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Motiva, Matrix Silk Surface PLUS</Name>
            <Description>Sterile Silicone Breast Implants, Motiva Matrix, SilkSurface PLUS - prostheses, Internal, Mammary, gel filled</Description>
            <Size>500cc to 1050cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <ARTGs>
                <ARTG>282778</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH731</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BY014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Motiva, Matrix Silk Surface PLUS with QID</Name>
            <Description>Sterile Silicone Breast Implants, Motiva Matrix, SilkSurface PLUS with QID  - prostheses, Internal, Mammary, gel filled</Description>
            <Size>500cc TO 1050cc</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <ARTGs>
                <ARTG>282776</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN123</BillingCode>
            <Name>Mentor Smooth Round Gel Implant</Name>
            <Description>Smooth, Round Cohesive l Gel Implant</Description>
            <Size>≥500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <ARTGs>
                <ARTG>319150</ARTG>
                <ARTG>110587</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN125</BillingCode>
            <Name>Mentor Siltex Round Gel Implant</Name>
            <Description>Textured, Round Cohesive l Gel implant</Description>
            <Size>≥500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <ARTGs>
                <ARTG>326144</ARTG>
                <ARTG>110588</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN131</BillingCode>
            <Name>Mentor Siltex Round Gel Implant</Name>
            <Description>Textured, Round Cohesive Gel ll Implant</Description>
            <Size>≥500cc</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>23</CategoryID>
            <SubCategoryID>204</SubCategoryID>
            <GroupID>1610</GroupID>
            <SubGroupID>4432</SubGroupID>
            <ARTGs>
                <ARTG>110589</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS278</BillingCode>
            <Name>AUTOGEN ICD VR DF-1</Name>
            <Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector</Description>
            <Size>28.5cc -31.5cc, 61.9g - 70.7g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>221628</ARTG>
                <ARTG>221630</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS340</BillingCode>
            <Name>MOMENTUM EL VR DF-1</Name>
            <Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector. ENDURALIFE Battery Technology</Description>
            <Size>29.5cc, 68.9g, 5.37 x 7.79 x 0.99 cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>296568</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT229</BillingCode>
            <Name>Intica Neo 7 VR-T</Name>
            <Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description>
            <Size>W x H x D (mm) 65 x 55 x 11, Volume: 33cc, Mass: 82g</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>315500</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT230</BillingCode>
            <Name>Intica Neo 7 VR-T DX</Name>
            <Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, additional atrial detection (DX),automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description>
            <Size>65mm x 55mm x 11mm, 33cm3, 82grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>315503</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI112</BillingCode>
            <Name>Evera XT VR DF1/ Evera MRI XT VR SureScan DF1</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, Optimised Battery Chemistry, SmartShock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF1</Description>
            <Size>33cm³ 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>208026</ARTG>
                <ARTG>281609</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI114</BillingCode>
            <Name>Evera S VR DF1 / Evera MRI S VR SureScan DF1</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, DF1</Description>
            <Size>33cm³ 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>281612</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI255</BillingCode>
            <Name>VISIA AF XT ICDs/ VISIA AF MRI XT SureScan ICDs</Name>
            <Description>Digital single chamber implantable cardioverter defibrillator. PhysioCurve™ Design, SmartShock™ Technology, OptiVol™ 2.0 Fluid Status Monitoring, Complete Capture Management™ Diagnostic (RVCM), AF Diagnostics including SureScan/ MRI models</Description>
            <Size>33cm³ 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>282960</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI256</BillingCode>
            <Name>VISIA AF S ICDs/ VISIA AF MRI S SureScan ICDs</Name>
            <Description>Digital single chamber implantable cardioverter defibrillator. PhysioCurve™ Design, SmartShock™ Technology, OptiVol™ 2.0 Fluid Status Monitoring, Complete Capture Management™ Diagnostic (RVCM), AF Diagnostics including SureScan/ MRI models</Description>
            <Size>33cm³ 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>282961</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI385</BillingCode>
            <Name>Crome™ VR ICD MRI SureScan™</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>33.2 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>339486</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI386</BillingCode>
            <Name>Cobalt™ VR ICD MRI SureScan™</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>33.2 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>339485</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI394</BillingCode>
            <Name>Cobalt™ XT VR ICD MRI SureScan™</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>33.2 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>339484</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA176</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium VR 1210</Name>
            <Description>PLATINIUM VR  is an implantable single-chamber cardioverter defibrillator. It is equipped with an accelerometer to allow adaptation of pacing to suit the patient’s activity. PLATINIUM VR is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home, wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory. PLATINIUM VR provides high energy shocks (42 J) for enhanced safety, as well as automatic lead measurements to monitor system integrity. PLATINIUM VR is protected against high-frequency signals emitted by cellular telephones. The PLATINIUM VR ICD device and programming system. The programming system includes the Sorin dedicated programmer with the SMARTVIEW programming software connected to a CPR3 programming head. The programming system is configured and furnished by Sorin. The PLATINIUM VR can serve as a defibrillation electrode (active housing) with a total surface area of 63 cm2. PLATINIUM VR 1210 has two DF-1 and one IS-1 connector ports. The PLATINIUM VR is designed to recognize and treat slow or fast VT and VF by continuously monitoring ventricular activity to identify persistent ventricular arrhythmias and to deliver appropriate therapies. PLATINIUM VR features DISCRIMINATION algorithm.</Description>
            <Size>Dimensions 73 x 54.3 x 11.1mm&#xD;
Weight 85 g&#xD;
Volume 33 cm3&#xD;
Active surface area of casing 62.7cm2&#xD;
Connector IS-1 bipolar, 2*DF-1.</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>282817</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ326</BillingCode>
            <Name>Ellipse VR CD1377-36/CD1377-36C</Name>
            <Description>Single Chamber Cardioverter Defribrillator</Description>
            <Size>31cc, 66g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>207181</ARTG>
                <ARTG>207183</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ333</BillingCode>
            <Name>Fortify Assura VR CD1359-40/CD1359-40C</Name>
            <Description>Single Chamber Cardioverter Defibrillator with 40J delivered energy</Description>
            <Size>76g , 35cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d</Suffix>
            <ARTGs>
                <ARTG>207195</ARTG>
            </ARTGs>
            <MinimumBenefit>29250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS276</BillingCode>
            <Name>AUTOGEN ICD VR DF-4</Name>
            <Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector</Description>
            <Size>26.5cc - 29.5cc, 60.0g - 68.9g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>221627</ARTG>
                <ARTG>221629</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS338</BillingCode>
            <Name>RESONATE EL VR DF-4</Name>
            <Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector. ENDURALIFE Battery Technology and IMAGEREADY MR-Conditional</Description>
            <Size>29.5cc, 68.9g, 5.37 x 7.36 x 0.99 (cm)</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>296567</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT226</BillingCode>
            <Name>Rivacor 7 VR-T DX</Name>
            <Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, additional atrial detection (DX),automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, ComfortDesign DF4, IS-1 connector</Description>
            <Size>66.5mm x 60mm x 10mm, 32cm3, 77grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>315502</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT234</BillingCode>
            <Name>Rivacor 5 VR-T</Name>
            <Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI Conditional and AutoDetect, Comfort Design , DF4, IS-1 connector</Description>
            <Size>61.5mm x 60mm x 10mm, 30cm3, 75grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>315498</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT235</BillingCode>
            <Name>Rivacor 5 VR-T DX</Name>
            <Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, additional atrial detection (DX),automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, ComfortDesign,  DF4, IS-1 connector</Description>
            <Size>66.5mm x 60mm x 10mm, 32cm3, 77grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>315501</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT239</BillingCode>
            <Name>Rivacor 7 VR-T</Name>
            <Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI Conditional and AutoDetect, ComfortDesign, DF4, IS-1 connector</Description>
            <Size>W x H x D (mm) 61.5 x 60 x 10, Volume: 30cc, Mass: 75g</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>315499</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI253</BillingCode>
            <Name>VISIA AF XT MRI ICD</Name>
            <Description>Single Chamber, MRI compatible, Implantable Cardioverter Defibrillator with AF detection and diagnosis, PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF4</Description>
            <Size>33cm³ 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>280354</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI254</BillingCode>
            <Name>VISIA AF S MRI ICD</Name>
            <Description>Single Chamber, MRI compatible, Implantable Cardioverter Defibrillator with AF detection and diagnosis, PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF4</Description>
            <Size>33cm³ 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>280355</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI257</BillingCode>
            <Name>Evera MRI XT VR ICD</Name>
            <Description>Single chamber implantable cardioverter defibrillators with SureScan MRI Technology</Description>
            <Size>33cm³ 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>230020</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI258</BillingCode>
            <Name>Evera MRI S VR ICD</Name>
            <Description>Single chamber implantable cardioverter defibrillators with SureScan MRI Technology</Description>
            <Size>33cm3 77g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>230022</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI384</BillingCode>
            <Name>Crome™ VR ICD MRI SureScan™</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>32.8 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>339486</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI388</BillingCode>
            <Name>Cobalt™ VR ICD MRI SureScan™</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>32.8 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>339485</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI393</BillingCode>
            <Name>Cobalt™ XT VR ICD MRI SureScan™</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>32.8 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>339484</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA178</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium VR 1240</Name>
            <Description>PLATINIUM VR 1240 is an implantable single-chamber cardioverter defibrillator. It is equipped with an accelerometer to allow adaptation of pacing to suit the patient’s activity. PLATINIUM VR is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home, wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory. PLATINIUM VR provides high energy shocks (42 J) for enhanced safety, as well as automatic lead measurements to monitor system integrity. PLATINIUM VR is protected against high-frequency signals emitted by cellular telephones. The PLATINIUM VR can serve as a defibrillation electrode (active housing) with a total surface area of 63 cm2.&#xD;
The PLATINIUM VR is designed to recognize and treat slow or fast VT and VF by continuously monitoring ventricular activity to identify persistent ventricular arrhythmias and to deliver appropriate therapies. PLATINIUM VR features DISCRIMINATION algorithm, which is specifically designed to differentiate ventricular tachycardias from fast rhythms of supraventricular origin. DISCRIMINATION continuously monitors R-R interval stability, searches for long cycles and evaluates sudden onset.</Description>
            <Size>Dimensions 65.8 x 54.3 x 11.1 mm&#xD;
Weight 84 g&#xD;
Volume 31.2 cm3&#xD;
Active surface area of casing 62.9cm2&#xD;
Connector DF4.</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>282816</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ318</BillingCode>
            <Name>Fortify Assura VR CD1359-40Q/CD1359-40QC</Name>
            <Description>Single Chamber Cardioverter Defibrillator</Description>
            <Size>75g, 35cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>207188</ARTG>
                <ARTG>207196</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ332</BillingCode>
            <Name>Ellipse VR CD1377-36Q/CD1377-36QC</Name>
            <Description>Single Chamber Cardioverter Defibrillator with 36 J delivered energy</Description>
            <Size>67g, 30cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a, d, e</Suffix>
            <ARTGs>
                <ARTG>207182</ARTG>
                <ARTG>207184</ARTG>
            </ARTGs>
            <MinimumBenefit>29750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI410</BillingCode>
            <Name>Cobalt™ XT VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>33.2 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339484</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>30700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI411</BillingCode>
            <Name>Cobalt™ VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>33.2 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339485</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>30700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI412</BillingCode>
            <Name>Crome™ VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>33.2 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339486</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>30700</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI407</BillingCode>
            <Name>Cobalt™ XT VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>32.8 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339491</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>31200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI408</BillingCode>
            <Name>Cobalt™ VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>32.8 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339488</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>31200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI409</BillingCode>
            <Name>Crome™ VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>32.8 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339492</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>31200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ417</BillingCode>
            <Name>Gallant VR ICD Model CDVRA500Q</Name>
            <Description>Single Chamber Cardioverter Defibrillator    </Description>
            <Size>30cc, 69g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>336475</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>31200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ420</BillingCode>
            <Name>Entrant VR ICD Model CDVRA300Q</Name>
            <Description>Single Chamber Cardioverter Defibrillator</Description>
            <Size>30cc, 69g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>336479</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>31200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ422</BillingCode>
            <Name>Neutrino NxT VR ICD Model CDVRA600Q</Name>
            <Description>Single Chamber Cardioverter Defibrillator</Description>
            <Size>30cc, 69g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1723</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>336477</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>31200</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS329</BillingCode>
            <Name>Emblem MRI S-ICD Pulse Generator</Name>
            <Description>Subcutaneous Implantable Cardioverter Defibrillator with AF Monitor, SMART Pass and MRI Conditional</Description>
            <Size>59.5cc: (W) 83.1mm x (H) 69.1mm x (D)12.7mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>236</SubCategoryID>
            <GroupID>1812</GroupID>
            <ARTGs>
                <ARTG>286705</ARTG>
            </ARTGs>
            <MinimumBenefit>28398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI116</BillingCode>
            <Name>Evera XT DR IS1/DF1 / Evera MRI XT DR SureScan IS1/DF1</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management and Atrial Therapies. DF1</Description>
            <Size>34cm³ 78g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>281611</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI118</BillingCode>
            <Name>Evera S DR IS1/DF1 / Evera MRI S DR SureScan IS1/DF1</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, DF1</Description>
            <Size>34cm³ 78g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>281610</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI382</BillingCode>
            <Name>Cobalt™ DR ICD MRI SureScan™</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>33.1 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>339482</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI383</BillingCode>
            <Name>Crome™ DR ICD MRI SureScan™</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>33.1 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>339483</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI392</BillingCode>
            <Name>Cobalt™ XT DR ICD MRI SureScan™</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>33.1 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>339481</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI405</BillingCode>
            <Name>Cobalt™ XT DR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>33.1 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339481</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>32839</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI406</BillingCode>
            <Name>Cobalt™ DR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>33.1 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339482</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>32839</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI413</BillingCode>
            <Name>Crome™ DR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>33.1 cm3, 79 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339483</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>32839</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI251</BillingCode>
            <Name>Evera MRI XT DR ICD</Name>
            <Description>Dual chamber implantable cardioverter defibrillator with SureScan MRI Technology</Description>
            <Size>34cm3 78g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>230019</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI252</BillingCode>
            <Name>Evera MRI S DR ICD</Name>
            <Description>Dual chamber implantable cardioverter defibrillator with SureScan MRI Technology</Description>
            <Size>34cm3 78g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>230021</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI379</BillingCode>
            <Name>Cobalt™ XT DR ICD MRI SureScan™</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>33.7 cm3, 80 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>339481</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI380</BillingCode>
            <Name>Cobalt™ DR ICD MRI SureScan™</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>33.7 cm3, 80 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>339482</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI381</BillingCode>
            <Name>Crome™ DR ICD MRI SureScan™</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>33.7 cm3, 80 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>339483</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI402</BillingCode>
            <Name>Cobalt™ XT DR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>33.7 cm3, 80 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339487</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>33338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI403</BillingCode>
            <Name>Cobalt™ DR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>33.7 cm3, 80 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339489</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>33338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI404</BillingCode>
            <Name>Crome™ DR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>33.7 cm3, 80 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>339490</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>33338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS279</BillingCode>
            <Name>AUTOGEN ICD DR DF-1</Name>
            <Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector</Description>
            <Size>28.5cc - 31.5cc, 62.3g - 71g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>221641</ARTG>
                <ARTG>221643</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS341</BillingCode>
            <Name>MOMENTUM EL DR DF-1</Name>
            <Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector. ENDURALIFE Battery Technology</Description>
            <Size>31.5cc, 71.0g, 5.37 x 7.79 x 0.99cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>296570</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT231</BillingCode>
            <Name>Intica Neo 7 DR-T</Name>
            <Description>Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description>
            <Size>65mm x 55mm x 11mm, 33cm3, 82grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>315506</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA183</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium DR 1510</Name>
            <Description>PLATINIUM DR 1510 is an implantable dual-chamber cardioverter defibrillator. It is equipped with an accelerometer to allow adaptation of pacing to suit the patient’s activity. PLATINIUM DR 1510 is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home and wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory. The PLATINIUM DR 1510 is designed to recognize and treat slow or fast VT and VF by continuously monitoring atrial and ventricular activity to identify persistent ventricular arrhythmias and to deliver appropriate therapies. PLATINIUM DR 1510 features the PARAD/PARAD+ algorithm, which is specifically designed to differentiate ventricular tachycardias from fast rhythms of supraventricular origin. PARAD/PARAD+ continuously monitors R-R interval stability, searches for long cycles, assesses the degree of P-R association, evaluates sudden onset and determines the chamber of arrhythmia acceleration.</Description>
            <Size>Dimensions 73 x 54.3 x 11.1 mm&#xD;
Weight 86 g&#xD;
Volume 33 cm3 &#xD;
Active surface area of casing 62.7cm2&#xD;
Connector Atrium: IS-1 bipolar. Ventricle: IS-1 bipolar, 2*DF-1.</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>282818</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ324</BillingCode>
            <Name>Fortify Assura DR CD2359-40/CD2359-40C</Name>
            <Description>Dual Chamber Cardioverter &#xD;
Defibrillator</Description>
            <Size>75g, 35cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>207191</ARTG>
                <ARTG>207193</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ327</BillingCode>
            <Name>Ellipse DR CD2377-36/CD2377-36C</Name>
            <Description>Dual Chamber ICD</Description>
            <Size>66g, 31cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>207186</ARTG>
                <ARTG>207189</ARTG>
            </ARTGs>
            <MinimumBenefit>31389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS277</BillingCode>
            <Name>AUTOGEN ICD DR DF-4</Name>
            <Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector</Description>
            <Size>28.0cc - 31.0cc, 62.5g - 71.4g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>221640</ARTG>
                <ARTG>221642</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS339</BillingCode>
            <Name>RESONATE EL DR DF-4</Name>
            <Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector. ENDURALIFE Battery Technology and IMAGEREADY MR-Conditional</Description>
            <Size>71.4g, 31.0cc, 5.37 x 7.68 x 0.99cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>296569</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT227</BillingCode>
            <Name>Rivacor 7 DR-T</Name>
            <Description>Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, ComfortDesign DF4, IS-1 connector</Description>
            <Size>66.5mm x 60mm x 10mm, 32cm3, 77grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>315505</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT236</BillingCode>
            <Name>Rivacor 5 DR-T</Name>
            <Description>Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, ComfortDesign, DF4, IS-1 connector</Description>
            <Size>66.5mm x 60mm x 10mm, 32cm3, 77grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>315504</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA181</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium DR 1540</Name>
            <Description>PLATINIUM DR is an implantable dual-chamber cardioverter defibrillator. It is equipped with an accelerometer to allow adaptation of pacing to suit the patient’s activity. PLATINIUM DR is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home, wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory. PLATINIUM DR provides high energy shocks (42 J) for enhanced safety, as well as automatic lead measurements to monitor system integrity.The PLATINIUM DR can serve as a defibrillation electrode (active housing) with a total surface area of 63 cm². The PLATINIUM DR is designed to recognize and treat slow or fast VT and VF by continuously monitoring atrial and ventricular activity to identify persistent ventricular arrhythmias and to deliver appropriate therapies. PLATINIUM DR features the PARAD/PARAD+ algorithm, which is specifically designed to differentiate ventricular tachycardias from fast rhythms of supraventricular origin. PARAD/PARAD+ continuously monitors R-R interval stability, searches for long cycles, assesses the degree of P-R association, evaluates sudden onset and determines the chamber of arrhythmia acceleration. In addition to the advanced detection scheme, PLATINIUM DR offers programmable dual or single-chamber pacing</Description>
            <Size>Dimensions 72.3 x 54.3 x 11.1 mm&#xD;
Weight 86 g&#xD;
Volume 33 cm3&#xD;
Active surface area of casing 62.8cm2&#xD;
Connector Atrium: IS-1 bipolar. Ventricle: DF4.</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>282819</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ325</BillingCode>
            <Name>Fortify Assura DR CD2359-40Q/CD2359-40QC</Name>
            <Description>Dual Chamber Cardioverter Defibrillator with 40J delivered energy</Description>
            <Size>75g, 35cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>207192</ARTG>
                <ARTG>207194</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ331</BillingCode>
            <Name>Ellipse DR CD2377-36Q/CD2377-36QC</Name>
            <Description>Dual Chamber Cardioverter Defibrillator with 36J delivered energy</Description>
            <Size>68g, 31cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>207185</ARTG>
                <ARTG>207187</ARTG>
            </ARTGs>
            <MinimumBenefit>31888</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ418</BillingCode>
            <Name>Gallant DR ICD Model CDDRA500Q</Name>
            <Description>Dual Chamber Cardioverter Defibrillator</Description>
            <Size>31cc, 71g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>336476</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>33338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ419</BillingCode>
            <Name>Entrant DR ICD Model CDDRA300Q</Name>
            <Description>Dual Chamber Cardioverter Defibrillator</Description>
            <Size>31cc, 71g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>336480</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>33338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ421</BillingCode>
            <Name>Neutrino NxT DR ICD Model CDDRA600Q</Name>
            <Description>Dual Chamber Cardioverter Defibrillator</Description>
            <Size>31cc, 71g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>237</SubCategoryID>
            <GroupID>1725</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>336478</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>33338</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI232</BillingCode>
            <Name>Claria MRI CRT-D SureScan</Name>
            <Description>Digital implantable cardioverter defibrillator with cardiac resynchronisation therapy and SureScanTM technology</Description>
            <Size>35cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>281607</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI235</BillingCode>
            <Name>Amplia MRI CRT-D SureScan IS1/DF1</Name>
            <Description>Digital implantable cardioverter defibrillator with cardiac resynchronization therapy and SureScan™ Technology (DDE-DDDR), DF1</Description>
            <Size>35cm3 80g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>281606</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI372</BillingCode>
            <Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™ </Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>36.3 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>341549</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI376</BillingCode>
            <Name>Cobalt™ HF Quad CRT-D MRI SureScan™ </Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>36.3 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>341550</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI377</BillingCode>
            <Name>Cobalt™ HF CRT-D MRI SureScan™ </Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>341551</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI378</BillingCode>
            <Name>Crome™ HF CRT-D MRI SureScan™ </Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>341552</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI390</BillingCode>
            <Name>Cobalt™ XT HF CRT-D MRI SureScan™ </Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>341548</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI391</BillingCode>
            <Name>Crome™ HF Quad CRT-D MRI SureScan™ </Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1</Description>
            <Size>36.3 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d</Suffix>
            <ARTGs>
                <ARTG>341547</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI416</BillingCode>
            <Name>Cobalt™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>36.3 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341554</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI417</BillingCode>
            <Name>Cobalt™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341551</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI418</BillingCode>
            <Name>Crome™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>36.3 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341555</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI419</BillingCode>
            <Name>Crome™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341552</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI424</BillingCode>
            <Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>36.3 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341553</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI425</BillingCode>
            <Name>Cobalt™ XT HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341548</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI205</BillingCode>
            <Name>Amplia MRI CRT-D</Name>
            <Description>ICD with CRT. MRI compatible, PhysioCurve Design, CardioSync Optimisation, VectorExpress, V Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0. Complete Capture management. DF4.</Description>
            <Size>35cm3 80g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>280184</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI370</BillingCode>
            <Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4</Description>
            <Size>35.5 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>341549</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI371</BillingCode>
            <Name>Cobalt™ XT HF CRT-D MRI SureScan™</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>341548</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI373</BillingCode>
            <Name>Cobalt™ HF CRT-D MRI SureScan™</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>341551</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI374</BillingCode>
            <Name>Crome™ HF Quad CRT-D MRI SureScan™</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4</Description>
            <Size>35.5 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>341547</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI375</BillingCode>
            <Name>Crome™ HF CRT-D MRI SureScan™</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>341552</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI389</BillingCode>
            <Name>Cobalt™ HF Quad CRT-D MRI SureScan™</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4</Description>
            <Size>35.5 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e</Suffix>
            <ARTGs>
                <ARTG>341550</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI420</BillingCode>
            <Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4 with BlueSync mobile remote monitoring</Description>
            <Size>35.5 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341549</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI421</BillingCode>
            <Name>Cobalt™ XT HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341556</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI422</BillingCode>
            <Name>Crome™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4 with BlueSync mobile remote monitoring</Description>
            <Size>35.5 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341547</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI423</BillingCode>
            <Name>Crome™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341558</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI426</BillingCode>
            <Name>Cobalt™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4 with BlueSync mobile remote monitoring</Description>
            <Size>35.5 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341550</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI427</BillingCode>
            <Name>Cobalt™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name>
            <Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description>
            <Size>35 cm3, 83 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,c,d,e Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341557</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS286</BillingCode>
            <Name>AUTOGEN CRT-D DF-1</Name>
            <Description>High energy CRT-D with DF-1 RV connector &amp; lS-1 (G173) or LV-1 (G175) LV connector. PaceSafe RV, RA, and LV auto threshold.</Description>
            <Size>32.0cc, 72.8g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>221616</ARTG>
                <ARTG>221617</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS287</BillingCode>
            <Name>AUTOGEN X4 CRT-D DF-1</Name>
            <Description>High energy CRT-D with DF-1 RV connector &amp; lS4 LV connector</Description>
            <Size>32.0cc, 73.4g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>221618</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS343</BillingCode>
            <Name>MOMENTUM X4 CRT-D DF-1</Name>
            <Description>High energy CRT-D with DF-1 RV connector &amp; lS4 LV connector. ENDURALIFE Battery Technology</Description>
            <Size>32cc, 73.4g, 5.37 x 8.08 x 0.99cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>296566</ARTG>
                <ARTG>315165</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS345</BillingCode>
            <Name>MOMENTUM CRT-D DF-1</Name>
            <Description>High energy CRT-D with DF-1 RV connector &amp; lS-1/LV-1 LV connector. SmartCRT, Heart Failure Sensor Suite, ENDURALIFE Battery Technology</Description>
            <Size>32cc, 72.8-72.9g, 5.37 x 8.08 x 0.99cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>296564</ARTG>
                <ARTG>296565</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT232</BillingCode>
            <Name>Intica Neo 7 HF-T</Name>
            <Description>Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description>
            <Size>65mm x 58.5mm x 11mm, 34cm3, 83grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>315509</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT233</BillingCode>
            <Name>Intica Neo 7 HF-T QP</Name>
            <Description>Triple  Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, LV Multipolar pacing, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1,IS-1, IS4 quadripolar connectors</Description>
            <Size>65mm x 60.5mm x 11mm, 36cm3, 86grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>315512</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI230</BillingCode>
            <Name>Claria MRI Quad CRT-D SureScan</Name>
            <Description>Digital implantable cardioverter defibrillator with cardiac resynchronization therapy and SureScan™ Technology (DDE-DDDR), DF1</Description>
            <Size>36 cm3 82 g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>281608</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA182</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium CRT-D SonR 1811</Name>
            <Description>PLATINIUM SonR CRT-D is an implantable cardioverter defibrillator for the recognition and treatment of ventricular tachycardia and fibrillation, with ventricular resynchronization, in patients with spontaneous or inducible tachyarrhythmias. PLATINIUM SonR CRT-D is equipped with an accelerometer to allow adaptation of pacing to suit the patient’s activity.&#xD;
PLATINIUM SonR CRT-D is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home, and wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory. If used in conjunction with a dedicated atrial lead featuring the SonR sensor, PLATINIUM SonR CRT-D can analyze micro-accelerations of the heart walls to derive information pertaining to cardiac contractility. The signal picked-up by the SonR sensor can be processed by PLATINIUM SonR CRT-D in order to automatically adjust AV and VV delays for optimal resynchronization therapy. PLATINIUM SonR CRT-D provides a range of therapeutic and diagnostic functions:&#xD;
─ high energy shocks&#xD;
─ atrial tachyarrhythmia prevention&#xD;
─ automatic lead measurements&#xD;
─ advanced diagnostic functions&#xD;
─ automatic AV and VV delay optimization&#xD;
PLATINIUM SonR CRT-D is protected against high-frequency signals emitted by cellular telephones.</Description>
            <Size>1811 MODEL:&#xD;
Dimensions 73 x 54.3 x 11.1 mm&#xD;
Weight 86 g&#xD;
Volume 33 cm3&#xD;
Active surface area of casing 62.7cm2&#xD;
Connector Atrium: SonR (IS-1 bipolar compatible). Right ventricle: IS-1&#xD;
bipolar, 2*DF-1. Left ventricle: IS-1 bipolar (unipolar compatible).</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>282822</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA177</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium CRT-D 1711</Name>
            <Description>PLATINIUM CRT-D is an implantable cardioverter defibrillator for the recognition and treatment of ventricular tachycardia and fibrillation, with ventricular resynchronization, in patients with spontaneous or inducible tachyarrhythmias. PLATINIUM CRT-D is equipped with an accelerometer to allow adaptation of pacing to suit the patient’s activity. PLATINIUM CRT-D is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home and wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory.&#xD;
PLATINIUM CRT-D provides a range of therapeutic and diagnostic functions including high energy shocks,  atrial tachyarrhythmia prevention, automatic lead measurements, and advanced diagnostic functions.&#xD;
PLATINIUM CRT-D is protected against high-frequency signals emitted by cellular telephones.</Description>
            <Size>Dimensions 73 x 54.3 x 11.1 mm&#xD;
Weight 86 g&#xD;
Volume 33 cm3&#xD;
Active surface area of casing 62.7cm2&#xD;
Connector Atrium: IS-1 bipolar. Right ventricle: IS-1 bipolar, 2*DF-1. Left&#xD;
ventricle: IS-1 bipolar (unipolar compatible).</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>282820</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ319</BillingCode>
            <Name>Quadra Assura MP CD3371-40/CD3371/40C</Name>
            <Description>Cardiac Resynchronisation Therapy Cardioverter Defibrillator</Description>
            <Size>83g, 40cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>207157</ARTG>
                <ARTG>207163</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ320</BillingCode>
            <Name>Unify Assura CD3361-40/CD3361-40C</Name>
            <Description>Cardiac Resynchronisation Therapy Cardioverter Defibrillator</Description>
            <Size>78g, 36cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d</Suffix>
            <ARTGs>
                <ARTG>207199</ARTG>
                <ARTG>207200</ARTG>
            </ARTGs>
            <MinimumBenefit>34632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS284</BillingCode>
            <Name>AUTOGEN CRT-D DF-4</Name>
            <Description>ICD with cardiac resynchronization therapy. PaceSafe RV, RA, and LV auto threshold.</Description>
            <Size>32.5cc, 73.6g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>221615</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS285</BillingCode>
            <Name>AUTOGEN X4 CRT-D DF-4</Name>
            <Description>ICD with cardiac resynchronization therapy.</Description>
            <Size>32.5cc, 73.8g, 9.9mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>221633</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS342</BillingCode>
            <Name>RESONATE X4 CRT-D DF-4</Name>
            <Description>High energy CRT-D with DF-4 RV connector &amp; lS4 LV connector. SmartCRT, Heart Failure Sensor Suite, ENDURALIFE Battery Technology, IMAGEREADY MR-Conditional</Description>
            <Size>32.5cc, 73.8g, 5.37 x 8.18 x 0.99cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>296562</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS344</BillingCode>
            <Name>MOMENTUM CRT-D DF-4</Name>
            <Description>High energy CRT-D with DF-4 RV connector &amp; IS-1 LV connector. SmartCRT, Heart Failure Sensor Suite, ENDURALIFE Battery Technology</Description>
            <Size>32.5cc, 73.6g, 5.37 x 8.18 x 0.99cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>296563</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT228</BillingCode>
            <Name>Rivacor 7 HF-T</Name>
            <Description>Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, ComfortDesign DF4, IS-1 connector</Description>
            <Size>71.5mm x 60mm x 10 mm, 33cm3, 78grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>315508</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT237</BillingCode>
            <Name>Rivacor 5 HF-T</Name>
            <Description>Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, ComfortDesign,  DF4, IS-1 connector</Description>
            <Size>71.5mm x 60mm x 10mm, 33cm3, 78grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>315507</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT238</BillingCode>
            <Name>Rivacor 5 HF-T QP</Name>
            <Description>Triple  Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, LV Multipolar pacing, Home Monitoring, MRI conditional and AutoDetect, Comfort Design, DF4,IS-1, IS-4 quadripolar connectors</Description>
            <Size>75mm x 60mm x 10mm, 35cm3, 82grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>315510</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT240</BillingCode>
            <Name>Rivacor 7 HF-T QP</Name>
            <Description>Triple  Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, LV Multipole pacing, Home Monitoring w/ Quickcheck, MRI conditional and AutoDetect, ComfortDesign, DF4,IS-1, IS-4 quadripolar connector,</Description>
            <Size>75mm x 60mm x 10mm, 35cm3, 82grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>315511</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI109</BillingCode>
            <Name>VIVA QUAD XT CRT-D IS4/DF4</Name>
            <Description>ICD with CRT. PhysioCurve Design, AdaptivCRT Algorithm, CardioSync Optimisation, VextorExpress, LV Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management and Atrial Therapies. IS4 DF4</Description>
            <Size>35cm³ 81g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>203840</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI200</BillingCode>
            <Name>Claria Quad MRI CRT-D</Name>
            <Description>Digital implantable cardioverter defibrillator with cardiac resynchronisation therapy and SureScan™ Technology</Description>
            <Size>35cm3 81g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>280183</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI206</BillingCode>
            <Name>Amplia MRI Quad CRT-D</Name>
            <Description>ICD with CRT. MRI compatible, PhysioCurve Design, CardioSync Optimisation, VectorExpress, V Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0. Complete Capture management. Quad DF4.</Description>
            <Size>35cm3 81g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>280182</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI210</BillingCode>
            <Name>Claria MRI CRT-D</Name>
            <Description>Digital implantable cardioverter defibrillator with cardiac resynchronisation therapy and SureScan™ Technology</Description>
            <Size>35cm3 80g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>280186</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA179</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium CRT-D SonR 1841 DF4</Name>
            <Description>PLATINIUM SonR CRT-D is an implantable cardioverter defibrillator for the recognition and treatment of ventricular tachycardia and fibrillation, with ventricular resynchronization, in patients with spontaneous or inducible tachyarrhythmias. PLATINIUM SonR CRT-D is equipped with an  accelerometer to allow adaptation of pacing to suit the patient’s activity.&#xD;
PLATINIUM SonR CRT-D is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home, wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory. If used in conjunction with a dedicated atrial lead featuring the SonR sensor, PLATINIUM SonR CRT-D can analyze micro-accelerations of the heart walls to derive information pertaining to cardiac contractility. The signal picked-up by the SonR sensor can be processed by PLATINIUM SonR CRT-D in order to automatically adjust AV and VV delays for optimal resynchronization therapy. PLATINIUM SonR CRT-D provides a range of therapeutic and diagnostic functions:&#xD;
─ high energy shocks&#xD;
─ atrial tachyarrhythmia prevention&#xD;
─ automatic lead measurements&#xD;
─ advanced diagnostic functions&#xD;
─ automatic AV and VV delay optimization&#xD;
PLATINIUM SonR CRT-D is protected against high-frequency signals emitted by cellular telephones.</Description>
            <Size>1841 MODEL:&#xD;
Dimensions 72.3 x 54.3 x 11.1 mm&#xD;
Weight 87 g&#xD;
Volume 33 cm3&#xD;
Active surface area of casing 62.8cm2&#xD;
Connector Atrium: SonR (IS-1 bipolar compatible). Right ventricle: DF4.&#xD;
Left ventricle: IS-1 bipolar (unipolar compatible).</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>282823</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA180</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Platinium CRT-D 1741</Name>
            <Description>PLATINIUM CRT-D 1741 is an implantable cardioverter defibrillator for the recognition and treatment of ventricular tachycardia and fibrillation, with ventricular resynchronization, in patients with spontaneous or inducible tachyarrhythmias. PLATINIUM CRT-D 1741 is equipped with an accelerometer to allow adaptation of pacing to suit the patient’s activity. PLATINIUM CRT-D 1741 is also equipped with the RF wireless technology which enables remote monitoring of patients who have the Sorin SMARTVIEW Monitor installed at home and wireless interrogation and device programming by Orchestra Plus programmer equipped with ORCHESTRA PLUS LINK accessory.&#xD;
PLATINIUM CRT-D 1741 provides a range of therapeutic and diagnostic functions including high energy shocks,  atrial tachyarrhythmia prevention, automatic lead measurements, and advanced diagnostic functions. PLATINIUM CRT-D is protected against high-frequency signals emitted by cellular telephones.</Description>
            <Size>Dimensions 72.3 x 54.3 x 11.1 mm&#xD;
Weight 87 g&#xD;
Volume 33 cm3&#xD;
Active surface area of casing 62.8cm2&#xD;
Connector Atrium: IS-1 bipolar. Right ventricle: DF4. Left ventricle: IS-1&#xD;
bipolar (unipolar compatible).</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>282821</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF019</BillingCode>
            <Name>Platinium 4LV SonR CRT-D 1844</Name>
            <Description>Implantable cardioverter defibrillator with remote monitoring, cardiac resynchronisation therapy and SonR optimisation.</Description>
            <Size>78.1 X 54.3 X 11.1 mm  33.7cc  91g</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>321363</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF020</BillingCode>
            <Name>Platinium 4LV CRT-D 1744</Name>
            <Description>Implantable cardioverter defibrillator with cardiac resynchronisation therapy and remote monitoring</Description>
            <Size>78.1 X 54.3 X 11.1 mm  91g  33.7cc</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>321362</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ321</BillingCode>
            <Name>Quadra Assura MP CD3371-40Q/CD3371-40QC</Name>
            <Description>Cardiac Resynchronisation Therapy Defibrillator</Description>
            <Size>80gm, 38cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>207156</ARTG>
                <ARTG>207158</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ329</BillingCode>
            <Name>Unify Assura CD3361-40Q/CD3361-40QC</Name>
            <Description>Cardiac Resynchronisation Therapy Cardioverter Defibrillator</Description>
            <Size>77g, 36cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>207190</ARTG>
                <ARTG>207198</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ330</BillingCode>
            <Name>Quadra Assura CD3367-40Q/CD3367-40QC</Name>
            <Description>Cardiac Resynchronisation Therapy Defibrillator with 40J delivered energy</Description>
            <Size>80g, 38cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e</Suffix>
            <ARTGs>
                <ARTG>207161</ARTG>
                <ARTG>207162</ARTG>
            </ARTGs>
            <MinimumBenefit>35132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ424</BillingCode>
            <Name>Gallant HF CRT-D Model CDHFA500Q</Name>
            <Description>Cardiac Resynchronisation Therapy Defibrillator  </Description>
            <Size>34cc, 76g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341252</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ425</BillingCode>
            <Name>Neutrino NxT HF CRT-D Model CDHFA600Q</Name>
            <Description>Cardiac Resynchronisation Therapy Defibrillator  </Description>
            <Size>34cc, 76g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341253</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ426</BillingCode>
            <Name>Entrant HF CRT-D Model CDHFA300Q  </Name>
            <Description>Cardiac Resynchronisation Therapy Defibrillator  </Description>
            <Size>34cc, 76g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>238</SubCategoryID>
            <GroupID>1727</GroupID>
            <Suffix>a,d,e  Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>341254</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>36582</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI446</BillingCode>
            <Name>Azure XT SR MRI SureScan  with BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR) with BlueSync mobile remote monitoring</Description>
            <Size>12.25cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>292011</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>5398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI447</BillingCode>
            <Name>Azure S SR MRI SureScanTM with BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR) with BlueSync mobile remote monitoring</Description>
            <Size>12.25cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>292012</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>5398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ027</BillingCode>
            <Name>St Jude Medical Microny II SR+ Model 2525T Pacemaker</Name>
            <Description>Single Chamber Rate Responsive Pacemaker</Description>
            <Size>Volume 5.9cc, Weight 12.8gm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>f</Suffix>
            <ARTGs>
                <ARTG>140612</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS271</BillingCode>
            <Name>VITALIO MRI SR</Name>
            <Description>Single Chamber Pacemaker, MRI Compatible</Description>
            <Size>11.5cc</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>213925</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS320</BillingCode>
            <Name>ACCOLADE MRI SR</Name>
            <Description>Single Chamber Pacemaker, MRI Conditional</Description>
            <Size>ACCOLADE MRI SR 4.45 x 4.81 x 0.75cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>280319</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT203</BillingCode>
            <Name>Edora 8 SR-T</Name>
            <Description>Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDect, MRI conditional, IS-1 connector</Description>
            <Size>48 x 40 x 6.5 mm, 10 cm3 , 20.8 grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>290550</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT215</BillingCode>
            <Name>Evity 8 SR-T</Name>
            <Description>Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDect, MRI conditional, IS-1 connector</Description>
            <Size>IS-1 (1x)   10 cm3/ 20.8g     48 mm × 40 mm × 6.5 mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>290551</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ363</BillingCode>
            <Name>Assurity MRI PM1272</Name>
            <Description>MRI Conditional RF Single Chamber Rate Responsive Pacemaker</Description>
            <Size>10.4cc, 20g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>267512</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ365</BillingCode>
            <Name>Endurity MRI PM1172</Name>
            <Description>MR Conditional Single Chamber Pacing System</Description>
            <Size>9.7cc, 19g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>267515</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT218</BillingCode>
            <Name>Evity 6 SR-T</Name>
            <Description>Single Chamber Pacemaker, ventricular capture control, physiological rate adaption,&#xD;
automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home&#xD;
Monitoring, MRI AutoDect, MRI conditional, IS-1 connector</Description>
            <Size>IS-1 (1x) 10 cm3/ 20.8g 48 mm × 40 mm × 6.5 mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>290552</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC728</BillingCode>
            <Name>Adapta Pacemaker</Name>
            <Description>SR Pacemaker
Models ADSR01, ADSR06, ADSR03</Description>
            <Size>9.7 - 11.0cc
21.5 - 22.5g</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>125081</ARTG>
                <ARTG>125082</ARTG>
                <ARTG>125083</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI161</BillingCode>
            <Name>Advisa SR MRI SureScan pacemaker A3SR01</Name>
            <Description>Single chamber pacemaker with SureScan MRI Technology</Description>
            <Size>11.9cm3 21g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>230023</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI223</BillingCode>
            <Name>Azure S SR MRI SureScan</Name>
            <Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR)</Description>
            <Size>12.25cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>292012</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI228</BillingCode>
            <Name>Attesta SR MRI SureScan pacemaker</Name>
            <Description>MRI, single chamber rate responsive pacemaker (AAIR/VVIR, AAI/VVI)</Description>
            <Size>9.7cm3 21.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>292416</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI246</BillingCode>
            <Name>Azure XT SR MRI SureScan</Name>
            <Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR)</Description>
            <Size>12.25cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>292011</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA172</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KORA 100 SR</Name>
            <Description>KORA 100 SR is a Single Chamber MRI conditional rate-responsive pacemaker.</Description>
            <Size>Dimensions 37.4 x 41.5 x 6.1mm,  Weight 19g. Volume 7.5cm3. Connector IS-1. Sensors Minute Ventilation (MV) and Accelerometer (G).</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>260253</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF027</BillingCode>
            <Name>OTO SR</Name>
            <Description>Single Chamber MRI Conditional Pacemaker</Description>
            <Size>Weight- 19g  Volume - 7.5cc</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>327725</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF028</BillingCode>
            <Name>TEO SR</Name>
            <Description>Single Chamber MRI Conditional Pacemaker</Description>
            <Size>Weight - 19g  Volume- 7.5cc</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>327721</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF031</BillingCode>
            <Name>ENO SR</Name>
            <Description>Single Chamber MRI Conditional Pacemaker</Description>
            <Size>Weight -19g  Volume 7.5cc  </Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>327723</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF043</BillingCode>
            <Name>Alizea™ SR</Name>
            <Description>Single Chamber MRI Conditional Pacemaker</Description>
            <Size>Volume - 10.5cc    Weight -23.3g</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>239</SubCategoryID>
            <GroupID>1730</GroupID>
            <ARTGs>
                <ARTG>383899</ARTG>
            </ARTGs>
            <MinimumBenefit>3948</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC713</BillingCode>
            <Name>Adapta Pacemaker</Name>
            <Description>VDDR Pacemaker
Models ADVDD01</Description>
            <Size>11.1cc
23.6g</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1732</GroupID>
            <ARTGs>
                <ARTG>125080</ARTG>
            </ARTGs>
            <MinimumBenefit>4502</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT193</BillingCode>
            <Name>Edora 8 DR-T</Name>
            <Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector</Description>
            <Size>48 x 44 x 6.5 mm, 11 cm3,  23.2 grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>290553</ARTG>
            </ARTGs>
            <MinimumBenefit>7846</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT214</BillingCode>
            <Name>Evity 8 DR-T</Name>
            <Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector</Description>
            <Size>IS-1 (2x) 11 cm3/ 23.2 g     48 mm × 44 mm × 6.5 mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>290554</ARTG>
            </ARTGs>
            <MinimumBenefit>7846</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT242</BillingCode>
            <Name>Enitra 8 DR-T</Name>
            <Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption,automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector</Description>
            <Size>11 cm3/ 23.2 g        48 mm × 44 mm × 6.5 mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>321346</ARTG>
            </ARTGs>
            <MinimumBenefit>7846</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC933</BillingCode>
            <Name>Advisa DR MRI SureScan</Name>
            <Description>Model A3DR01 Digital dual chamber pacemaker with SureScan Technology (OAE-DDDR) MR Conditional with MVP Mode, Complete Capture Management Diagnostic (ACM, RVCM), AT/AF Suite Diagnostics and Therapies, OptiVol Fluid Status Monitoring, and Therapy Guide Fea</Description>
            <Size>13cc, 22g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>164513</ARTG>
            </ARTGs>
            <MinimumBenefit>7846</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI237</BillingCode>
            <Name>Azure XT DR MRI SureScan</Name>
            <Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry</Description>
            <Size>12.75 cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>292009</ARTG>
            </ARTGs>
            <MinimumBenefit>7846</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI243</BillingCode>
            <Name>Azure S DR MRI SureScan</Name>
            <Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-DDDR)</Description>
            <Size>12.75cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>292010</ARTG>
            </ARTGs>
            <MinimumBenefit>7846</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI448</BillingCode>
            <Name>Azure XT DR MRI SureScan with BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry with BlueSync mobile remote monitoring</Description>
            <Size>12.75 cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g, Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>292009</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>9296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI449</BillingCode>
            <Name>Azure S DR MRI SureScan with  BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-DDDR) with BlueSync mobile remote monitoring</Description>
            <Size>12.75 cm3 22.5g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>g, Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>292010</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>9296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS269</BillingCode>
            <Name>VITALIO MRI EL DR</Name>
            <Description>Dual Chamber Pacemaker, extended life MRI Compatible</Description>
            <Size>14cc</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>213927</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS321</BillingCode>
            <Name>ACCOLADE MRI DR SL and EL</Name>
            <Description>Dual Chamber Pacemaker, MRI Conditional</Description>
            <Size>ACCOLADE MRI DR SL 4.45 x 5.02 x 0.75cm and ACCOLADE MRI DR EL 4.45 x 5.88 x 0.75cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>280315</ARTG>
                <ARTG>280316</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ364</BillingCode>
            <Name>Assurity MRI PM2272</Name>
            <Description>MR Conditional RF Dual Chamber Rate Responsive Pacemaker</Description>
            <Size>10.4cc, 20g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>267513</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ366</BillingCode>
            <Name>Endurity MRI PM2172</Name>
            <Description>Dual Chamber MR Conditional Rate Responsive Pacemaker</Description>
            <Size>10.4cc, 20g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>267514</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT219</BillingCode>
            <Name>Evity 6 DR-T</Name>
            <Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption,automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector</Description>
            <Size>IS-1 (2x) 11 cm3/ 23.2 g 48 mm × 44 mm × 6.5 mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>290555</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC726</BillingCode>
            <Name>Adapta Pacemaker</Name>
            <Description>DR Pacemaker
Models ADDR01, ADDRS1, ADDRL1, ADDR06, ADDR03</Description>
            <Size>11.1-14.2cc
23.6g-31.3g</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>125076</ARTG>
                <ARTG>125077</ARTG>
                <ARTG>125084</ARTG>
                <ARTG>125085</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI222</BillingCode>
            <Name>Attesta DR MRI SureScan pacemaker</Name>
            <Description>MRI safe, dual chamber rate responsive pacemaker (DDDR)</Description>
            <Size>12.1cm3 23.6g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>292415</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI226</BillingCode>
            <Name>Attesta L DR MRI SureScan pacemaker</Name>
            <Description>MRI, dual chamber rate responsible pacemaker (DDDR)</Description>
            <Size>13.1cm3 31.3g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>292417</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI233</BillingCode>
            <Name>Attesta S DR MRI SureScan pacemaker</Name>
            <Description>MRI, dual chamber rate responsive pacemaker (DDDR)</Description>
            <Size>11.1cm3 23.6g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>292418</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA171</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KORA 100 DR</Name>
            <Description>KORA 100 DR is a Dual Chamber MRI conditional, Rate Responsive Pacemaker</Description>
            <Size>41.2 x 41.5 x 6.1mm</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>260252</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF026</BillingCode>
            <Name>ENO DR</Name>
            <Description>Dual Chamber MRI Conditional Pacemaker</Description>
            <Size>Weight 20g  Volume 8cc</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>327722</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF029</BillingCode>
            <Name>OTO DR</Name>
            <Description>Dual Chamber MRI Conditional  Pacemaker</Description>
            <Size>Weight - 20g  Volume - 8cc</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>327724</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF030</BillingCode>
            <Name>TEO DR</Name>
            <Description>Dual Chamber MRI Conditional Pacemaker</Description>
            <Size>Weight - 20g   Volume - 8cc</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>327720</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF042</BillingCode>
            <Name>Alizea™ DR</Name>
            <Description>Dual chamber MRI conditional pacemaker</Description>
            <Size>Volume - 10.95cc  Weight - 24.2g</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>240</SubCategoryID>
            <GroupID>1734</GroupID>
            <ARTGs>
                <ARTG>383903</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI231</BillingCode>
            <Name>Percepta MRI SureScan CRT-P</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronization therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description>
            <Size>20cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>291818</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI236</BillingCode>
            <Name>Serena Quad MRI SureScan CRT-P</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description>
            <Size>20.5cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>291821</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI244</BillingCode>
            <Name>Serena MRI SureScan CRT-P</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description>
            <Size>20cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>291820</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI245</BillingCode>
            <Name>Percepta Quad MRI SureScan CRT-P</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description>
            <Size>20.5cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g</Suffix>
            <ARTGs>
                <ARTG>291819</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI439</BillingCode>
            <Name>Percepta Quad MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronization therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description>
            <Size>20.5cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g, Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>291819</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>10454</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI440</BillingCode>
            <Name>Percepta MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronization therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description>
            <Size>20cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g, Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>291818</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>10454</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI441</BillingCode>
            <Name>Serena Quad MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description>
            <Size>20.5cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g, Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>291821</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>10454</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI442</BillingCode>
            <Name>Serena MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name>
            <Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description>
            <Size>20.5cm3 30g</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>g, Remote Monitoring Service</Suffix>
            <ARTGs>
                <ARTG>291820</ARTG>
            </ARTGs>
            <Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note>
            <MinimumBenefit>10454</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS326</BillingCode>
            <Name>VISIONIST X4 CRT-P, VISIONIST CRT-P</Name>
            <Description>Cardiac Resynchronization Therapy Pacemaker</Description>
            <Size>U228: 4.45 x 6.17 x 0.75cm. U225 and U226: 4.45 x 6.13 x 0.75cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>279330</ARTG>
                <ARTG>279331</ARTG>
                <ARTG>279332</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT191</BillingCode>
            <Name>Edora 8 HF-T</Name>
            <Description>Triple Chamber CRT Pacemaker, capture management all chambers, physiological rate adaption, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-1 connector</Description>
            <Size>53 x 52 x 6.5 mm, 14 cm3,  26.9 grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>290556</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT199</BillingCode>
            <Name>Edora 8 HF-T QP</Name>
            <Description>Triple Chamber CRT-Pacemaker, capture management all chambers, physiological rate adaption, quadripolar LV pacing, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-4  IS-1 connectors</Description>
            <Size>53 x 53 x 6.5 mm, 15cm3,  31.2 grams</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>290558</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT241</BillingCode>
            <Name>Enitra 8 HF-T QP</Name>
            <Description>Triple Chamber CRT-Pacemaker, capture management all chambers, physiological rate adaption, quadripolar LV pacing, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-4  IS-1 connectors</Description>
            <Size>15 cm3/ 31.2g          53 mm × 53 mm × 6.5 mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>321348</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT243</BillingCode>
            <Name>Enitra 8 HF-T</Name>
            <Description>Triple Chamber CRT Pacemaker, capture management all chambers, physiological rate adaption, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-1 connector</Description>
            <Size>14 cm3/ 26.9g                    53 mm × 52 mm × 6.5 mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>321347</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ337</BillingCode>
            <Name>Allure RF PM3222</Name>
            <Description>CRT Rate Responsive Pacemaker with RF Telemetry</Description>
            <Size>14cc, 24g</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>216290</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ353</BillingCode>
            <Name>Quadra Allure MP RF PM 3262</Name>
            <Description>Quadra Allure MP RF Biventricular Pacemaker</Description>
            <Size>27g, 15cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>231759</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ403</BillingCode>
            <Name>Quadra Allure MP MRI</Name>
            <Description>CRT Quadripolar, Rate Responsive Pacemaker with multipoint pacing</Description>
            <Size>27g, 15cc</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>241</SubCategoryID>
            <GroupID>1736</GroupID>
            <Suffix>i</Suffix>
            <ARTGs>
                <ARTG>309821</ARTG>
            </ARTGs>
            <MinimumBenefit>9004</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC026</BillingCode>
            <Name>Medtronic Transvene SVC Lead Model 6937;</Name>
            <Description>Model 6937-35, Model 6937-52, Model 6937-58, Model 6937-110; Silicone;</Description>
            <Size>35 - 110cm x  660mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1737</GroupID>
            <ARTGs>
                <ARTG>136182</ARTG>
            </ARTGs>
            <MinimumBenefit>1559</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC251</BillingCode>
            <Name>Implantable Subcutaneous Defibrillator Lead Model 6996SQ 41cm, 58cm, 85cm</Name>
            <Description>Silicone and Platinum Alloy</Description>
            <Size>Lengths 41-85cm inclusive</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1738</GroupID>
            <ARTGs>
                <ARTG>132315</ARTG>
            </ARTGs>
            <MinimumBenefit>3117</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS170</BillingCode>
            <Name>Endotak Reliance S 4-SITE</Name>
            <Description>Passive fixation single coil defibrillation leads &amp; 4-SITE connector.</Description>
            <Size>50-70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>327983</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS180</BillingCode>
            <Name>Endotak Reliance 4-SITE</Name>
            <Description>Passive fixation dual coil defibrillation leads with 4-SITE connector</Description>
            <Size>50-70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>165641</ARTG>
                <ARTG>165643</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS181</BillingCode>
            <Name>Endotak Reliance SG 4-SITE</Name>
            <Description>Passive fixation single coil defibrillation leads with ePTFE covered coil &amp; 4-SITE connector</Description>
            <Size>50-70</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>165642</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS183</BillingCode>
            <Name>Endotak Reliance 4-SITE</Name>
            <Description>Passive fixation dual coil defibrillation leads with 4-SITE connector</Description>
            <Size>50-70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>165643</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS261</BillingCode>
            <Name>RELIANCE 4-FRONT</Name>
            <Description>Passive, single/dual coil, defibrillation lead</Description>
            <Size>Length: 59cm - 70cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>303417</ARTG>
                <ARTG>217433</ARTG>
                <ARTG>217434</ARTG>
                <ARTG>217435</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI369</BillingCode>
            <Name>Medtronic Sprint Quattro 6946M Lead</Name>
            <Description>Passive fixation, tined, steroid eluting, quadripolar, dual coil defibrillation leads with silicone backfill and DF-4 connector, including MRI compatible models</Description>
            <Size>55-62 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>341671</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ245</BillingCode>
            <Name>Durata 7170Q, 7171Q and 7172Q</Name>
            <Description>7170Q/7171Q - passive fixation, bipolar, dual coil, 7172Q - passive fixation, bipolar - single coil steroid eluting endocardial defibrillation leads with Optim insulation overlay and SJ4 quadripolar lead connector</Description>
            <Size>52, 58 and 65cm, 7F introducer</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>170592</ARTG>
                <ARTG>170593</ARTG>
                <ARTG>170594</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ346</BillingCode>
            <Name>Optisure ICD Lead LDP210Q/220Q/230Q</Name>
            <Description>Passive fixation ICD lead with DF-4 connector.</Description>
            <Size>52cm-65cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>221013</ARTG>
                <ARTG>221037</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC002</BillingCode>
            <Name>Medtronic Sprint Quattro Lead Model 6944RV/SVC 65cm; Model 6944RV/SVC 75cm; or Model 6944RV/SVC 100cm; Medtronic Sprint Quattro Lead Model 6944RV/SVC 58cm</Name>
            <Description>Silicone and polyurethane</Description>
            <Size>65-100cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1741</GroupID>
            <ARTGs>
                <ARTG>142172</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS174</BillingCode>
            <Name>Endotak Reliance SG 4-SITE</Name>
            <Description>Active fixation single coil defibrillation leads with ePTFE covered coil &amp; 4-SITE connector.</Description>
            <Size>50-70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>165645</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS178</BillingCode>
            <Name>Endotak Reliance 4-SITE</Name>
            <Description>Active fixation dual coil defibrillation leads with 4-SITE connector</Description>
            <Size>50-70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>165639</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS179</BillingCode>
            <Name>Endotak Reliance S 4-SITE</Name>
            <Description>Active fixation single coil defibrillation leads &amp; 4-SITE connector</Description>
            <Size>50-70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>327981</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS182</BillingCode>
            <Name>Endotak Reliance 4-SITE</Name>
            <Description>Active fixation dual coil defibrillation leads with 4-SITE connector.</Description>
            <Size>50-70cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>165639</ARTG>
                <ARTG>165644</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS260</BillingCode>
            <Name>RELIANCE 4-FRONT</Name>
            <Description>Active, Single/Dual coil, defibrillation lead</Description>
            <Size>Length: 59cm -70cm</Size>
            <SupplierCode>AM</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>303416</ARTG>
                <ARTG>217430</ARTG>
                <ARTG>217431</ARTG>
                <ARTG>217432</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT212</BillingCode>
            <Name>Plexa ProMRI S</Name>
            <Description>Tripolar MR conditional ICD lead  with active fixation</Description>
            <Size>Diameter 7.8F ; Length 61cm, 65cm , 75cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>298187</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT213</BillingCode>
            <Name>Plexa ProMRI SD</Name>
            <Description>Quadripolar MR conditional ICD lead  with active fixation</Description>
            <Size>Diamter 7.8F , Length/Dist prox. shock coil to tip  61/16cm, 65/16cm, 65/18cm, 75/18cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>298343</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI033</BillingCode>
            <Name>Sprint Quattro Secure 6947M Lead</Name>
            <Description>Active fixation, true bipolar, dual coil defibrillation leads with silicone backfill and DF-4 connector</Description>
            <Size>45-110cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>191092</ARTG>
                <ARTG>191093</ARTG>
                <ARTG>236884</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI108</BillingCode>
            <Name>Sprint Quattro Secure S DF4</Name>
            <Description>Dexamethasone acetate and dexamethasone sodium phosphate steroid-eluting, tripolar, screw-in, ventricular lead with RV defibrillation coil electrode</Description>
            <Size>49 - 97 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>212486</ARTG>
                <ARTG>236885</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ230</BillingCode>
            <Name>Durata 7120Q, 7121Q and 7122Q</Name>
            <Description>7120/1Q - Adtive fixation, true bipolar; 7122Q - Active fixation true bipolar - single coil steroid eluting endocardial defibrillation leads with Optim insulation overlay and SJ4 quadripolar lead connector.</Description>
            <Size>52cm, 58cm and 65cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>170589</ARTG>
                <ARTG>170590</ARTG>
                <ARTG>170591</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ344</BillingCode>
            <Name>Optisure ICD Lead LDA210Q/220Q/230Q</Name>
            <Description>Active fixation ICD lead with DF-4 connector</Description>
            <Size>52cm-65cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <Suffix>e</Suffix>
            <ARTGs>
                <ARTG>221011</ARTG>
                <ARTG>221036</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS352</BillingCode>
            <Name>ENDOTAK RELIANCE SG Active</Name>
            <Description>Active Single coil with GORE ePTFE covered coils</Description>
            <Size>59-90cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>119322</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT209</BillingCode>
            <Name>Plexa ProMRI DF-1 S</Name>
            <Description>Tripolar MR conditional ICD lead&#xD;
with active fixation</Description>
            <Size>Diameter 7.8 F ; Length 65cm ,75cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>298206</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT210</BillingCode>
            <Name>Plexa ProMRI DF-1 SD</Name>
            <Description>Quadripolar MR conditional ICD lead&#xD;
with active fixation</Description>
            <Size>Diameter 7.8F ; Lengths/Dist.Prox Shock coil to Tip - 65/16cm, 65/18cm, 75/18cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>298207</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT211</BillingCode>
            <Name>Plexa ProMRI DF-1 S DX</Name>
            <Description>Pentapolar MR conditional ICD lead&#xD;
with active fixation</Description>
            <Size>Diameter 7.8F; Length/Dist Dipole to Tip  65/15 cm , 65/17 cm.</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>298208</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT245</BillingCode>
            <Name>Plexa ProMRI DF4 S DX</Name>
            <Description>Pentapolar MR conditional ICD lead  with active fixation  </Description>
            <Size>Diameter 7.8F; Length/Dist Dipole to Tip  65/15 cm , 65/17 cm.  </Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>329340</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC208</BillingCode>
            <Name>Medtronic Sprint Quattro Secure Lead Model 6947 (MRI SureScan)</Name>
            <Description>Leads, Defibrillator, Implantable, Silicone, polyurethane, platinized tantalum coils, steroid eluting tip, including MRI compatible versions</Description>
            <Size>58-100cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>286980</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC834</BillingCode>
            <Name>Sprint Quattro Secure S (MRI SureScan)</Name>
            <Description>Model 6935, Active Fixation Single Coil Defibrillation Lead, including MRI models</Description>
            <Size>52 - 100cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>286979</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ157</BillingCode>
            <Name>Durata 7120, 7121, 7122</Name>
            <Description>Active fixation bipolar, dual-coil/single coil Steroid-eluting Endocardial Defibrillation Leads</Description>
            <Size>60, 65, 75cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1743</GroupID>
            <ARTGs>
                <ARTG>159843</ARTG>
                <ARTG>159845</ARTG>
                <ARTG>159846</ARTG>
            </ARTGs>
            <MinimumBenefit>5994</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC027</BillingCode>
            <Name>Model 6721 Unipolar Epicardial Patch Leads S/M/L</Name>
            <Description>Model 6721S-50, Model 6721M-50, Model 6721L-50; Silicone</Description>
            <Size>370, 660, 840mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>242</SubCategoryID>
            <GroupID>1745</GroupID>
            <ARTGs>
                <ARTG>136183</ARTG>
            </ARTGs>
            <MinimumBenefit>1559</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS153</BillingCode>
            <Name>Myopore</Name>
            <Description>Bipolar sutureless myocardial pacing lead</Description>
            <Size>25-54cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1746</GroupID>
            <ARTGs>
                <ARTG>161123</ARTG>
            </ARTGs>
            <MinimumBenefit>1142</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC011</BillingCode>
            <Name>Capsure EPI steroid eluting bipolar epicardial lead Model 4968 - ventricle</Name>
            <Description>Silicone</Description>
            <Size>25 - 60cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1746</GroupID>
            <ARTGs>
                <ARTG>134287</ARTG>
            </ARTGs>
            <MinimumBenefit>1142</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ140</BillingCode>
            <Name>Myodex 1084T and FasTac Flex Lead Implant Tool</Name>
            <Description>Steroid -Eluting Bipolar Sutureless Myocardial Pacing Lead with Titanium Nitride Electrodes and Lead implant tool with articulating distal end.</Description>
            <Size>35cm and 54cm, Lead implant tool - 44cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1746</GroupID>
            <ARTGs>
                <ARTG>212854</ARTG>
            </ARTGs>
            <MinimumBenefit>1142</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC053</BillingCode>
            <Name>Capsure EPI steroid eluting unipolar epicardial lead Model 4965 ventricle</Name>
            <Description>Silicone</Description>
            <Size>25 - 50cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1747</GroupID>
            <ARTGs>
                <ARTG>134427</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC009</BillingCode>
            <Name>Medtronic Epicardial Pacing Leads IS-1 Model 5071</Name>
            <Description>Silicone</Description>
            <Size>25 - 53 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1748</GroupID>
            <ARTGs>
                <ARTG>136181</ARTG>
            </ARTGs>
            <MinimumBenefit>762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS133</BillingCode>
            <Name>Acuity Spiral</Name>
            <Description>Unipolar passive fixation</Description>
            <Size>80, 90 &amp; 100cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1751</GroupID>
            <ARTGs>
                <ARTG>155274</ARTG>
            </ARTGs>
            <MinimumBenefit>2078</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC052</BillingCode>
            <Name>Medtronic Capsure VDD2 Model 5038 AV Pacing Lead</Name>
            <Description>Silicone; Contents: 1 x lead with anchoring sleeve, stylet &amp; guide, 1 x vein lifter, 2 x fixation tools, extra stylets</Description>
            <Size>52cm, 58cm, 65cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <Suffix>k</Suffix>
            <ARTGs>
                <ARTG>142171</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS295</BillingCode>
            <Name>Ingevity</Name>
            <Description>Passive MR conditional pacing lead</Description>
            <Size>45cm to 59cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <ARTGs>
                <ARTG>263512</ARTG>
                <ARTG>263513</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS346</BillingCode>
            <Name>Fineline II Sterox IROX Lead</Name>
            <Description>Bipolar passive fixation</Description>
            <Size>52cm, 58cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <ARTGs>
                <ARTG>299176</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS347</BillingCode>
            <Name>Fineline II Sterox IROX Lead</Name>
            <Description>Bipolar, passive fixation</Description>
            <Size>45cm, 52cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <ARTGs>
                <ARTG>128060</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT163</BillingCode>
            <Name>Solia T</Name>
            <Description>Sub 6F, steoid-eluting transvenous, endocardial, bipolar passive-fixation lead MRI conditional</Description>
            <Size>Lengths: 53, 60cm; Diameter: 5.6Fr</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <ARTGs>
                <ARTG>224798</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT216</BillingCode>
            <Name>Solia JT</Name>
            <Description>Sub 6F, steroid-eluting, transvenous, endocardial, bipolar passive fixation lead. MRI conditional</Description>
            <Size>Lengths: 45, 53 cm; Diameter: 5.6Fr</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <ARTGs>
                <ARTG>294253</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC372</BillingCode>
            <Name>CapSure Sense MRI SureScan pacemaker leads Models 4074 &amp; 4574</Name>
            <Description>Bipolar, steroid, passive fixation pacing lead</Description>
            <Size>Model 4074:  52 - 58cm; Model 4574: 45 - 53cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <ARTGs>
                <ARTG>134331</ARTG>
                <ARTG>134426</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ146</BillingCode>
            <Name>Isoflex 1944T &amp; 1948T</Name>
            <Description>Passive-Fixation, Bipolar, Steriod Eluting, Endocardial Pacing Lead with Optim insulation</Description>
            <Size>46cm, 52cm, 58cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1753</GroupID>
            <ARTGs>
                <ARTG>159532</ARTG>
                <ARTG>159533</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC301</BillingCode>
            <Name>SelectSecure Model 3830 and SelectSecure MRI SureScan Model 3830</Name>
            <Description>Steroid eluting, bipolar, implantable, nonretractable screw-in, atrial/ventricular, catheter delivered, transvenous pacemaker lead.</Description>
            <Size>49-110 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <Suffix>j</Suffix>
            <ARTGs>
                <ARTG>131307</ARTG>
                <ARTG>301080</ARTG>
            </ARTGs>
            <MinimumBenefit>1732</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS296</BillingCode>
            <Name>Ingevity</Name>
            <Description>Active MR conditional pacing lead</Description>
            <Size>45cm to 59cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>263514</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS348</BillingCode>
            <Name>Fineline II EZ Sterox IROX Lead</Name>
            <Description>Bipolar, active fixation</Description>
            <Size>45cm, 52cm, 58cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>299177</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS390</BillingCode>
            <Name>Ingevity+</Name>
            <Description>Active MR conditional pacing lead</Description>
            <Size>45cm to 59cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>374841</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT123</BillingCode>
            <Name>Safio S</Name>
            <Description>Steroid eluting active fixation pacemaker lead with an electrically active extendable/ retractable screw for fixating the lead in the myocardium. The lead body is insulated in Silicone. The entire lead is conditionally safe to be used in a MRI system.</Description>
            <Size>Length: 53, 60cm; Diameter: 6.6F</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>188217</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT164</BillingCode>
            <Name>Solia S</Name>
            <Description>Sub 6F, steroid-eluting, transvenous, endocardial, bipolar active fixation lead with an extendable/retractable, electrically active screw. MRI conditional</Description>
            <Size>Lengths: 45, 53, 60cm; Diameter: 5.6Fr</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>224786</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC338</BillingCode>
            <Name>Medtronic Capsurefix Novus Model 5076 Pacing Lead</Name>
            <Description>Silicone; Contents: 1 x lead with anchoring sleeve, stylet &amp; guide, 1 x vein lifter, 2 x fixation tools, extra stylets</Description>
            <Size>45-85cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>134286</ARTG>
                <ARTG>236828</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC833</BillingCode>
            <Name>CapSureFix Novus Model 4076 Pacing Lead (MRI SureScan)</Name>
            <Description>Active fixation pacemaker lead, including MRI compatible models</Description>
            <Size>35 - 85cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>286952</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA184</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SonR tip PS55D Lead</Name>
            <Description>The SonR tip™ lead is an atrial endocardial pacemaker lead equipped with a hemodynamic sensor embedded in the tip of a straight, bipolar RA pacing lead&#xD;
· Unlike other automatic optimisation strategies, the signal recorded by&#xD;
the SonR sensor reflects global ventricular contractility&#xD;
· Optimisation by SonR is similar to continuous AV and VV optimisation&#xD;
by echocardiography.</Description>
            <Size>Length - 520mm, Diameter 2.6mm, 7.8 F</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>275553</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF044</BillingCode>
            <Name>VEGA Pacemaker Lead</Name>
            <Description>Bipolar endocardial pacemaker lead</Description>
            <Size>45cm, 52cm, and 58cm</Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>392590</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ129</BillingCode>
            <Name>Tendril ST 1882TC</Name>
            <Description>Endocardial Bi-polar Steroid-Eluting Active Fixation Pacing Leads</Description>
            <Size>46-65cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>143300</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ151</BillingCode>
            <Name>OptiSense Model 1999</Name>
            <Description>Active-Fixation Bipolar, Steroid Eluting, endocardial, atrial pacing lead with Optim insulation</Description>
            <Size>40, 46 &amp; 52cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>159534</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ238</BillingCode>
            <Name>Tendril STS 2088TC</Name>
            <Description>Endocardial Bi-polar Steroid-Eluting Active Fixation Pacing Leads</Description>
            <Size>34cm-100cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>170587</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ270</BillingCode>
            <Name>Tendril MRI LPA 1200M</Name>
            <Description>The Tendril MRI™ lead, Model LPA1200M, is an MR Conditional, bipolar, steroid-eluting, active fixation implantable pacing lead with Optim™  insulation.</Description>
            <Size>46cm, 52cm and 58cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1756</GroupID>
            <ARTGs>
                <ARTG>193132</ARTG>
            </ARTGs>
            <MinimumBenefit>831</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS292</BillingCode>
            <Name>ACUITY X4</Name>
            <Description>Left ventricular family of quad leads with four pacing and sensing electrodes. Three lead configurations offered to assist in LV lead placement and avoid phrenic nerve stimulation and high thresholds.</Description>
            <Size>86cm, 95cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <Suffix>j</Suffix>
            <ARTGs>
                <ARTG>235035</ARTG>
                <ARTG>235036</ARTG>
                <ARTG>235037</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ208</BillingCode>
            <Name>Quick Flex µ 1258T</Name>
            <Description>4F Bipolar Left Ventricular Pacing Lead</Description>
            <Size>75cm, 86cm, 92cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <Suffix>j</Suffix>
            <ARTGs>
                <ARTG>161391</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT185</BillingCode>
            <Name>Sentus ProMRI OTW QP L &amp; S</Name>
            <Description>Quadripolar, steroid eluting left ventricular lead with standard/short pole spacing's and fractal coating. IS4 Connector &amp; MRI Conditional for CRT</Description>
            <Size>Lengths: 77cm, 87 cm, 97cm 4.8F</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>272573</ARTG>
                <ARTG>272574</ARTG>
                <ARTG>312682</ARTG>
                <ARTG>312683</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC811</BillingCode>
            <Name>Attain Ability 4196 LV Lead/ Attain Ability SureScan 4196 MRI LV Lead</Name>
            <Description>Over the wire dual electrode left ventricular lead</Description>
            <Size>78, 88, and 103 cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>284518</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI013</BillingCode>
            <Name>Attain Ability Plus 4296/ Attain Ability Plus SureScan MRI 4296</Name>
            <Description>Over the wire electrode left ventricular lead</Description>
            <Size>78cm, 88cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>284542</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI014</BillingCode>
            <Name>Attain Ability Straight 4396/ Attain Ability Straight 4396 SureScan MRI</Name>
            <Description>Over the wire dual left ventricular lead</Description>
            <Size>78cm, 88cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>284541</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI129</BillingCode>
            <Name>Attain Performa Leads/ Attain Performa SureScan MRI Leads</Name>
            <Description>LV lead family with four electrodes and an IS4 connector for LV pacing w/premium and standard IS4 CRT-D devices. The Attain Perfoma™ Lead provides LV pacing options to avoid the following: phrenic nerve stimulation, high pacing thresholds, and ischemic tissue (including MRI versions)</Description>
            <Size>78, 88cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>284516</ARTG>
                <ARTG>284517</ARTG>
                <ARTG>284519</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI201</BillingCode>
            <Name>Attain stability lead</Name>
            <Description>Steroid eluting, active fixation, dual electrode, transvenous, guide wire delivered, cardiac vein pacing lead with an IS-1 connector</Description>
            <Size>88cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>279781</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI283</BillingCode>
            <Name>Attain Stability Quad MRI SureScan</Name>
            <Description>Steroid-eluting, quadripolar electrode, transvenous, over-the-wire, cardiac vein pacing lead with active fixation</Description>
            <Size>88 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>307331</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ243</BillingCode>
            <Name>Quartet</Name>
            <Description>Quadripolar, Left Ventricular Pacing Lead with Optim Lead Insulation</Description>
            <Size>75, 86 and 92cm, 5 French introducer</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>243</SubCategoryID>
            <GroupID>1759</GroupID>
            <ARTGs>
                <ARTG>171332</ARTG>
            </ARTGs>
            <MinimumBenefit>4156</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS334</BillingCode>
            <Name>Bipolar Lead Adaptor Models 6986, 4402, 4403</Name>
            <Description>Model 6986: Bipolar 3.2mm to IS-1; Model 4402: Bipolar IS-1 to Bipolar LV-1; Model 4403: Bipolar or Unipolar LV-1 to Bipolar or Unipolar IS-1</Description>
            <Size>14cm-17cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>244</SubCategoryID>
            <GroupID>1763</GroupID>
            <ARTGs>
                <ARTG>189952</ARTG>
                <ARTG>218790</ARTG>
            </ARTGs>
            <MinimumBenefit>333</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS335</BillingCode>
            <Name>Unipolar Lead Adaptor Models 6161, 6162</Name>
            <Description>Model 6161: 6mm Unipolar to IS-1; Model 6162: Split 5mm Unipolar to IS-1</Description>
            <Size>10cm-15cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>244</SubCategoryID>
            <GroupID>1763</GroupID>
            <ARTGs>
                <ARTG>189952</ARTG>
            </ARTGs>
            <MinimumBenefit>333</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI045</BillingCode>
            <Name>Adaptor Kits</Name>
            <Description>Lead adaptors</Description>
            <Size>10-50cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>244</SubCategoryID>
            <GroupID>1763</GroupID>
            <ARTGs>
                <ARTG>129420</ARTG>
                <ARTG>137315</ARTG>
            </ARTGs>
            <MinimumBenefit>333</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ393</BillingCode>
            <Name>Lead Adaptor Kit</Name>
            <Description>Lead adaptors/extender for ICD/Pacemakers</Description>
            <Size>one size per model</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>244</SubCategoryID>
            <GroupID>1763</GroupID>
            <ARTGs>
                <ARTG>131928</ARTG>
                <ARTG>160470</ARTG>
            </ARTGs>
            <MinimumBenefit>333</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS333</BillingCode>
            <Name>Bipolar Lead Extender Model 6987</Name>
            <Description>Bipolar 3.2mm to IS-1 lead extender</Description>
            <Size>45cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>245</SubCategoryID>
            <GroupID>1764</GroupID>
            <ARTGs>
                <ARTG>218790</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC831</BillingCode>
            <Name>Medtronic Lead Extender Kits</Name>
            <Description>Lead extenders</Description>
            <Size>10 - 50cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>245</SubCategoryID>
            <GroupID>1764</GroupID>
            <ARTGs>
                <ARTG>129420</ARTG>
                <ARTG>137315</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS212</BillingCode>
            <Name>Pacemaker/Defibrillator port safety plug</Name>
            <Description>Pacemaker/Defibrillator Plug that seals unused IS-1/DF-1 or IS-4/DF-4 port</Description>
            <Size>3.2mm x 38mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>190242</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS213</BillingCode>
            <Name>Lead Cap Kit</Name>
            <Description>Caps used to protect lead terminal connector pin</Description>
            <Size>4.75mm and 3.2mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>133934</ARTG>
                <ARTG>133935</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS336</BillingCode>
            <Name>Pacing Lead Suture Sleeve Models 6773, 6403, 4603</Name>
            <Description>Suture sleeves are used to secure and immobilise Pacing/ICD Leads</Description>
            <Size>One Size Only</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>132495</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT190</BillingCode>
            <Name>Biotronik BK &amp; BS Sealing Caps &amp; Blind Plugs</Name>
            <Description>BK BS Lead Sealing Caps  BS Device Blind Plugs</Description>
            <Size>BK-IS: IS1/DF1 Caps  BK-IS4/DF4:IS4/DF4 Caps  BS-IS4: BS-IS4 Blind Plugs  BS- IS1 Blind Plugs  BS- DF1 Blind Plugs</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>302014</ARTG>
                <ARTG>302015</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT217</BillingCode>
            <Name>Biotronik Lead Fixation Sleeves</Name>
            <Description>EFH Lead Fixation Sleeves</Description>
            <Size>EFH-7F,8F,16,20,22,25,27</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>250355</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI042</BillingCode>
            <Name>Medtronic Lead End Cap Kit Model: 5867-3M</Name>
            <Description>Lead End Cap Kit</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>131305</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI043</BillingCode>
            <Name>Medtronic DF-1 Port Pin Plug Kit: Model 6719; Medtronic IS-1 Port Pin Plug Kit: Model 6725</Name>
            <Description>DF-1 unipolar connector port pin plug, one per kit</Description>
            <Size>One size per model</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>132184</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI044</BillingCode>
            <Name>Medtronic Upsizing Sleeve: Model 5866-45, Model 5866-46</Name>
            <Description>5866-45: IS1 UNI Lead to 5/6mm UNI IPG; 5866-46: IS1 UNI Lead to 5mm UNI IPG or 5mm Bifurcated BI IPG</Description>
            <Size>18-25mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>129420</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ391</BillingCode>
            <Name>Pacemaker port safety plug</Name>
            <Description>Plug that seals unused IS-1, DF-1 and DF- 4 port</Description>
            <Size>one size per model</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>124950</ARTG>
                <ARTG>200956</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ392</BillingCode>
            <Name>Lead Cap Kit</Name>
            <Description>Caps used to protect lead terminal connector pin</Description>
            <Size>one size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1765</GroupID>
            <ARTGs>
                <ARTG>124950</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI195</BillingCode>
            <Name>TYRX Absorbable Antibacterial Envelope</Name>
            <Description>Antibacterial surgically implanted mesh envelope which stablises EID placement and prevents infection</Description>
            <Size>6.3 x 6.9cm, 7.4 x 8.5cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>246</SubCategoryID>
            <GroupID>1829</GroupID>
            <SubGroupID>6027</SubGroupID>
            <ARTGs>
                <ARTG>334380</ARTG>
            </ARTGs>
            <MinimumBenefit>867</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BE002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER375</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CRE8 Coronary Stent</Name>
            <Description>Coronary Artery Drug Eluting Stent</Description>
            <Size>The stent is available in 7 diameters: 2.25mm; 2.5mm; 2.75mm; 3.0mm; 3.5mm; 4.0mm; 4.5mm and 8 lengths: 8mm; 12mm; 16mm; 20mm; 25mm; 31mm; 38 mm and 46 mm.</Size>
            <SupplierCode>BE</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>230863</ARTG>
                <ARTG>230864</ARTG>
                <ARTG>230865</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BE003</BillingCode>
            <Name>CRE8 EVO</Name>
            <Description>Coronary Artery Drug Eluting Stent </Description>
            <Size>Stent Diameter (mm) 2.00, 2.25, 2.50, 2.75, 3.00, 3.50, 4.00, 4.50                           Stent Length(mm): 9, 13, 16, 20, 26, 33, 40, 46</Size>
            <SupplierCode>BE</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>347171</ARTG>
                <ARTG>347172</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS272</BillingCode>
            <Name>SYNERGY</Name>
            <Description>Everolimus-Eluting Platinum Chromium Coronary Stent System with Bioabsorbable Polymer</Description>
            <Size>8mm to 48mm in length, diameter of 2.25 mm - 5.0 mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>220361</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS273</BillingCode>
            <Name>PROMUS PREMIER</Name>
            <Description>Platinum chromium alloy stent coated with a blended polymer mixed with everolimus.</Description>
            <Size>8mm to 38mm in length, diameter of 2.25 mm - 4.0 mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>220360</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS366</BillingCode>
            <Name>Promus ELITE</Name>
            <Description>Everolimus-Eluting Platinum Chromium Coronary Stent System</Description>
            <Size>8mm - 38mm in length, diameter of 2.25mm - 4.0mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>327735</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS395</BillingCode>
            <Name>Synergy Megatron</Name>
            <Description>Everolimus-Eluting Platinum Chromium Coronary Stent System with Bioabsorbable Polymer</Description>
            <Size>8 mm to 32 mm in length, diameter of 3.50 mm - 5.00 mm (over expansion capability to 6.00 mm)</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>380476</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS397</BillingCode>
            <Name>SYNERGY XD</Name>
            <Description>Everolimus-Eluting Platinum Chromium Coronary Stent System with Bioabsorbable Polymer</Description>
            <Size>8mm to 48mm in length, diameter of 2.25 mm - 5.0 mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>365215</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT178</BillingCode>
            <Name>Orsiro</Name>
            <Description>Sirolimus Coronary Artery Stent, Drug Eluting Co/Cr Alloy coated in PLLA</Description>
            <Size>Stent diameters ø 2.25 -4.0mm Lengths: 9-40mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>220414</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT254</BillingCode>
            <Name>ORSIRO Mission</Name>
            <Description>Sirolimus Coronary Artery Stent, Drug Eluting Co/Cr Alloy coated in PLLA</Description>
            <Size>Stent diameters ø 2.25 - 4.0mm Lengths: 9-40mm  </Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>352490</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DO001</BillingCode>
            <Name>BioFreedom Drug Coated Coronary Stent System</Name>
            <Description>Coronary Artery Stent, Drug Coated</Description>
            <Size>Diameter: 2.25mm to 4.0mm&#xD;
Length: 8mm to 36mm</Size>
            <SupplierCode>DO</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>280282</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI189</BillingCode>
            <Name>Resolute Onyx Zotarolimus-Eluting Coronary Stent System</Name>
            <Description>coronary stent system; drug eluting</Description>
            <Size>diameter: 2mm to 5mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>263413</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RF037</BillingCode>
            <Name>Firehawk™</Name>
            <Description>Sirolimus - Eluting Coronary Stent System</Description>
            <Size>Length - 13mm - 38mm  Diameter -  2.25mm - 4.0mm </Size>
            <SupplierCode>RF</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>381401</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ434</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Xience PRIME LL Everolimus Eluting Coronary Stent; Xience PRIME Everolimus Eluting Coronary Stent;  Xience PRIME SV Everolimus Eluting Coronary Stent</Name>
            <Description>Coronary Artery Stent, Drug Eluting</Description>
            <Size>XIENCE PRIME LL 2.50; 2.75; 3.00; 3.50; 4.0 x 33MM;  XIENCE PRIME LL 2.50; 2.75; 3.00; 3.50; 4.0 x 38MM;  XIENCE PRIME SV 2.25 x 08; 12; 15; 18; 23; 28MM; XIENCE PRIME 2.50 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 2.75 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 3.00 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 3.50 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 4.00 x 08; 12; 15; 18; 23; 28MM</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>167859</ARTG>
                <ARTG>167879</ARTG>
                <ARTG>167878</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ435</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>XIENCE Xpedition Everolimus Eluting Coronary Stent System</Name>
            <Description>Coronary Artery Stent, Drug Eluting</Description>
            <Size>Xience Xpedition DES - 2.25 x (8,12,15,18,23,28) RX CE, 2.50 x (8,12,15,18,23,28,33,38,48) RX CE; 2.75 x (8,12,15,18,23,28,33,38,48) RX CE; 3.00 x (8,12,15,18,23,28,33,38,48) RX CE; 3.25 x (8,12,15,18,23,28,33,38) RX CE; 3.50 x (8,12,15,18,23,28,33,38,48) RX CE; 4.00 x (8,12,15,18,23,28,33,38) RX CE;</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>215603</ARTG>
                <ARTG>215602</ARTG>
                <ARTG>215604</ARTG>
                <ARTG>264373</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ436</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>XIENCE Alpine Everolimus Eluting Coronary Stent System</Name>
            <Description>Drug eluting coronary artery stent</Description>
            <Size>2.00 mm x (08, 12, 15, 18, 23, 28) mm  2.25 mm x (08, 12, 15, 18, 23, 28) mm  2.50 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  2.75 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  3.00 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  3.25 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  3.50 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  4.00 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>266175</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ437</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY047</PriorBillingCode>
            </PriorBillingCodes>
            <Name>XIENCE Sierra Everolimus Eluting Coronary Stent System</Name>
            <Description>Drug eluting coronary artery stent</Description>
            <Size>Diameter: 2.00mm to 4.0mm. Length: 8mm to 38mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>313811</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ478</BillingCode>
            <Name>XIENCE Skypoint Everolimus Eluting Coronary Stent System</Name>
            <Description>Drug eluting coronary artery stent</Description>
            <Size>stent diameters 2.0 - 4.0 mm in lengths 8 mm - 38 mm;  stent diameters 2.5 - 4.0 mm in 48 mm length</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>393511</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU064</BillingCode>
            <Name>Ultimaster Sirolimus Eluting Coronary Stent System</Name>
            <Description>The Ultimaster Sirolimus Eluting Coronary Stent System is a device/drug combination comprised of a Co-Cr stent coated with sirolimus in a matrix of poly(D,L-Lactide-co-Caprolactone), mounted on a balloon delivery catheter</Description>
            <Size>length 9-38mm; diameter 2.25-4.0mm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1766</GroupID>
            <SubGroupID>5346</SubGroupID>
            <ARTGs>
                <ARTG>288132</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT107</BillingCode>
            <Name>PRO-Kinetic Energy</Name>
            <Description>Balloon-expandable cobalt chromium (CoCr) stent. The stent surface is fully coated with amorphous hydrogen-rich silicon carbide (aSiC:H).</Description>
            <Size>Lengths: 8 - 40mm, Diameters: 2.0 - 5.0mm.</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1767</GroupID>
            <SubGroupID>5348</SubGroupID>
            <ARTGs>
                <ARTG>159908</ARTG>
            </ARTGs>
            <MinimumBenefit>583</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ438</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY028</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Multilink Coronary Stent System - Vision</Name>
            <Description>Cobalt chrome stent</Description>
            <Size>2.25mm to 4.0mm widths, 8mm to 38mm lengths</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1767</GroupID>
            <SubGroupID>5348</SubGroupID>
            <ARTGs>
                <ARTG>126481</ARTG>
                <ARTG>126482</ARTG>
            </ARTGs>
            <MinimumBenefit>583</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ439</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MULTI-LINK 8 Coronary Stent System, MULTI-LINK 8 SV Coronary Stent System and MULTI-LINK 8 LL Coronary Stent System</Name>
            <Description>The MULTI-LINK 8,  MULTI-LINK 8 SV, MULTI-LINK 8 LL Coronary Stent System (CSS) is comprised of two main components: the cobalt chromium (CoCr) stent and the balloon expandable delivery system.</Description>
            <Size>MULTI-LINK 8: Diam: 2.5, 2.75, 3.0, 3.5, 4.0mm, Stent Length: 8, 12, 15, 18, 23, 28mm; MULTI-LINK 8 SV CSS: Diam: 2.25mm, Stent Length: 8, 12, 15, 18, 23, 28mm; MULTI-LINK 8 LL CSS: Diam: 2.5, 2.75, 3.0, 3.5, 4.0mm, Stent Length: 33 and 38mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1767</GroupID>
            <SubGroupID>5348</SubGroupID>
            <ARTGs>
                <ARTG>174511</ARTG>
                <ARTG>176896</ARTG>
                <ARTG>174519</ARTG>
            </ARTGs>
            <MinimumBenefit>583</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT220</BillingCode>
            <Name>PK Papyrus Covered Coronary Stent System</Name>
            <Description>Highly flexible, low profile , polyurethane/CoCr Covered Coronary Stent System</Description>
            <Size>Length – 15,20,26mm     Diameter – 5F:2.5,3,3.5,4mm   6F:4.5,5mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1767</GroupID>
            <SubGroupID>5349</SubGroupID>
            <Suffix>l, m</Suffix>
            <ARTGs>
                <ARTG>307104</ARTG>
            </ARTGs>
            <MinimumBenefit>2146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY050</BillingCode>
            <Name>BeGraft Coronary Stent Graft System</Name>
            <Description>Coronary Stent Graft System</Description>
            <Size>Diameter: 2.50mm, 2.75mm, 3.00mm, 3.50mm, 4.00mm, 4.50mm, 5.00m  Length: 8mm, 12mm, 16mm, 18mm, 21mm, 24mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1767</GroupID>
            <SubGroupID>5349</SubGroupID>
            <Suffix>l, m</Suffix>
            <ARTGs>
                <ARTG>278654</ARTG>
            </ARTGs>
            <MinimumBenefit>2146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ440</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GRAFTMASTER RX Coronary Stent Graft</Name>
            <Description>Stainless Steel/PTFE</Description>
            <Size>16-26 mm x 2.8 - 4.8 mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>247</SubCategoryID>
            <GroupID>1767</GroupID>
            <SubGroupID>5349</SubGroupID>
            <Suffix>l, m</Suffix>
            <ARTGs>
                <ARTG>214226</ARTG>
            </ARTGs>
            <MinimumBenefit>2146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT270</BillingCode>
            <Name>GORE® CARDIOFORM Septal Occluder</Name>
            <Description>The GORE® CARDIOFORM Septal Occluder consists of an implantable occluder comprised of a platinum-filled nickel-titanium (Nitinol) wire frame covered with expanded polytetrafluoroethylene (ePTFE). The occluder is available in sizes of 15, 20, 25, and 30 mm.</Description>
            <Size>15mm Nominal Disc Diameter; 20mm Nominal Disc Diameter; 25mm Nominal  Disc Diameter; 30mm Nominal Disc Diameter</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>202817</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RP001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME196</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Figulla Flex II ASD Occluder</Name>
            <Description>Occlutech Flexx II ASD Occlusion device</Description>
            <Size>Figulla Flex II ASD Waist Ø (mm): Size 4,5,6,7.5,9,10.5,12,13.5,15,16.5,18,21,24,27,30,33,36,39,40</Size>
            <SupplierCode>RP</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>201602</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RP002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME197</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Figulla Flex II PFO Occluder</Name>
            <Description>The Figulla® Flex II PFO is an implant for closure of a patent foramen ovale (PFO) defect in the heart and is deployed via a minimally invasive catheter delivery system.  The Figulla® Flex PFO is intended for patients with substantiated Right-Left-Shunt in the contrast agent echocardiography under Valsalva maneuver and presence of a "cryptogenic", paradoxical thromboembolism.</Description>
            <Size>Figulla Flex II PFO Disc Ø (mm): 23/25, 16/18, 27/30, 31/35</Size>
            <SupplierCode>RP</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>201603</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ260</BillingCode>
            <Name>Amplatzer Duct Occluder</Name>
            <Description>Nitinol Wire Mesh</Description>
            <Size>5 - 24mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>134070</ARTG>
                <ARTG>345211</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ261</BillingCode>
            <Name>Amplatzer Septal Occluder</Name>
            <Description>Nitinol Wire Mesh</Description>
            <Size>4mm - 40mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>134067</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ262</BillingCode>
            <Name>Amplatzer Muscular VSD Occluder</Name>
            <Description>Nitinol Wire Mesh</Description>
            <Size>4 - 24mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>134071</ARTG>
                <ARTG>134072</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ263</BillingCode>
            <Name>Amplatzer PFO Occluder</Name>
            <Description>Nitinol Wire Mesh</Description>
            <Size>25mm &amp; 35mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>134069</ARTG>
                <ARTG>345213</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ264</BillingCode>
            <Name>Amplatzer Membranous VSD Occluder</Name>
            <Description>Nitinol wire mesh, double disc occluder and delivery system</Description>
            <Size>4-24mm, Length 7-10mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>134073</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ267</BillingCode>
            <Name>AMPLATZER Duct Occluder II</Name>
            <Description>Self expandable multiple Nitinol wire mesh PDA occlusion device</Description>
            <Size>Waist diameter 3-6mm, Nominal length 4-6mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <Suffix>o</Suffix>
            <ARTGs>
                <ARTG>154956</ARTG>
                <ARTG>348711</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RP003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME228</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Patent Ductus Arteriosus</Name>
            <Description>The Occlutech® PDA Occluder is an occlusion system, which is percutaneously implanted through a catheter intervention technique and intended for the non-surgical occlusion of  Patent Ductus Arteriosus (PDA)</Description>
            <Size>(PDA) with Standard Shank, D2 Ø 3.5mm, D3 Ø 5mm, D1 Ø 9mm, Length 4.25mm, Introducing System size 6FR;   (PDA) with Standard Shank, D2 Ø 4mm, D3 Ø 6mm, D1 Ø 10mm, Length 5mm, Introducing system size 6FR; (PDA) with Standard Shank, D2 Ø 5mm, D3 Ø 7mm, D1 Ø 11mm, Length 6.05mm, Introducing system size 6FR;   (PDA) with Standard Shank, D2 Ø 6mm, D3 Ø 8mm, D1 Ø 13mm, Length 6.30mm, Introducing system size 6FR;   (PDA) with Standard Shank, D2 Ø 8mm, D3 Ø 10mm, D1 Ø 16mm, Length 7mm, Introducing system size 7FR;   (PDA) with Standard Shank, D2 Ø 10mm, D3 Ø 12mm, D1 Ø 18mm, Length 12mm, Introducing system size 7FR;   (PDA) with Standard Shank, D2 Ø 12mm, D3 Ø 15mm, D1 Ø 20mm, Length 14mm, Introducing system size 8FR;   (PDA) with Standard Shank, D2 Ø 14mm, D3 Ø 18mm, D1 Ø 24mm, Length 16mm, Introducing system size 9FR;   (PDA) with Long Shank, D2 Ø 3.5mm, D3 Ø 5mm, D1 Ø 9mm, Length 7mm, Introducing system size 6FR; (PDA) with Long Shank, D2 Ø 4mm, D3 Ø 6mm, D1 Ø 10mm, Length 7.5mm, Introducing system size 6FR; (PDA) with Long Shank, D2 Ø 5mm, D3 Ø 7mm, D1 Ø 11mm, Length 8.5mm, Introducing system size 6FR; (PDA) with Long Shank, D2 Ø 6mm, D3 Ø 8mm, D1 Ø 13mm, Length 9mm, Introducing system size 6FR; (PDA) with Long Shank, D2 Ø 8mm, D3 Ø 10mm, D1 Ø 16mm, Length 10.5mm, Introducing system size 7FR.</Size>
            <SupplierCode>RP</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <ARTGs>
                <ARTG>219253</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ280</BillingCode>
            <Name>Amplatzer Duct Occluder II Additional Sizes</Name>
            <Description>Single use implantable transcatheter device for minimally invasive closure of Patent Ductus Arterious</Description>
            <Size>0.2cm-0.6cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <ARTGs>
                <ARTG>191422</ARTG>
                <ARTG>348712</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ429</BillingCode>
            <Name>Amplatzer Piccolo Occluder</Name>
            <Description>Single use implantable transcatheter device for minimally invasive closure of Patent Ductus Arteriosus</Description>
            <Size>0.2cm-0.6cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>1768</GroupID>
            <ARTGs>
                <ARTG>332782</ARTG>
            </ARTGs>
            <MinimumBenefit>7436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS332</BillingCode>
            <Name>WATCHMAN</Name>
            <Description>Left Atrial Appendage Closure Device</Description>
            <Size>21mm to 33mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>2181</GroupID>
            <ARTGs>
                <ARTG>216434</ARTG>
            </ARTGs>
            <MinimumBenefit>11269</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS384</BillingCode>
            <Name>WATCHMAN FLX</Name>
            <Description>Left Atrial Appendage Closure Device</Description>
            <Size>20mm to 35mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>2181</GroupID>
            <ARTGs>
                <ARTG>340173</ARTG>
            </ARTGs>
            <MinimumBenefit>11269</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ395</BillingCode>
            <Name>Amplatzer Left Atrial Appendage Closure Device</Name>
            <Description>Amplatzer Amulet Occluder, Amplatzer Cardiac Plug. Nitinol wire mesh</Description>
            <Size>16-34 mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>248</SubCategoryID>
            <GroupID>2181</GroupID>
            <ARTGs>
                <ARTG>216398</ARTG>
                <ARTG>345210</ARTG>
            </ARTGs>
            <MinimumBenefit>11269</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JI002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH581</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CP Stent</Name>
            <Description>CP Stent Uncovered, mounted on BIB balloon</Description>
            <Size>16,22,28,34,39,&amp;45mm length</Size>
            <SupplierCode>JI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>257</SubCategoryID>
            <GroupID>1804</GroupID>
            <Suffix>Balloon- in-Balloon</Suffix>
            <ARTGs>
                <ARTG>121892</ARTG>
            </ARTGs>
            <MinimumBenefit>2124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JI003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH579</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CP Stent</Name>
            <Description>CP Stent Uncovered</Description>
            <Size>16,22,28,34,39,&amp;45mm length</Size>
            <SupplierCode>JI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>257</SubCategoryID>
            <GroupID>1804</GroupID>
            <ARTGs>
                <ARTG>121892</ARTG>
            </ARTGs>
            <MinimumBenefit>1199</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JI004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH582</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CP Stent</Name>
            <Description>CP Stent Covered, mounted on BIB balloon</Description>
            <Size>16,22,28,34,39,&amp;45mm length</Size>
            <SupplierCode>JI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>257</SubCategoryID>
            <GroupID>1805</GroupID>
            <Suffix>Balloon-in-Balloon</Suffix>
            <ARTGs>
                <ARTG>121892</ARTG>
            </ARTGs>
            <MinimumBenefit>2923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JI005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH580</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CP Stent</Name>
            <Description>CP Stent Covered</Description>
            <Size>16,22,28,34,39,&amp;45mm length</Size>
            <SupplierCode>JI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>257</SubCategoryID>
            <GroupID>1805</GroupID>
            <ARTGs>
                <ARTG>121892</ARTG>
            </ARTGs>
            <MinimumBenefit>1998</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL063</BillingCode>
            <Name>Edwards SAPIEN 3 Transcatheter Heart Valve</Name>
            <Description>Transcatheter, balloon expanded aortic heart valve with Commander Delivery System</Description>
            <Size>20mm, 23mm, 26mm and 29mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>267</SubCategoryID>
            <GroupID>2641</GroupID>
            <ARTGs>
                <ARTG>284496</ARTG>
            </ARTGs>
            <MinimumBenefit>22932</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL067</BillingCode>
            <Name>Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System </Name>
            <Description>The Edwards SAPIEN 3 Ultra Transcatheter Heart Valve (THV) system is an Aortic transcatheter heart valve bioprosthesis, with stent-like framework. It  consists of the Edwards SAPIEN 3 Ultra transcatheter heart valves and delivery systems. The Edwards SAPIEN 3 Ultra Valve is comprised of a balloon-expandable, radiopaque, cobalt-chromium frame, trileaflet bovine pericardial tissue valve, and polyethylene terephthalate inner and outer fabric skirts. </Description>
            <Size> (mm) 20, 23, 26</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>267</SubCategoryID>
            <GroupID>2641</GroupID>
            <ARTGs>
                <ARTG>343715</ARTG>
            </ARTGs>
            <MinimumBenefit>22932</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI259</BillingCode>
            <Name>Medtronic CoreValve™ Evolut™ R transcatheter aortic valve</Name>
            <Description>Transcatheter aortic valve, self-expanding, re-sheath and/or complete recapture after partial deployment and redeployment</Description>
            <Size>23mm-34mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>267</SubCategoryID>
            <GroupID>2641</GroupID>
            <ARTGs>
                <ARTG>284003</ARTG>
            </ARTGs>
            <MinimumBenefit>22932</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI315</BillingCode>
            <Name>Medtronic CoreValve™ Evolut™ PRO transcatheter aortic valve</Name>
            <Description>Transcatheter aortic valve, self-expanding, re-sheath and/or complete recapture after partial deployment and redeployment</Description>
            <Size>23mm-29mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>267</SubCategoryID>
            <GroupID>2641</GroupID>
            <ARTGs>
                <ARTG>319850</ARTG>
            </ARTGs>
            <MinimumBenefit>22932</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ394</BillingCode>
            <Name>Portico transcatheter aortic valve</Name>
            <Description>Self-expanding transcatheter aortic tissue valve, nitinol stent, bovine valve</Description>
            <Size>23-29</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>267</SubCategoryID>
            <GroupID>2641</GroupID>
            <ARTGs>
                <ARTG>254835</ARTG>
            </ARTGs>
            <MinimumBenefit>22932</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ453</BillingCode>
            <Name>MitraClip mitral valve clip</Name>
            <Description>transmitral valve repair clip</Description>
            <Size>9-12mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>267</SubCategoryID>
            <GroupID>2952</GroupID>
            <SubGroupID>7365</SubGroupID>
            <ARTGs>
                <ARTG>309701</ARTG>
            </ARTGs>
            <MinimumBenefit>26386</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ460</BillingCode>
            <Name>MitraClip G4 system</Name>
            <Description>Transmitral valve repair clip, steerable guide catheter, clip delivery system</Description>
            <Size>9 - 12 mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>27</CategoryID>
            <SubCategoryID>267</SubCategoryID>
            <GroupID>2952</GroupID>
            <SubGroupID>7365</SubGroupID>
            <ARTGs>
                <ARTG>357023</ARTG>
            </ARTGs>
            <MinimumBenefit>26386</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE607</BillingCode>
            <Name>On-X Prosthetic Heart Valve</Name>
            <Description>Bileaflet Mechanical Heart Valve</Description>
            <Size>19-33mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>178</SubCategoryID>
            <GroupID>1497</GroupID>
            <ARTGs>
                <ARTG>123500</ARTG>
                <ARTG>123501</ARTG>
                <ARTG>123502</ARTG>
                <ARTG>123503</ARTG>
            </ARTGs>
            <MinimumBenefit>5275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC980</BillingCode>
            <Name>Open Pivot Heart Valve (Model 500FA)
Open Pivot Heart Valve (Model 500DM)</Name>
            <Description>Pyrolythic Carbon, Double Velour Polyester, Titanium</Description>
            <Size>16-33mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>178</SubCategoryID>
            <GroupID>1497</GroupID>
            <ARTGs>
                <ARTG>127419</ARTG>
                <ARTG>127478</ARTG>
            </ARTGs>
            <MinimumBenefit>5275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI124</BillingCode>
            <Name>Open Pivot Heart Valve AP360 - Mitral</Name>
            <Description>Supra-annular mechanical valve; Pyrolythic Carbon, Double Velour Polyester, Titanium</Description>
            <Size>Mitral: 16, 18, 20, 22, 24, 26,  28 and 30 mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>178</SubCategoryID>
            <GroupID>1497</GroupID>
            <ARTGs>
                <ARTG>219161</ARTG>
            </ARTGs>
            <MinimumBenefit>5275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI125</BillingCode>
            <Name>Open Pivot Heart Valve AP360 - Aortic</Name>
            <Description>Supra-annular mechanical valve; Pyrolythic Carbon, Double Velour Polyester, Titanium</Description>
            <Size>Aortic: 16, 18, 20, 22, 24, 26 and 28 mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>178</SubCategoryID>
            <GroupID>1497</GroupID>
            <ARTGs>
                <ARTG>219162</ARTG>
            </ARTGs>
            <MinimumBenefit>5275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA129</BillingCode>
            <Name>Optiform</Name>
            <Description>Mechanical Valve</Description>
            <Size>19mm to 33mm</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>178</SubCategoryID>
            <GroupID>1497</GroupID>
            <ARTGs>
                <ARTG>150082</ARTG>
            </ARTGs>
            <MinimumBenefit>5275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ037</BillingCode>
            <Name>Masters Series Heart Valve Mitral and Aortic - Expanded Cuff/Hemodynamic Plus</Name>
            <Description>Aortic Expanded Cuff, Aortic Hemodynamic Plus Cuff, Mitral hemodynamic Cuff, Aortic &amp; Mitral Rotatable Cuff</Description>
            <Size>Aortic Expanded 19 - 31mm, Aortic Hemodynamic 17 - 27mm, Mitral Hemodynamic 17 - 27mm, Rotable 17 - 33mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>178</SubCategoryID>
            <GroupID>1497</GroupID>
            <ARTGs>
                <ARTG>129879</ARTG>
                <ARTG>129925</ARTG>
                <ARTG>129926</ARTG>
            </ARTGs>
            <MinimumBenefit>5275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ317</BillingCode>
            <Name>Regent Prosthetic Heart Valve</Name>
            <Description>Standard Cuff</Description>
            <Size>Standard cuff - 17-23mm/25mm-29mm, Flex cuff - 17-23mm/25mm-29mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>178</SubCategoryID>
            <GroupID>1497</GroupID>
            <ARTGs>
                <ARTG>116294</ARTG>
            </ARTGs>
            <MinimumBenefit>5275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL056</BillingCode>
            <Name>Carpentier-Edwards PERIMOUNT Magna Mitral Bioprosthesis (Model: 7000TFX)</Name>
            <Description>Stented Bovine Pericardial Mitral Tissue Valve with a reduced profile height and assymetric sewing band design</Description>
            <Size>25mm, 27mm, 29mm, 31mm, 33mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>154459</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL058</BillingCode>
            <Name>Carpentier-Edwards PERIMOUNT Magna Ease Aortic Bioprosthesis (Model: 3300TFX)</Name>
            <Description>Stented Bovine Pericardial Aortic Tissue Valve with a reduced profile height</Description>
            <Size>19mm, 21mm, 23mm, 25mm, 27mm and 29mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>156355</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL064</BillingCode>
            <Name>Edwards INSPIRIS RESILIA Aortic Valve, Model 11500A</Name>
            <Description>A stented, trileaflet aortic valve, with leaflets comprised of RESILIA bovine pericardial tissue mounted on a flexible cobalt-chromium alloy frame (see Attachment 1 for product images).</Description>
            <Size>INSPIRIS RESILIA is available in tissue annulus/stent diameter sizes 19, 21, 23, 25, 27, and 29 mm.</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>308830</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC701</BillingCode>
            <Name>Mosaic Cinch, Aortic, Mitral</Name>
            <Description>Models 305cxx, 310cxx</Description>
            <Size>19mm - 35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>145761</ARTG>
                <ARTG>145762</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC950</BillingCode>
            <Name>Mosaic Ultra Cinch II</Name>
            <Description>Small Aortic Root Bioprosthesis</Description>
            <Size>19mm - 29mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>145761</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC962</BillingCode>
            <Name>Mosaic Cinch II</Name>
            <Description>Aortic Bioprosthesis</Description>
            <Size>19mm -29mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>145761</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ136</BillingCode>
            <Name>SJM Biocor Heart Valve</Name>
            <Description>Stented Porcine tissue valve</Description>
            <Size>Aortic Valves - Tissue Annulus Diameter - 21 - 29mm                                                                             Mitral Valves - Tissue Annulus Diameter - 25-35mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>155281</ARTG>
                <ARTG>155282</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ192</BillingCode>
            <Name>Epic Flexfit</Name>
            <Description>Triple-composite Bioprosthetic heart valve</Description>
            <Size>Aortic Valves 21-29mm tissue annulus diameter, 14-20mm total height. Mitral Valves 25-33mm tissue annulus diameter, 15-20mm total height.</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>164941</ARTG>
                <ARTG>164942</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ201</BillingCode>
            <Name>Epic FlexFit Supra</Name>
            <Description>Triple-composite Bioprosthetic heart valve for supra-annular placement in the aortic position</Description>
            <Size>Tissue Annulus Diameter - 19mm-23mm. Total Height 14mm-16mm.</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1499</GroupID>
            <ARTGs>
                <ARTG>164943</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL031</BillingCode>
            <Name>Carpentier-Edwards Perimount Pericardial Bioprosthesis - Models 2900/6900  Carpentier-Edwards Perimount Plus Pericardial Bioprosthesis Mitral - Model 6900P</Name>
            <Description>Carpentier-Edwards Pericardial Bioprosthesis. Composition: Bovine Pericardium; Elgiloy Alloy; Silicone Rubber, Polytetrafluoroethylene</Description>
            <Size>Models 2900/6900 19-33mm, Model 6900P 25, 27, 29, 31, 33mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1500</GroupID>
            <ARTGs>
                <ARTG>154064</ARTG>
                <ARTG>154073</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL039</BillingCode>
            <Name>Edwards Perimount Magna Model 3000</Name>
            <Description>Carpentier-Edwards Perimount Magna composition: Glutaraldehyde treated bovine pericardium/elgiloy wireform stent/polyester band/silicone rubber suture ring/polytetrafluoroethylene cloth/polyester cloth.</Description>
            <Size>19MM Aortic Pericardial Tissue Valve; 21MM Aortic Pericardial Tissue Valve; 23MM Aortic Pericardial Tissue Valve; 25MM Aortic Pericardial Tissue Valve; 27MM Aortic Pericardial Tissue Valve; 29MM Aortic Pericardial Tissue Valve</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1500</GroupID>
            <ARTGs>
                <ARTG>154072</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL060</BillingCode>
            <Name>Carpentier-Edwards PERIMOUNT Magna Mitral Ease Tissue Valve</Name>
            <Description>The Carpentenier-Edwards PERIMOUNT Magna Mitral Ease Tissue is comprised of Bovine Pericardial Tissue and is bioengineered to withstand the higher pressures encountered in the mitral position, whilst maximising implantation ease.</Description>
            <Size>25, 27, 29, 31, 33mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1500</GroupID>
            <ARTGs>
                <ARTG>196126</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI289</BillingCode>
            <Name>Avalus Aortic Valve Bioprosthesis</Name>
            <Description>Next generation aortic valve bovine bioprosthesis</Description>
            <Size>19-29mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1500</GroupID>
            <ARTGs>
                <ARTG>302460</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ284</BillingCode>
            <Name>Trifecta Valve</Name>
            <Description>Tri-leaflet, stented pericardial valve.</Description>
            <Size>19-29mm Annulus diameter and 15-20mm height</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1500</GroupID>
            <ARTGs>
                <ARTG>190630</ARTG>
            </ARTGs>
            <MinimumBenefit>4750</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC015</BillingCode>
            <Name>Freestyle bioprosthesis</Name>
            <Description>Models 995xx, 995MSxx</Description>
            <Size>19 - 35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1501</GroupID>
            <Suffix>p</Suffix>
            <ARTGs>
                <ARTG>145752</ARTG>
            </ARTGs>
            <MinimumBenefit>4845</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL062</BillingCode>
            <Name>EDWARDS INTUITY Elite Aortic Valve System</Name>
            <Description>Rapid Deployment Aortic Valve System</Description>
            <Size>19mm - 27mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1815</GroupID>
            <Suffix>b (bovine)</Suffix>
            <ARTGs>
                <ARTG>261673</ARTG>
            </ARTGs>
            <MinimumBenefit>8978</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JS001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA170</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Perceval S Sutureless Aortic Heart Valve</Name>
            <Description>Sutureless Aortic Pericardial Heart Valve</Description>
            <Size>S (19-21mm), M (21-23mm), L(23-25mm), XL (25-27mm)</Size>
            <SupplierCode>JS</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>179</SubCategoryID>
            <GroupID>1815</GroupID>
            <Suffix>b (bovine)</Suffix>
            <ARTGs>
                <ARTG>232485</ARTG>
            </ARTGs>
            <MinimumBenefit>8978</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC979</BillingCode>
            <Name>Open Pivot Aortic Valved Graft (Model 502AG)</Name>
            <Description>Pyrolythic Carbon, Double Velour Polyester, Titanium</Description>
            <Size>21- 33mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>180</SubCategoryID>
            <GroupID>1502</GroupID>
            <ARTGs>
                <ARTG>206262</ARTG>
            </ARTGs>
            <MinimumBenefit>6603</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ036</BillingCode>
            <Name>St Jude Medical Coated Aortic Valved Graft</Name>
            <Description>Coated Aortic Valved Graft </Description>
            <Size>21mm - 33mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>180</SubCategoryID>
            <GroupID>1502</GroupID>
            <ARTGs>
                <ARTG>133847</ARTG>
            </ARTGs>
            <MinimumBenefit>6603</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ104</BillingCode>
            <Name>SJM Masters Series Aortic Valved Prosthesis - VAVGJ</Name>
            <Description>St Jude Medical Mechanical Heart Valve sewn into the base of a woven polyester fibre graft which has been impregnated with bovine-derived gelatin</Description>
            <Size>Annulus Diameter 19-29mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>180</SubCategoryID>
            <GroupID>1502</GroupID>
            <ARTGs>
                <ARTG>133848</ARTG>
            </ARTGs>
            <MinimumBenefit>6603</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC012</BillingCode>
            <Name>Medtronic Hancock Valved Conduit Model 150</Name>
            <Description>Porcine bioprosthesis, dacron</Description>
            <Size>12, 14, 16, 18, 20, 22, 25, 30mm.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>180</SubCategoryID>
            <GroupID>1503</GroupID>
            <Suffix>p</Suffix>
            <ARTGs>
                <ARTG>145760</ARTG>
            </ARTGs>
            <MinimumBenefit>6460</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL068</BillingCode>
            <Name>KONECT RESILIA Aortic Valved Conduit</Name>
            <Description>KONECT RESILIA Aortic Valved Conduit is developed specifically for  bio-Bentall procedures. Edwards Lifesciences’ integrity preservation technology  transforms bovine pericardial tissue into RESILIA tissue, effectively eliminating free aldehydes, while protecting and preserving the tissue.  RESILIA tissue is the first to deliver the combination of Improved anti-calcification properties, Improved sustained hemodynamic performance and  Stored dry and ready to use.</Description>
            <Size>KONECT Valve   11060A 21 mm – 29 mm      Model Accessories  TRAY1190   Accessory tray  1190 Individual sizers 19 mm* – 29 mm  1190SET Sizer set  19 mm* – 29 mm  </Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>180</SubCategoryID>
            <GroupID>1503</GroupID>
            <Suffix>valve and conduit</Suffix>
            <ARTGs>
                <ARTG>387297</ARTG>
            </ARTGs>
            <MinimumBenefit>7642</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL028</BillingCode>
            <Name>Baxter Sterile Grafts, Implants &amp; Prostheses, Non-Animal Origin Annuloplasty: Ring-Mitral Ring with Holder; Mitral Cosgrove-Edwards Annuloplasty System Model 4600; Classic Annuloplasty Ring-Tricuspid</Name>
            <Description>Carpentier-Edwards Classic Annuloplasty Ring. Composition: Titanium Alloy; Silicone Rubber; Polyester Fabric Carpentier-Edwards Physio Annuloplasty Ring. Composition: Elgiloy Bands; Polyester Film Strips; Silicone Rubber; Polyester Cloth, Cosgrove-Edwards Annuloplasty Band. Composition: Silicone Rubber; Polyester Cloth. Carpentier-Edwards Tricuspid Ring. Composition: Titanium Alloy; Silicone Rubber; Polyester Fabric</Description>
            <Size>24mm-40mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1841</GroupID>
            <ARTGs>
                <ARTG>158660</ARTG>
                <ARTG>158661</ARTG>
                <ARTG>158662</ARTG>
                <ARTG>158663</ARTG>
            </ARTGs>
            <MinimumBenefit>2090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC005</BillingCode>
            <Name>Medtronic Duran Annuloplasty Ring; Duran Ancore Ring 620R; Duran Ancore Chordal Model 620RG</Name>
            <Description>Annuloplasty Devices - Models 610R &amp; 620R Silicone / Barium Sulphate, Dacron.</Description>
            <Size>Model 610R 25-35mm &amp; Model 620R 23-35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1841</GroupID>
            <ARTGs>
                <ARTG>135737</ARTG>
            </ARTGs>
            <MinimumBenefit>2090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI181</BillingCode>
            <Name>SIMULUS Flexible Annuloplasty Ring</Name>
            <Description>Flexible mitral/tricuspid annuloplasty ring</Description>
            <Size>Ring size (mm): 23, 25, 27, 29, 31, 33, 35, 37, 39</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1841</GroupID>
            <ARTGs>
                <ARTG>271813</ARTG>
            </ARTGs>
            <MinimumBenefit>2090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI182</BillingCode>
            <Name>SIMULUS Flexible Annuloplasty Band</Name>
            <Description>Flexible mitral/tricuspid annuloplasty band</Description>
            <Size>Band size (mm): 23, 25, 27, 29, 31, 33, 35, 37, 39</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1841</GroupID>
            <ARTGs>
                <ARTG>271814</ARTG>
            </ARTGs>
            <MinimumBenefit>2090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI192</BillingCode>
            <Name>Duran Ancore Band 620B</Name>
            <Description>Silicone / Barium Sulphate, Dacron</Description>
            <Size>23-35mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1841</GroupID>
            <ARTGs>
                <ARTG>135738</ARTG>
            </ARTGs>
            <MinimumBenefit>2090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SA127</BillingCode>
            <Name>AnnuloFlo Annuloplasty System</Name>
            <Description>Annuloflex Ring or AnnuloFlo Ring</Description>
            <Size>26-36mm</Size>
            <SupplierCode>SA</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1841</GroupID>
            <ARTGs>
                <ARTG>155662</ARTG>
            </ARTGs>
            <MinimumBenefit>2090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ035</BillingCode>
            <Name>SJM Tailor Annuloplasty Ring</Name>
            <Description>Fully Flexible</Description>
            <Size>25mm - 35mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1841</GroupID>
            <ARTGs>
                <ARTG>123490</ARTG>
            </ARTGs>
            <MinimumBenefit>2090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL049</BillingCode>
            <Name>McCarthy-Edwards IMR Etlogix Annuloplasty Ring (Model: 4100)</Name>
            <Description>Rigid mitral annuloplasty ring with an assymetric design</Description>
            <Size>24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>114193</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL050</BillingCode>
            <Name>Edwards MC3 Tricuspid Ring Annuloplalsty System (Model: 4900)</Name>
            <Description>3D rigid annuloplasty ring with a tricuspid specific design</Description>
            <Size>26mm, 28mm, 30mm, 32mm, 34mm, 36mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>118648</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL057</BillingCode>
            <Name>Geoform</Name>
            <Description>Geoform annuloplasty ring Model 4200 with Holder</Description>
            <Size>26, 28, 30 and 32mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>152587</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL059</BillingCode>
            <Name>Carpentier-Edwards PHYSIO ll Mitral Annuloplasty Ring</Name>
            <Description>PHYSIO II is a semi rigid mitral annuloplasty ring, with an improved saddle shape and global disease based design</Description>
            <Size>24, 26, 28, 30, 32, 34, 36, 38, 40mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>170274</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL061</BillingCode>
            <Name>Carpentier-Edwards Physio Tricuspid Annuloplasty Ring</Name>
            <Description>The Carpentier-Edwards Physio Tricuspid annuloplasty ring, model 6200 is intended for use in patients with tricuspid valvular insufficiency. Designed with selective flexibility and 3D waveform shape.</Description>
            <Size>24,  26, 28, 30, 32, 34, 36mm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>196111</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JS002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA189</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Memo 4D Mitral/tricuspid annuloplasty ring</Name>
            <Description>Memo 4D Mitral/tricuspid annuloplasty ring device is intended for correction of mitral insufficiencies or steno-insufficiencies. The use of the Memo 4D device is indicated for correction of congenital or acquired mitral insufficiencies with dilatation and deformation of the mitral annulus.</Description>
            <Size>Sizes 24,26,28,30, 32,34, 36, 38, 40, 42 mm</Size>
            <SupplierCode>JS</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>332851</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JS003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SA150</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Memo 3D Mitral Semirigid Annuloplasty Ring</Name>
            <Description>Memo 3D Semirigid Mitral Annuloplasty Ring with 3D flexibility and coated with Carbofilm with or without Rechord system</Description>
            <Size>24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm</Size>
            <SupplierCode>JS</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>176450</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC745</BillingCode>
            <Name>CG Future Composite Ring</Name>
            <Description>Semi-rigid mitral annuloplasty ring, with anterior flexibility</Description>
            <Size>24, 26, 28, 30, 32, 34, 36 &amp; 38mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>136236</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC844</BillingCode>
            <Name>Profile 3D Annuloplasty Ring</Name>
            <Description>3D, rigid annuloplasty ring with physiologic mitral valve shape</Description>
            <Size>Diameter (mm) 24 - 40mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>158457</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI121</BillingCode>
            <Name>Contour 3D Tricuspid Annuloplasty Ring</Name>
            <Description>Annuloplasty Ring: Titanium core encapsulated with silicone, covered with polyester fabric</Description>
            <Size>26, 28, 30 32, 34, 36mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>202774</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI183</BillingCode>
            <Name>SIMULUS Semi-Rigid Annuloplasty Ring</Name>
            <Description>Semi-rigid mitral annuloplasty ring</Description>
            <Size>Ring size (mm): 24, 26, 28, 30, 32, 34, 36, 38, 40</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>271812</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI184</BillingCode>
            <Name>SIMULUS Semi-Rigid Annuloplasty Band</Name>
            <Description>Semi-rigid mitral annuloplasty band</Description>
            <Size>Band size (mm): 24, 26, 28, 30, 32, 34, 36, 38, 40</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>271815</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI191</BillingCode>
            <Name>Colvin - Galloway Future Band Model 638B</Name>
            <Description>Semi-rigid metal alloy core, silicone coating, polyester knit fabric</Description>
            <Size>26-38mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>136235</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ087</BillingCode>
            <Name>St Jude Medical Rigid Saddle Ring</Name>
            <Description>Rigid Annuloplasty Ring</Description>
            <Size>24 - 34mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>181</SubCategoryID>
            <GroupID>1842</GroupID>
            <ARTGs>
                <ARTG>124255</ARTG>
            </ARTGs>
            <MinimumBenefit>2280</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX292</BillingCode>
            <Name>Supple Peri-Guard (4 x 4cm)</Name>
            <Description>Model No PC0404SN - 4 x 4cm Bovine pericardium patch</Description>
            <Size>4 x 4cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5452</SubGroupID>
            <ARTGs>
                <ARTG>152945</ARTG>
            </ARTGs>
            <MinimumBenefit>333</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER507</BillingCode>
            <Name>LeMaitre Xenosure Biologic Patch-Small, &lt; 25cm²</Name>
            <Description>The XenoSure Biologic Patch is a high-quality bovine pericardium&#xD;
patch used for vascular and cardiovascular reconstructions.</Description>
            <Size>0.8 x 8 cm Tapered Patch&#xD;
  1 x 6 cm   Rounded Patch&#xD;
  1 x 10 cm Tapered Patch&#xD;
  1.5 x 10 cm Tapered Patch&#xD;
  1 x 14 cm Tapered Patch&#xD;
  2 x 9 cm Rounded Patch&#xD;
  4 x 4 cm Square Patch&#xD;
  4 x 6 cm Rectangular Patch</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5452</SubGroupID>
            <ARTGs>
                <ARTG>310096</ARTG>
            </ARTGs>
            <MinimumBenefit>333</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX293</BillingCode>
            <Name>Supple Peri-Guard (6 x 8cm)</Name>
            <Description>Model No PC0608SN -6 x 8cm Bovine pericardium patch</Description>
            <Size>6 x 8cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5453</SubGroupID>
            <ARTGs>
                <ARTG>152945</ARTG>
            </ARTGs>
            <MinimumBenefit>523</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER508</BillingCode>
            <Name>LeMaitre Xenosure Biologic Patch-Medium, 25-75cm²</Name>
            <Description>The XenoSure Biologic Patch is a high-quality bovine pericardium patch used for vascular and cardiovascular reconstructions.</Description>
            <Size>6 x 8 cm Rectangular Patch&#xD;
  5 x 10 cm Rectangular Patch</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5453</SubGroupID>
            <ARTGs>
                <ARTG>310096</ARTG>
            </ARTGs>
            <MinimumBenefit>523</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX294</BillingCode>
            <Name>Supple Peri-Guard (10 x 16cm)</Name>
            <Description>Model No PC1016SN - 10 x 16 Bovine pericardium patch</Description>
            <Size>10 x 16cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5454</SubGroupID>
            <ARTGs>
                <ARTG>152945</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX295</BillingCode>
            <Name>Supple Peri-Guard (8 x 14cm)</Name>
            <Description>Nodel No PC0814SN - 8 x 14 Bovine pericardium patch</Description>
            <Size>8 x 14cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5454</SubGroupID>
            <ARTGs>
                <ARTG>152945</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EL033</BillingCode>
            <Name>Baxter Augmentation / Substitution Material, Human or Animal Origin, Sterile Pericardial Patch.</Name>
            <Description>Edwards Pericardial Patch. Bovine Pericardium.</Description>
            <Size>10cm x 15cm</Size>
            <SupplierCode>EL</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5454</SubGroupID>
            <ARTGs>
                <ARTG>154067</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER509</BillingCode>
            <Name>LeMaitre Xenosure Biologic Patch-Large, &gt;75cm²</Name>
            <Description>The XenoSure Biologic Patch is a high-quality bovine pericardium patch used for vascular and cardiovascular reconstructions.</Description>
            <Size>8 x 14 cm Rectangular Patch&#xD;
10 x 16 cm Rectangular Patch&#xD;
12 x 25 cm Rectangular Patch</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1507</GroupID>
            <SubGroupID>5454</SubGroupID>
            <ARTGs>
                <ARTG>310096</ARTG>
            </ARTGs>
            <MinimumBenefit>722</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT292</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GT271</PriorBillingCode>
                <PriorBillingCode>GT275</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GORE-TEX ® Cardiovascular Patch</Name>
            <Description>E-PTFE</Description>
            <Size>Cardiovascular Patch &lt; 75cm²</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1508</GroupID>
            <SubGroupID>4141</SubGroupID>
            <ARTGs>
                <ARTG>153255</ARTG>
                <ARTG>153256</ARTG>
            </ARTGs>
            <MinimumBenefit>228</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT293</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GT120</PriorBillingCode>
                <PriorBillingCode>GT121</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GORE-TEX ® Cardiovascular Patch</Name>
            <Description>E-PTFE</Description>
            <Size>Cardiovascular Patch ≥ 75cm²</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>182</SubCategoryID>
            <GroupID>1508</GroupID>
            <SubGroupID>4142</SubGroupID>
            <ARTGs>
                <ARTG>153255</ARTG>
                <ARTG>153256</ARTG>
            </ARTGs>
            <MinimumBenefit>495</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT122</BillingCode>
            <Name>Preclude Pericardial Membrane</Name>
            <Description>ePTFE</Description>
            <Size>0.1mm Thickness 6 x 12cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>183</SubCategoryID>
            <GroupID>1509</GroupID>
            <ARTGs>
                <ARTG>153241</ARTG>
            </ARTGs>
            <MinimumBenefit>342</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT274</BillingCode>
            <Name>Preclude Percardial Membrane</Name>
            <Description>ePTFE</Description>
            <Size>0.1mm Thickness, 12-16cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>183</SubCategoryID>
            <GroupID>1510</GroupID>
            <ARTGs>
                <ARTG>153241</ARTG>
            </ARTGs>
            <MinimumBenefit>611</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT125</BillingCode>
            <Name>Preclude Pericardial Membrane</Name>
            <Description>ePTFE</Description>
            <Size>0.1mm Thickness 15 x 20cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>183</SubCategoryID>
            <GroupID>1511</GroupID>
            <ARTGs>
                <ARTG>153241</ARTG>
            </ARTGs>
            <MinimumBenefit>1382</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ066</BillingCode>
            <Name>AtriClip Left Atrial Appendage Exclusion System</Name>
            <Description>Gillinov-Cosgrove LAA Clip for open occlusion of the left atrial appendage mounted on a disposable applier</Description>
            <Size>35mm, 40mm, 45mm, 50mm,</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>251</SubCategoryID>
            <GroupID>1790</GroupID>
            <ARTGs>
                <ARTG>308862</ARTG>
            </ARTGs>
            <MinimumBenefit>1097</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ041</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cardioroot</Name>
            <Description>Woven polyester vascular prosthesis, gelatin sealed</Description>
            <Size>Diameter 24mm - 34mm Length 15cm</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>1517</GroupID>
            <ARTGs>
                <ARTG>343016</ARTG>
            </ARTGs>
            <MinimumBenefit>2892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU036</BillingCode>
            <Name>Gelweave Valsalva Graft</Name>
            <Description>Woven vascular prosthesis, polyester, gelatin sealed</Description>
            <Size>Diameter 24 - 34 mm, Overall length 18.4 - 19.6cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>1517</GroupID>
            <ARTGs>
                <ARTG>125606</ARTG>
            </ARTGs>
            <MinimumBenefit>2892</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU038</BillingCode>
            <Name>Gelweave Graft</Name>
            <Description>Straight/Curved Thoracic Graft, with anteflo side branch, Polyester, woven, gelatin sealed</Description>
            <Size>20 -34 mm x 20-50 cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>1518</GroupID>
            <ARTGs>
                <ARTG>125606</ARTG>
            </ARTGs>
            <MinimumBenefit>1538</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU037</BillingCode>
            <Name>Gelweave Graft</Name>
            <Description>Multi Branched, for Aortic Arch reconstruction, Polyester, Woven, gelatin sealed</Description>
            <Size>10 - 34 mm x 10 - 60 cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>1519</GroupID>
            <ARTGs>
                <ARTG>125606</ARTG>
            </ARTGs>
            <MinimumBenefit>2043</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE612</BillingCode>
            <Name>E-vita open plus stentgraft system (with or without collar)</Name>
            <Description>Hybrid device consisting of a conventional vascular graft incorporated with and endovascular stent graft that allows treatment of the ascending aorta, the arch and the descending aorta, in one procedure.</Description>
            <Size>Overall length: 100-160mm. Vascular graft length 50-70mm; Stent graft length 80-240mm; Stent graft diameter 20-40mm; Collar width 2-40mm.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>1811</GroupID>
            <ARTGs>
                <ARTG>216894</ARTG>
            </ARTGs>
            <MinimumBenefit>19000</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JY001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IU002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>E-vita OPEN NEO</Name>
            <Description>The E-vita OPEN NEO straight graft configuration is a hybrid aortic arch device for the repair and replacement of the thoracic aorta using the frozen elephant trunk procedure which provides an alternative for conventional open surgery. The device is a one-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part that allows the open surgical treatment of aneurysms or dissections in the aortic arch and the descending thoracic aorta with or without involvement of the ascending aorta. One-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part, including a delivery system. The E-vita OPEN NEO implant consists of a self-expanding stent graft part, a conventional vascular graft part, and the delivery system.</Description>
            <Size>Stent graft, 20-40mm diameter, 120-180mm length : Vascular graft, 26-30mm diameter, 100mm length : Perfusion branch, 10mm diameter, 100mm length : Collar, 30mm width</Size>
            <SupplierCode>JY</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>1811</GroupID>
            <ARTGs>
                <ARTG>374560</ARTG>
            </ARTGs>
            <MinimumBenefit>19000</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JY002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>IU001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>E-vita OPEN NEO</Name>
            <Description>The E-vita OPEN NEO is a hybrid aortic arch device for the repair and replacement of the thoracic aorta using the frozen elephant trunk procedure which provides an alternative for conventional open surgery. The device is a one-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part that allows the open surgical treatment of aneurysms or dissections in the aortic arch and the descending thoracic aorta with or without involvement of the ascending aorta. It is available in a range of sizes with varying diameters and lengths and comes in three different configurations for individual supra-aortic vessel management. One-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part, including a delivery system. The E-vita OPEN NEO implant consists of a self expanding stent graft part, a conventional vascular graft part, and the delivery system.</Description>
            <Size>Stent graft, 20-40mm diameter, 120-180mm length : Vascular graft, 26-30mm diameter, 100mm length : Perfusion branch, 10mm diameter, 100mm length : Collar, 15mm width : Brachiocephalic trunk, 12 mm diameter, 100 mm length : Left common carotid artery, 8mm diameter, 100mm length : Left subclavian artery, 10mm diameter, 100mm length.</Size>
            <SupplierCode>JY</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>2601</GroupID>
            <ARTGs>
                <ARTG>374560</ARTG>
            </ARTGs>
            <MinimumBenefit>19430</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU068</BillingCode>
            <Name>Thoraflex™ Hybrid</Name>
            <Description>Thoraflex™ Hybrid device is a woven polyester prosthesis, with the addition of nitinol ring stents. &#xD;
&#xD;
The device is specifically designed for the treatment of aneurysm and/or dissection in the ascending thoracic aorta, aortic arch and descending thoracic aorta. Branches are provided to accommodate reconstruction of the major aortic branch vessels and intra-operative attachment of a perfusion cannula during cardio-pulmonary bypass where antegrade perfusion techniques are employed. &#xD;
&#xD;
The stented section of the graft enables treatment of the diseased descending thoracic aorta in a single-stage procedure without the need to anastamose a stented and unstented prostheses together.&#xD;
&#xD;
Thoraflex Hybrid™ device has been impregnated with an absorbable protein. The aim of the impregnation is to provide a polyester vascular prosthesis which does not require pre-clotting. The protein is a bovine gelatin which has been cross-linked to a set level to control its rate of removal. It serves in place of fibrin, which seals the polyester prosthesis during normal pre-clotting. The gelatin is hydrolyzed within approximately 14 days and is replaced by normal tissue incorporation. Gelatin has been chosen as it is a non-toxic protein, a fact which is reflected by its extensive use as a safe plasma expander.</Description>
            <Size>The stent graft comes in two nominal lengths (100mm or 150mm) with different inner vessel (ID) and outside vessel OD graft diameters (mm).  &#xD;
&#xD;
There are 40 catalogue items with the above combinations&#xD;
&#xD;
&#xD;
Overall length: 340-390 mm. &#xD;
Vascular graft length 240 mm; &#xD;
Stent graft length 100-150 mm; &#xD;
Stent graft diameter 20-40 mm; &#xD;
Collar width 12 mm;</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>2601</GroupID>
            <ARTGs>
                <ARTG>307356</ARTG>
                <ARTG>307357</ARTG>
            </ARTGs>
            <MinimumBenefit>19430</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU048</BillingCode>
            <Name>Gelweave Graft</Name>
            <Description>Straight Polyester Woven</Description>
            <Size>6-38mm x 15-20cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>2957</GroupID>
            <SubGroupID>7369</SubGroupID>
            <ARTGs>
                <ARTG>125606</ARTG>
            </ARTGs>
            <MinimumBenefit>590</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU047</BillingCode>
            <Name>Gelweave Graft</Name>
            <Description>Straight Polyester Woven</Description>
            <Size>6-38mm x 25-40cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>2957</GroupID>
            <SubGroupID>7370</SubGroupID>
            <ARTGs>
                <ARTG>125606</ARTG>
            </ARTGs>
            <MinimumBenefit>632</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU023</BillingCode>
            <Name>Gelweave Graft</Name>
            <Description>Straight, Polyester, Woven</Description>
            <Size>6-38mm x 50-60cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>186</SubCategoryID>
            <GroupID>2957</GroupID>
            <SubGroupID>7371</SubGroupID>
            <ARTGs>
                <ARTG>125606</ARTG>
            </ARTGs>
            <MinimumBenefit>749</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY688</BillingCode>
            <Name>Sternal ZipFix System</Name>
            <Description>Sternal Closure Tie with Needle</Description>
            <Size>One Size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>252</SubCategoryID>
            <GroupID>1791</GroupID>
            <ARTGs>
                <ARTG>187295</ARTG>
            </ARTGs>
            <MinimumBenefit>124</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI316</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>CQ001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HeartWare Ventricular Assist System</Name>
            <Description>Implant and patient sets include: 1. The HVAD pump, the HVAD strain relief, the HVAD sewing ring, and the HVAD driveline Cap; 2. The HVAD pump surgical tools; 3. the HVAD pump outflow graft; 4. the HVAD driveline extension cable; 5. The HVAD controller kits (2); 6. The DC adapter, the battery charger and the batteries (4); and 7. Shower bag, patient pack, shoulder pack and waist pack.</Description>
            <Size>n/a</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1819</GroupID>
            <ARTGs>
                <ARTG>181875</ARTG>
            </ARTGs>
            <MinimumBenefit>95000</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ401</BillingCode>
            <Name>HeartMate 3 Implant Kit</Name>
            <Description>Left ventricular assist device</Description>
            <Size>one size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1819</GroupID>
            <ARTGs>
                <ARTG>300895</ARTG>
            </ARTGs>
            <MinimumBenefit>95000</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ384</BillingCode>
            <Name>HeartMate II Left Ventricular Assist System - System Controller</Name>
            <Description>System controller</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1830</GroupID>
            <SubGroupID>6028</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>172007</ARTG>
            </ARTGs>
            <MinimumBenefit>4275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ396</BillingCode>
            <Name>HeartMate 3 System Controller</Name>
            <Description>System Controller</Description>
            <Size>One size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1830</GroupID>
            <SubGroupID>6028</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>289763</ARTG>
            </ARTGs>
            <MinimumBenefit>4275</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI221</BillingCode>
            <Name>HeartWare ® Battery Charger</Name>
            <Description>HeartWare ® Battery Charger</Description>
            <Size>one size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1830</GroupID>
            <SubGroupID>6030</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>277518</ARTG>
            </ARTGs>
            <MinimumBenefit>2296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI234</BillingCode>
            <Name>HeartWare ® Battery</Name>
            <Description>HeartWare ® Battery</Description>
            <Size>one size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1830</GroupID>
            <SubGroupID>6030</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>277233</ARTG>
            </ARTGs>
            <MinimumBenefit>2296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ385</BillingCode>
            <Name>HeartMate Left Ventricular Assist System - Battery Set</Name>
            <Description>Rechargeable HeartMate specific batteries</Description>
            <Size>One size only, set of 4</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1830</GroupID>
            <SubGroupID>6030</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>167134</ARTG>
            </ARTGs>
            <MinimumBenefit>2296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ400</BillingCode>
            <Name>HeartMate Left Ventricular System - Battery Charger</Name>
            <Description>Battery Charger for HeartMate Batteries</Description>
            <Size>one size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1830</GroupID>
            <SubGroupID>6030</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>167132</ARTG>
            </ARTGs>
            <MinimumBenefit>2296</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ375</BillingCode>
            <Name>HeartMate Left Ventricular Assist System - Battery Clip Set</Name>
            <Description>Battery clip set</Description>
            <Size>one size only</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1830</GroupID>
            <SubGroupID>6032</SubGroupID>
            <ARTGs>
                <ARTG>167134</ARTG>
            </ARTGs>
            <MinimumBenefit>1520</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ381</BillingCode>
            <Name>HeartMate II Left Ventricular Assist System - Stabilization Belt</Name>
            <Description>Fabric belt for Stabilizing percutaneous lead</Description>
            <Size>Small / medium; set of 2 &#xD;
large; set of 2</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6031</SubGroupID>
            <Suffix>No suffix</Suffix>
            <ARTGs>
                <ARTG>221217</ARTG>
            </ARTGs>
            <MinimumBenefit>95</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI224</BillingCode>
            <Name>HeartWare ® Shoulder pack</Name>
            <Description>HeartWare ® Shoulder pack</Description>
            <Size>one size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6033</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>277524</ARTG>
            </ARTGs>
            <MinimumBenefit>328</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI239</BillingCode>
            <Name>HeartWare ® Waist Pack</Name>
            <Description>HeartWare ® Waist Pack</Description>
            <Size>one size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6033</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>277523</ARTG>
            </ARTGs>
            <MinimumBenefit>328</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ382</BillingCode>
            <Name>HeartMate II Left Ventricular Assist System - Modular Belt</Name>
            <Description>Modular belt to hold System Controller and Batteries</Description>
            <Size>Small / Medium &#xD;
Large</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6033</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>272795</ARTG>
            </ARTGs>
            <MinimumBenefit>328</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ399</BillingCode>
            <Name>Heart Mate 3 Holster Vest</Name>
            <Description>Holster Vest</Description>
            <Size>Small, medium and large</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6033</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>272795</ARTG>
            </ARTGs>
            <MinimumBenefit>328</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI220</BillingCode>
            <Name>HeartWare ® Shower bag</Name>
            <Description>HeartWare ® Shower bag</Description>
            <Size>one size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6034</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>277522</ARTG>
            </ARTGs>
            <MinimumBenefit>428</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ380</BillingCode>
            <Name>HeartMate II Left Ventricular Assist System - Shower Bag</Name>
            <Description>Shower Bag</Description>
            <Size>One size only; set of 2</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6034</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>272795</ARTG>
            </ARTGs>
            <MinimumBenefit>428</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ397</BillingCode>
            <Name>Heart Mate 3 Shower Bag</Name>
            <Description>Shower Bag</Description>
            <Size>One size only; set of 2</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>259</SubCategoryID>
            <GroupID>1831</GroupID>
            <SubGroupID>6034</SubGroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>272795</ARTG>
            </ARTGs>
            <MinimumBenefit>428</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI472</BillingCode>
            <Name>Pectus Bar</Name>
            <Description>Pectus Bar, Stainless Steel</Description>
            <Size>80-432mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>264</SubCategoryID>
            <GroupID>1824</GroupID>
            <ARTGs>
                <ARTG>149413</ARTG>
            </ARTGs>
            <MinimumBenefit>1193</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE620</BillingCode>
            <Name>Park Modified Pectus Bar</Name>
            <Description>Park Modified Pectus bar available in titanium alloy and stainless steel</Description>
            <Size>6" - 152mm, 7" - 178mm, 8" - 203mm, 9" - 228mm, 10" - 254mm, 11" - 279mm, 12" - 305mm, 13" - 330mm, 14" - 356mm, 15" = 381mm, 16" - 406mm, 17" - 432mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>264</SubCategoryID>
            <GroupID>1824</GroupID>
            <SubGroupID>6012</SubGroupID>
            <ARTGs>
                <ARTG>317581</ARTG>
            </ARTGs>
            <MinimumBenefit>1193</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI483</BillingCode>
            <Name>Pectus Bar</Name>
            <Description>Stabilizer, Triangular or Elongated, Stainless Steel</Description>
            <Size>One size only</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>264</SubCategoryID>
            <GroupID>1825</GroupID>
            <ARTGs>
                <ARTG>149413</ARTG>
            </ARTGs>
            <MinimumBenefit>480</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE621</BillingCode>
            <Name>Park Pectus Hinge Plate Stabiliser</Name>
            <Description>Stabilisation of Pectus Bar - optional use in asymmetric or adult pectus excavatum to prevent bar displacement stripping of intercostal muscles</Description>
            <Size>65mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>264</SubCategoryID>
            <GroupID>1825</GroupID>
            <SubGroupID>6013</SubGroupID>
            <ARTGs>
                <ARTG>317581</ARTG>
            </ARTGs>
            <MinimumBenefit>480</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE622</BillingCode>
            <Name>Park Bridge Stabiliser</Name>
            <Description>Stablisation of Pectus Bar - optional use for multiple bar placement</Description>
            <Size>3 sizes: 6 hole - 60mm, 8 hole 80mm, 10 hole - 100mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>264</SubCategoryID>
            <GroupID>1825</GroupID>
            <ARTGs>
                <ARTG>224584</ARTG>
            </ARTGs>
            <MinimumBenefit>480</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE623</BillingCode>
            <Name>Park Claw Fixator, Clip and Nut Stabiliser</Name>
            <Description>Stabilisation of Pectus Bar</Description>
            <Size>Park Claw Fixator - Small (20mm x 12mm), Medium (23mm x 15mm), Large (25mm x 18mm), Extra Large (30mm x 18mm).&#xD;
Fixator Clip - 15mm.&#xD;
Nut - 7mm.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>264</SubCategoryID>
            <GroupID>1825</GroupID>
            <ARTGs>
                <ARTG>224584</ARTG>
            </ARTGs>
            <MinimumBenefit>480</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE624</BillingCode>
            <Name>Chord-X</Name>
            <Description>ePTFE chordal repair</Description>
            <Size>Five (5) loop lengths -(0mm/adjustable, 12mm, 16mm, 20mm and 24mm),&#xD;
Two (2) sutures (2-0 ePTFE or 3-0 ePTFE),&#xD;
Two (2) needle shapes (1/2 circle and 3/8 circle),&#xD;
Two (2) needle lengths (18mm and 22mm).</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>20</CategoryID>
            <SubCategoryID>265</SubCategoryID>
            <GroupID>1828</GroupID>
            <Suffix>No Suffix</Suffix>
            <ARTGs>
                <ARTG>262630</ARTG>
            </ARTGs>
            <MinimumBenefit>256</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA218</BillingCode>
            <Name>Lifestent Valeo</Name>
            <Description>Stainless Steel Balloon Expandable Peripheral Stent</Description>
            <Size>6-10mm diameter 17-56mm length</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>161500</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB244</BillingCode>
            <Name>Coroflex Blue</Name>
            <Description>Cobalt Chromium Alloy L605</Description>
            <Size>2-4mm diameter, 8-25mm length</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>112447</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS059</BillingCode>
            <Name>Express Vascular LD Stent; Express Vascular SD Stent</Name>
            <Description>Stainless Steel, Balloon Expanding Stent</Description>
            <Size>Stent Diameters up to 10mm and lengths up to 60mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>153169</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT094</BillingCode>
            <Name>Dynamic</Name>
            <Description>PTA Balloon Expandable Stent</Description>
            <Size>Diameters: 5-10mm, Lengths: 15, 25, 38, 56mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>209440</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT249</BillingCode>
            <Name>Dynetic-35 Peripheral Balloon-Expandable Stent System</Name>
            <Description> Dynetic-35 is a balloon-expandable  cobalt chromium alloy (L-605) stent pre-mounted on an over-the-wire PTA balloon catheter delivery system.</Description>
            <Size>Diameter: 5-10mm; Length: 18-78mm; Catheter length: 90-170 cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>209440</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Palmaz Genesis Peripheral Stent on Opta Pro (Medium)</Name>
            <Description>Stainless steel balloon expandable stent mounted on an Opta Pro Balloon</Description>
            <Size>Diameter 4-8mm, length 12-39mm</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>188675</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Palmaz Blue .014 Renal Stent System (on Aviator Plus)</Name>
            <Description>CoCr balloon expandable stent</Description>
            <Size>12, 15, 18, 24mm Lengths  40, 50, 60, 70mm diameters  80, 142cm shaft lengths</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>190149</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Palmaz Genesis Peripheral Stent on Opta Pro (Large)</Name>
            <Description>Stainless steel balloon expandable stent mounted on an Opta Pro Balloon.</Description>
            <Size>Diameter 4-12mm, length 11-79mm</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>188675</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PALMAZ® BLUE™ .018 Peripheral Stent System</Name>
            <Description>L605 Cobalt Chromium Alloy Balloon Expandable Stent</Description>
            <Size>12, 15, 18, 24mm length 4, 5, 6, 7mm diameter</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>187122</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ441</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Omnilink Stainless Steel Balloon Deployable Peripheral Stent</Name>
            <Description>Stainless Steel Balloon Expandable Peripheral Stent on 018/035 system</Description>
            <Size>018 &amp; 035 system: 5-10mm diameter by 12, 16, 18, 28, 38, 58mm length</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>146848</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ442</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Omnilink Elite Vascular Balloon-Expandable Stent System</Name>
            <Description>Omnilink Elite Vascular Balloon-Expandable Stent System is a balloon- expandable stent system  indicated for the treatment of atherosclerotic iliac artery lesions with reference vessel diameters of ≥ 5.0 mm and ≤ 11.0 mm, and lesion lengths up to 50 mm.</Description>
            <Size>6.0mm x (12,16,19,29,39,59)mm x 80cm                       7.0mm x (12,16,19,29,39,59)mm x 80cm                      8.0mm x (19,29,39,59)mm x 80cm                                 9.0mm x (19,29,39,59)mm x 80cm                                10.0mm x (19,29,39,59)mm x 80cm                              6.0mm x (12, 16,19,29,39,59)mm x 135cm                 7.0mm x (12, 16,19,29,39,59)mm x 135cm                  8.0mm x (19,29,39,59)mm x 135cm                              9.0mm x (19,29,39,59)mm x 135cm                              10.0mm x (19,29,39,59)mm x 135cm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>269609</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ464</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cobalt Chromium Balloon Expandable Peripheral Stent</Name>
            <Description>Cobalt Chromium</Description>
            <Size>Diameter 4-10mm, Length 12-58mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>146848</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VD004</BillingCode>
            <Name>NEFRO-C Renal Stent with Delivery System</Name>
            <Description>The NEFRO-C Renal Stent with Delivery System is intended to be implanted in the renal artery to maintain its patency and improve its luminal diameter for the treatment of atherosclerotic, radiation-induced, and posttraumatic lesions resulting in arteriostenosis of haemodynamic importance and which are intractable otherwise.   The device consists of a cobalt-chromium alloy L605 stent pre-loaded on a balloon catheter.</Description>
            <Size>Stent diameter: 5-7mm  Stent Length: 8-25</Size>
            <SupplierCode>VD</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>316764</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VD005</BillingCode>
            <Name>NEPTUN C Peripheral Stent with Delivery System</Name>
            <Description>The NEPTUN C Peripheral Stent with Delivery System is intended for use in percutaneous intravascular implantation in patients with atherosclerotic, radiation-induced and posttraumatic lesions causing peripheral vessel stenosis of hemodynamic significance and intractable in other forms of treatment.The device consists of a cobalt-chromium alloy L605 stent pre-loaded on a balloon  catheter.</Description>
            <Size>Stent Diameter: 2-12mm  Stent Length: 8-100mm  Delivery Catheter Length: 80-135cm  Guidewire Diameter: 0.014"-0.035"</Size>
            <SupplierCode>VD</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4439</SubGroupID>
            <ARTGs>
                <ARTG>316765</ARTG>
            </ARTGs>
            <MinimumBenefit>1335</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY029</BillingCode>
            <Name>Sinus-XL Stent ≥25mm Ø</Name>
            <Description>Self-expanding Nitinol stent</Description>
            <Size>Diameter: 25mm to 36mm&#xD;
Length: 30 to 100mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <Suffix>LD (large diameter, &gt;25mm)</Suffix>
            <ARTGs>
                <ARTG>187326</ARTG>
            </ARTGs>
            <MinimumBenefit>2519</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS189</BillingCode>
            <Name>Protege GPS Peripheral and Carotid Stents</Name>
            <Description>Protege RX Peripheral Stent&#xD;
Protege RX Carotid Stent</Description>
            <Size>Diameter 6-10mm Length 20mm - &lt;150mm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>124533</ARTG>
                <ARTG>124534</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS194</BillingCode>
            <Name>EverFlex Peripheral Stent</Name>
            <Description>EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system.</Description>
            <Size>Diameter 5-8, Length 20-120mm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>151132</ARTG>
                <ARTG>215979</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA178</BillingCode>
            <Name>Peripheral Vascular Bare Metal Stent</Name>
            <Description>Nitonol self expanding stent</Description>
            <Size>4mm - 14mm diameters,&#xD;
2cm - 12cm lengths</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>52136</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA216</BillingCode>
            <Name>Lifestent</Name>
            <Description>Lifestent cut nitinol self expanding stent</Description>
            <Size>6-10mm diameter 20mm-120mm length</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>160453</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA271</BillingCode>
            <Name>Bard Venous Stent</Name>
            <Description>Self Expanding Venous Stent</Description>
            <Size>Length: &lt;150mm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>277403</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS056</BillingCode>
            <Name>Carotid WALLSTENT</Name>
            <Description>Elgiloy self expanding stent</Description>
            <Size>Stent diameters up to 10mm and lengths up to 40mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>166856</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS137</BillingCode>
            <Name>EPIC Nitinol Stent</Name>
            <Description>Nitinol self expanding stent</Description>
            <Size>Stent diameters up to 14mm and lengths up to 120mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>104281</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS196</BillingCode>
            <Name>Innova Self-Expanding Stent</Name>
            <Description>Nitinol, self expanding stent</Description>
            <Size>Diameters up to 8mm, lengths less than 150mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>104281</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT103</BillingCode>
            <Name>Astron Pulsar</Name>
            <Description>Astron Pulsar is a 4F compatible, Nitinol self expanding stent (OTW design) used to treat peripheral vessel disease.</Description>
            <Size>4-7mm by 20-80mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>124625</ARTG>
                <ARTG>142025</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT126</BillingCode>
            <Name>Pulsar 18 Peripheral self expanding Nitinol stent system</Name>
            <Description>Pulsar 18  self expanding Nitinol stent system</Description>
            <Size>Stent: Ø 4- 7mm length: 20-120mm Catheter length: 90-135mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>169368</ARTG>
                <ARTG>313356</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT133</BillingCode>
            <Name>Pulsar 35 Peripheral self-expanding Nitinol stent system</Name>
            <Description>Pulsar 35 Peripheral self-expanding Nitinol stent system</Description>
            <Size>Diameter: 5-7mm; Length: 30-120mm; Catheter length: 90cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>142025</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DL001</BillingCode>
            <Name>iVolution</Name>
            <Description>Self-expanding nitinol stent system</Description>
            <Size>Diameters: 5-10mm &#xD;
Lengths: 40-100mm&#xD;
Catheter Length: 80-140cm</Size>
            <SupplierCode>DL</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>281201</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DL005</BillingCode>
            <Name>CGuard</Name>
            <Description>Carotid Stent System</Description>
            <Size>Diameters: 6-10mm&#xD;
Lengths: 20mm-60mm</Size>
            <SupplierCode>DL</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>311660</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>S.M.A.R.T. Flex Vascular Stent System</Name>
            <Description>A fully connected, laser cut nitinol stent </Description>
            <Size>5-8mm diameter, 30-120mm length</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>223910</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Precise Pro Rx Nitinol Stent System</Name>
            <Description>Nitinol self expanding stent</Description>
            <Size>Diameter:  5, 6, 7, 8, 9, 10mm;  Length:  20, 30, 40mm</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>149399</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SMART Control Peripheral Stent System</Name>
            <Description>SMART Control is a laser cut nitinol self expanding stent, used to treat peripheral vessel disease.</Description>
            <Size>Dia 6 – 14mm; Length 20 – 100mm</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>151010</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SMART Nitinol Stent System</Name>
            <Description>Long 120mm Stent, 6F compatible</Description>
            <Size>6-8mm diameter, 120mm stent length, 120cm delivery system</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>151011</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI414</BillingCode>
            <Name>Abre venous stent system</Name>
            <Description>The Abre stent system consists of a stent and stent delivery system designed specifically for implantation in the peripheral venous system. The system consists of a flexible self expanding stent made of a nickel-titanium alloy (nitinol) provided in multiple lengths and diameters and an over-the wire stent delivery system.</Description>
            <Size>Length: 40mm-120mm.  Diameter: 10mm-20mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>315001</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY031</BillingCode>
            <Name>Optimed Sinus Stents</Name>
            <Description>Sinus-wave nitinol stent</Description>
            <Size>Diameter: 3mm to 14mm   Length:  20mm to 130mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>178915</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY036</BillingCode>
            <Name>Sinus-Venous and Sinus-Obliquus Stents</Name>
            <Description>Sinus-Venous and Sinus-Obliquus Stents used for treating venous insufficiency, occlusion and stenosis</Description>
            <Size>Diameter: 10, 12, 14, 16, 18mm &#xD;
Length: 60, 80, 100, 120mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>201852</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY042</BillingCode>
            <Name>sinus-XL Flex Stent</Name>
            <Description>Self expanding Nitinol Stents</Description>
            <Size>Diameter:  14mm to 24mm&#xD;
Length:  30mm to &lt;150mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>281019</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY043</BillingCode>
            <Name>sinus-XL Stent</Name>
            <Description>Self expanding Nitinol Stents</Description>
            <Size>Diameter:  14mm to 24mm&#xD;
Length:  30mm to &lt;150mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>187326</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY044</BillingCode>
            <Name>sinus-XL 6F Stents</Name>
            <Description>Self expanding Nitinol Stents</Description>
            <Size>Diameter:  14mm to 24mm&#xD;
Length:  30mm to &lt;150mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>281020</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ444</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACCULINK Peripheral Stent System</Name>
            <Description>Nickel-Titanium Intra-vascular stent</Description>
            <Size>4-10mm diameter, 13-56mm length</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>150102</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ445</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY041</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Absolute Self Expanding Peripheral stent</Name>
            <Description>Laser cut nitinol self expanding stent, 20mm - 120mm lengths</Description>
            <Size>Size ranges from:  5.0X20MM, 80CM - 8.0x120MM, 135CM</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>146848</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ446</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY043</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Supera Peripheral Stent System</Name>
            <Description>Interwoven Self-Expanding Nitnol Stent</Description>
            <Size>Stent inner diameter: 4.0 mm - 8.0 mm  Stent outer diameter: 4.5 mm - 7.5 mm  Stent length: 20 mm - 120 mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>227976</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ462</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Xact/ Xact Flex Carotid Stent</Name>
            <Description>Nitinol Self-Expanding stent on rapid exchange delivery system</Description>
            <Size>Diameter 7-10mm Length 20 + 30mm Straight; Diameter 8-6, 9-7, 10-8mm Length 20 + 30mm Tapered</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>168620</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VD001</BillingCode>
            <Name>JAGUAR Self-Expanding Stent with Delivery System (Regular)</Name>
            <Description>The JAGUAR Self-Expanding Stent with Delivery System consists of a laser-cut self-expanding nitinol stent loaded onto the end of a delivery system. The device is intended for percutaneous intravascular implantation to maintain patency and improve luminal diamater of peripheral arteries in patients with atherosclerotic, radiation induced and post-traumatic lesions causing vessel stenosis</Description>
            <Size>Stent Diameter: 4-14mm  Stent Length: 15-120mm  Guidewire Diameter: 0.018"-0.035"  Guidewire Length: 80-135cm</Size>
            <SupplierCode>VD</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>316740</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VD007</BillingCode>
            <Name>MER Self-Expanding Stent with Delivery System</Name>
            <Description>The MER Self-Expanding Stent with Delivery System consists of a laser-cut Nitinol stent loaded onto the end of a rapid-exchange delivery system.     The device is intended to be implanted in the carotid artery to maintain its patency and improve its luminal diameter for the treatment of atherosclerotic carotid artery disease.</Description>
            <Size>Straight Stent Model:  Stent Diameter: 4-10mm  Stent Length: 20-80mm  Delivery System Length: 80-165cm    Tapered Stent Model:  Distal Diameter: 5-8mm  Proximal Diameter: 7-10mm  Stent Length: 20-80mm  Delivery System Length: 80-165cm</Size>
            <SupplierCode>VD</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>321233</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC287</BillingCode>
            <Name>Zilver® Flex 35™ Vascular Stent</Name>
            <Description>The Zilver® Flew 35™ Stent (ZFV) is a self-expandable stent made of nitinol.  The special laser-cut pattern of the nitinol tube provides a construction with a strong radial force and high flexibility.  The stent has radiopaque markers at both ends.  The stent is supplied preloaded in a 6.0 French inducer catheter. A radiopaque marker on the distal tip of the sheath is used to visualize deployment of the stent. Stent deployment is controlled by means of a hand held device.</Description>
            <Size>The Zilver®  Flex 35™ Stent is available in the following sizes: stent outer diameters of 5 -10mm and stent lengths of 20 -140mm.</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>183865</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC290</BillingCode>
            <Name>Zilver®  Vena ™ Venous Stent</Name>
            <Description>The Zilver® Vena™ Venous Stent is a self-expanding, flexible, slotted-tube nitinol stent. Post-deployment, the stent is designed to impart an outward radial force upon the inner lumen of the vessel, establishing patency in the stented region.</Description>
            <Size>14mm and 16mm diameters, and 60mm/100mm/140mm lengths.</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4440</SubGroupID>
            <ARTGs>
                <ARTG>183864</ARTG>
            </ARTGs>
            <MinimumBenefit>1407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS195</BillingCode>
            <Name>EverFlex Peripheral Stent</Name>
            <Description>EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system.</Description>
            <Size>Diameter 5-8mm, Length 150-200mm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>215979</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA217</BillingCode>
            <Name>Lifestent</Name>
            <Description>Laser cut nitinol self expanding stent</Description>
            <Size>Diameter 5mm to 10mm; length 150mm - 200mm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>160453</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA270</BillingCode>
            <Name>Bard Venous Stent</Name>
            <Description>Self Expanding Venous Stent</Description>
            <Size>Length ≥150mm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>277403</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS197</BillingCode>
            <Name>Innova Self-Expanding Stent</Name>
            <Description>Nitinol, self expanding stent</Description>
            <Size>Diameters up to 8mm, Lengths greater than 150mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>104281</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT127</BillingCode>
            <Name>Pulsar 18 Peripheral self expanding Nitinol stent system</Name>
            <Description>Pulsar 18  self expanding Nitinol stent system</Description>
            <Size>Stent: 4-7mm Stent length: 150-200mm Catheter length: 90-135mm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>169368</ARTG>
                <ARTG>313356</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BT132</BillingCode>
            <Name>Pulsar 35 Peripheral self-expanding Nitinol stent system</Name>
            <Description>Pulsar 35 Peripheral self-expanding Nitinol stent system</Description>
            <Size>Diameter: 5-7mm; Length: 150-200mm; Catheter length: 90cm, 135cm</Size>
            <SupplierCode>BT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>142025</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DL002</BillingCode>
            <Name>iVolution  ≥150mm</Name>
            <Description>Self-expanding nitinol stent system</Description>
            <Size>Diameters: 5-8mm   Lengths: 150-200mm  Catheter Length: 80-140cm</Size>
            <SupplierCode>DL</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>281201</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>S.M.A.R.T. Flex Vascular Stent System</Name>
            <Description>A fully connected, laser cut nitinol stent </Description>
            <Size>5-8mm diameter, 150-200mm length</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>223910</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SMART Nitinol Stent System</Name>
            <Description>Long 150mm stent, 6F compatible</Description>
            <Size>6-8mm diameter, 150mm length, 120cm delivery system</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>151011</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI415</BillingCode>
            <Name>Abre venous stent system</Name>
            <Description>The Abre stent system consists of a stent and stent delivery system designed specifically for implantation in the peripheral venous system. The system consists of a flexible self expanding stent made of a nickel-titanium alloy (nitinol) provided in multiple lengths and diameters and an over-the wire stent delivery system.</Description>
            <Size>Length: 150mm.  Diameter: 10mm-20mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>315001</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY016</BillingCode>
            <Name>Optimed Iliac Sinus Stent - extra long</Name>
            <Description>Sinus-wave nitinol stent - extra long</Description>
            <Size>Diameter: 3mm to 8 mm&#xD;
Length:  150mm to 200mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>178915</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY037</BillingCode>
            <Name>Sinus-Venous and Sinus-Obliquus Stents</Name>
            <Description>Sinus-Venous and Sinus-Obliquus Stents used for treating venous insufficiency, occlusion and stenosis</Description>
            <Size>Diameter: 10, 12, 14, 16, 18mm&#xD;
Length: 150mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>201852</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY041</BillingCode>
            <Name>sinus-XL Flex Stent</Name>
            <Description>Flexible Nitinol Stent with diameters up to 24mm</Description>
            <Size>Diameter:  14mm to 24mm&#xD;
Length:  &gt;150mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>281019</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ447</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Absolute Pro (Long Length)</Name>
            <Description>Laser cut nitinol self expanding stent ≥150</Description>
            <Size>Diameter 5mm to 10mm; length 150mm, 170mm, 200mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>146848</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ448</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY042</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Supera Peripheral Stent System</Name>
            <Description>Interwooven Self-Expanding Nitinol Stent</Description>
            <Size>Stent inner diameter: 4.0 mm - 6.0 mm  Stent outer diameter: 4.5 mm - 6.5 mm  Stent length: 150 mm - 200mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>227976</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VD002</BillingCode>
            <Name>JAGUAR Self-Expanding Stent with Delivery System (Long)</Name>
            <Description>The JAGUAR Self-Expanding Stent with Delivery System consists of a laser-cut self-expanding nitinol stent loaded onto the end of a delivery system. The device is intended for percutaneous intravascular implantation to maintain patency and improve luminal diamater of peripheral arteries in patients with atherosclerotic, radiation induced and post-traumatic lesions causing vessel stenosis</Description>
            <Size>Stent Diameter: 4-14mm  Stent Length: 150mm  Guidewire Diameter: 0.018"-0.035"  Guidewire Length: 80-135cm</Size>
            <SupplierCode>VD</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>316740</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC285</BillingCode>
            <Name>Zilver® Flex35™ Vascular Stent</Name>
            <Description>The Zilver® Flex35™ Stent (ZFV) is a self-expandable stent made of nitinol.  The special laser-cut pattern of the nitinol tube provides a construction with a strong radial force and high flexibility.  The stent has radiopaque markers at both ends.</Description>
            <Size>Diameter: 5-8mm; Length:170mm and 200mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>4441</SubGroupID>
            <ARTGs>
                <ARTG>183865</ARTG>
            </ARTGs>
            <MinimumBenefit>2033</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC316</BillingCode>
            <Name>Zenith Dissection Endovascular Stent with the Z-Trak Plus Introduction System</Name>
            <Description>Dissection Endovascular Stent</Description>
            <Size>Diameter: 36mm and 46mm&#xD;
Lengths: 80mm, 120mm, 180mm, 185mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>5471</SubGroupID>
            <ARTGs>
                <ARTG>208854</ARTG>
            </ARTGs>
            <MinimumBenefit>4197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER542</BillingCode>
            <Name>Tack Endovascular System</Name>
            <Description>The Tack Endovascular System is a dissection repair device that is purpose-built to provide precision treatment of peripheral arterial dissections following balloon angioplasty. </Description>
            <Size>Diameter: 5.7-9.8mm (unconstrained); Diameter treatment range: 1.5-8.0 mm;  Length: ~6-8mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1622</GroupID>
            <SubGroupID>7364</SubGroupID>
            <ARTGs>
                <ARTG>352394</ARTG>
            </ARTGs>
            <MinimumBenefit>1367</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS327</BillingCode>
            <Name>Eluvia</Name>
            <Description>Drug Eluting Vascular Stent System</Description>
            <Size>Diameter 6-7mm, Length 40-120mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1624</GroupID>
            <SubGroupID>6562</SubGroupID>
            <Suffix>&lt;150mm</Suffix>
            <ARTGs>
                <ARTG>285061</ARTG>
            </ARTGs>
            <MinimumBenefit>2060</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS328</BillingCode>
            <Name>Eluvia</Name>
            <Description>Drug Eluting Vascular Stent System</Description>
            <Size>Diameter 6-7mm, Length 150-200mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1624</GroupID>
            <SubGroupID>6562</SubGroupID>
            <Suffix>≥150mm</Suffix>
            <ARTGs>
                <ARTG>285061</ARTG>
            </ARTGs>
            <MinimumBenefit>2678</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS353</BillingCode>
            <Name>Promus PREMIER BTK</Name>
            <Description>Everolimus-Eluting Platinum Chromium Stent System</Description>
            <Size>Diameter 2.5-4mm, Length 20-38mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1624</GroupID>
            <ARTGs>
                <ARTG>302114</ARTG>
            </ARTGs>
            <MinimumBenefit>2063</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC289</BillingCode>
            <Name>Zilver PTX</Name>
            <Description>The Zilver PTX Drug Eluting Peripheral Stent is a self-expanding stent made of nitinol and coated with the drug Paclitaxel.  The stent is preloaded in a 6.0 French delivery catheter.</Description>
            <Size>6French: 5, 6, 7, 8 mm diameters in 20, 30, 40, 60, 80, 100, 120, 140mm lengths</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>206</SubCategoryID>
            <GroupID>1624</GroupID>
            <ARTGs>
                <ARTG>279510</ARTG>
            </ARTGs>
            <MinimumBenefit>2063</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT259</BillingCode>
            <Name>Conformable GORE TAG Thoracic Endoprosthesis</Name>
            <Description>Conformable GORE TAG</Description>
            <Size>Straight Stent Grafts:&#xD;
Diameters (mm): 21, 26, 28, 31, 34, 37, 40, 45&#xD;
Length (cm): 10&#xD;
Tapered Stent Grafts:&#xD;
Diameters (mm): 26x21; 31x26&#xD;
Lengths (cm): 10</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>157814</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT260</BillingCode>
            <Name>Conformable GORE TAG Thoracic Endoprosthesis</Name>
            <Description>Conformable GORE TAG</Description>
            <Size>Diameters (mm): 21, 26, 28, 31, 34, 37, 40, 45&#xD;
Length (cm) 15</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>157814</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC952</BillingCode>
            <Name>Valiant Captivia</Name>
            <Description>Valient Stent Graft with Captivia Delivery System</Description>
            <Size>22-46mm diameter, 150mm length</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>169353</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC960</BillingCode>
            <Name>Valiant Captivia</Name>
            <Description>Valiant Stent Graft with captivia delivery system</Description>
            <Size>22 - 46 mm diameter: 100mm length</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>169353</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI149</BillingCode>
            <Name>Valiant Thoracic FreeFlo Tapered stent graft</Name>
            <Description>Valiant Thoracic FreeFlo Tapered Stent Graft with Captivia Delivery System</Description>
            <Size>Proximal diameter: 26 to 46 mm; distal diameter: 22 to 42 mm; stent graft covered length: 152 to 162 mm. Catheter outer diameter: 22 to 25F</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>169353</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC240</BillingCode>
            <Name>Zenith Thoracic Endovascular Graft</Name>
            <Description>Thoracic Distal Graft</Description>
            <Size>26mm to 42mm diameter, 127mm to 179mm Length</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>164328</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC275</BillingCode>
            <Name>Zenith TX2 TAA Endovascular Graft with Pro_Form and the Z-Trak Plus Introduction System Short Proximal Component</Name>
            <Description>Short Thoracic Proximal Graft</Description>
            <Size>Diameter 22mm - 42mm&#xD;
Length 115mm - 167mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>164328</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC307</BillingCode>
            <Name>Zenith TX2 Dissection Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (Short proximal component)</Name>
            <Description>Short Thoracic Proximal Graft</Description>
            <Size>Diameter 22mm - 42mm &#xD;
Length 117mm - 165</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>197412</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC322</BillingCode>
            <Name>Zenith Alpha Thoracic Endovascular Graft Distal Component</Name>
            <Description>Thoracic Distal Graft (short)</Description>
            <Size>Diameter: 28-46mm.  Length: 142-160mm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>281254</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC324</BillingCode>
            <Name>Zenith Alpha Thoracic Endovascular Graft Proximal Component</Name>
            <Description>Straight Thoracic Proximal Graft (short)</Description>
            <Size>Diameter: 24-46mm. Length: 105-179mm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>281253</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC326</BillingCode>
            <Name>Zenith Alpha Thoracic Endovascular Graft Proximal Tapered Component</Name>
            <Description>Tapered Thoracic Proximal Graft (short)</Description>
            <Size>Proximal diameter: 32-46mm.  Length: 161-179mm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4442</SubGroupID>
            <ARTGs>
                <ARTG>281255</ARTG>
            </ARTGs>
            <MinimumBenefit>9952</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT261</BillingCode>
            <Name>Conformable GORE TAG Thoracic Endoprosthesis</Name>
            <Description>Conformable GORE TAG</Description>
            <Size>Diameters (mm): 21, 26, 28, 31, 34, 37, 40, 45&#xD;
Length (cm): 20</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>157814</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC958</BillingCode>
            <Name>Valiant Captivia</Name>
            <Description>Valiant Stent Graft with Captivia Delivery System</Description>
            <Size>24-46mm diameter, 200mm length</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>169353</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC241</BillingCode>
            <Name>Zenith Thoracic Endovascular Graft</Name>
            <Description>Thoracic Distal Graft</Description>
            <Size>26mm to 42mm diameter, 180mm to 207mm Length</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>164328</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC276</BillingCode>
            <Name>Zenith TX2 TAA Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System - Long Proximal Component</Name>
            <Description>Long Thoracic Proximal Endovascular Graft</Description>
            <Size>Diameter: 22mm-42mm Length: 192mm-216mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>164328</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC305</BillingCode>
            <Name>Zenith TX2 Dissection Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (Long proximal component)</Name>
            <Description>Long thoracic proximal graft</Description>
            <Size>Diameter 28mm-42mm; Length 194mm-218</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>197412</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC323</BillingCode>
            <Name>Zenith Alpha Thoracic Endovascular Graft Distal Component</Name>
            <Description>Thoracic Distal Graft (long)</Description>
            <Size>Diameter: 28-46mm.  Length: 190-229mm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>281254</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC325</BillingCode>
            <Name>Zenith Alpha Thoracic Endovascular Graft Proximal Component</Name>
            <Description>Straight Thoracic Proximal Graft (long)</Description>
            <Size>Diameter: 28-46mm.  Length: 201-233mm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>281253</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC327</BillingCode>
            <Name>Zenith Alpha Thoracic Endovascular Graft Proximal Tapered Component</Name>
            <Description>Tapered Thoracic Proximal Graft (long)</Description>
            <Size>Proximal diameter: 32-46mm. Length: 201-233mm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1625</GroupID>
            <SubGroupID>4443</SubGroupID>
            <ARTGs>
                <ARTG>281255</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI060</BillingCode>
            <Name>Endurant II AAA Abdominal Tube</Name>
            <Description>Endurant II Endoluminal Stent Graft System - Abdominal Tube</Description>
            <Size>Proximal diameter: 23 to 36mm; Distal diameter: 23 to 36mm; Covered length: 70mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1626</GroupID>
            <ARTGs>
                <ARTG>202471</ARTG>
            </ARTGs>
            <MinimumBenefit>4378</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC998</BillingCode>
            <Name>Endurant II AAA Aorto-Uni-Iliac</Name>
            <Description>Endurant II Endoluminal Stent Graft System - AUI</Description>
            <Size>Proximal diameter: 23 to 36mm; Distal daimeter: 14mm; Covered length: 102mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1627</GroupID>
            <ARTGs>
                <ARTG>197539</ARTG>
            </ARTGs>
            <MinimumBenefit>9206</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU002</BillingCode>
            <Name>Anaconda Endovascular Graft System</Name>
            <Description>Bifurcated Aortic System, Ultra thin woven polyester, nitinol ring stents, tantalum markers</Description>
            <Size>18 - 34mm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4444</SubGroupID>
            <ARTGs>
                <ARTG>172404</ARTG>
            </ARTGs>
            <MinimumBenefit>11196</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT263</BillingCode>
            <Name>GORE EXCLUDER AAA Endoprosthesis</Name>
            <Description>AAA Stent Graft Nitinol &amp; ePTFE Two piece system (1/2) Trunk-ipsilateral component</Description>
            <Size>Diameters: 23, 26, 28.5, 35mm&#xD;
Lengths: 12, 14, 16, 18cm&#xD;
Diameters: 31mm&#xD;
Lengths: 13, 15, 17cm&#xD;
Diameters: 35mm&#xD;
Lengths: 14, 16, 18cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4445</SubGroupID>
            <ARTGs>
                <ARTG>157813</ARTG>
            </ARTGs>
            <MinimumBenefit>8082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC997</BillingCode>
            <Name>Endurant II AAA Stent Graft Bifurcation</Name>
            <Description>Endurant II Endoluminal Stent Graft System - Bifurcated Graft</Description>
            <Size>Proximal diameters: 23 to 36mm; Distal diameters: 13 to 20mm; Covered lengths: 124 to 166mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4445</SubGroupID>
            <ARTGs>
                <ARTG>197540</ARTG>
                <ARTG>302574</ARTG>
            </ARTGs>
            <MinimumBenefit>8082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI173</BillingCode>
            <Name>Endurant IIs AAA Stent Graft</Name>
            <Description>Endurant IIs Endoluminal Stent Graft System - Bifurcated Graft (body + single limb configuration), shorter ipsilateral leg</Description>
            <Size>Proximal diameters: 23 to 36 mm; Distal diameters: 14 mm; Covered length: 103 mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4445</SubGroupID>
            <ARTGs>
                <ARTG>235711</ARTG>
                <ARTG>302575</ARTG>
            </ARTGs>
            <MinimumBenefit>8082</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>InCraft AAA Stent-Graft System - Aortic Bifurcate</Name>
            <Description>Bifurcated main body</Description>
            <Size>22-34mm diameter, 86-94mm length</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4446</SubGroupID>
            <ARTGs>
                <ARTG>231895</ARTG>
            </ARTGs>
            <MinimumBenefit>5229</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC261</BillingCode>
            <Name>Zenith Fenestrated AAA Endovascular Graft with Flexor</Name>
            <Description>Distal Bifurcated Body with Flexor sheath</Description>
            <Size>Diameter 12 - 24mm, 1st length 28 - 62mm, 2nd length 76 - 121mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4446</SubGroupID>
            <ARTGs>
                <ARTG>138797</ARTG>
            </ARTGs>
            <MinimumBenefit>5229</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC277</BillingCode>
            <Name>Zenith Flex AAA Endovascular Graft with the Z-Trak Introduction System - main body</Name>
            <Description>Zenith Flex with Z-trak main body - AAA endovascular graft</Description>
            <Size>Diameter - 22mm - 36mm. Length 82mm - 149mm.</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4446</SubGroupID>
            <ARTGs>
                <ARTG>161932</ARTG>
            </ARTGs>
            <MinimumBenefit>5229</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC332</BillingCode>
            <Name>Zenith Alpha Abdominal Endovascular Graft </Name>
            <Description>Bifurcated main body graft</Description>
            <Size>Diameters:22-36mm.  Lengths: 70-128mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1628</GroupID>
            <SubGroupID>4446</SubGroupID>
            <ARTGs>
                <ARTG>265762</ARTG>
            </ARTGs>
            <MinimumBenefit>5229</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC313</BillingCode>
            <Name>Zenith t-Branch Endovascular Graft</Name>
            <Description>The t-Branch is an endovascular graft designed for use in the thoracabdominal aorta.</Description>
            <Size>Diameter: 34mm  Length: 202mm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1629</GroupID>
            <SubGroupID>5516</SubGroupID>
            <Suffix>L</Suffix>
            <ARTGs>
                <ARTG>228114</ARTG>
            </ARTGs>
            <MinimumBenefit>13086</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC312</BillingCode>
            <Name>Zenith Universal Distal Body Endovascular Graft</Name>
            <Description>The Zenith Universal Distal Body Endovascular Graft (Unibody) consists of a bifurcated graft loaded into the H&amp;L-B One-Shot delivery system</Description>
            <Size>Diameters: 22 - 24mm&#xD;
Lengths: 81 - 132mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1629</GroupID>
            <SubGroupID>5516</SubGroupID>
            <ARTGs>
                <ARTG>208899</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT276</BillingCode>
            <Name>GORE EXCLUDER Iliac Branch Endoprosthesis</Name>
            <Description>The GORE EXCLUDER IBE provides an endovascular option for treatment allowing preservation of perfusion to the internal iliac, versus occlusion and covering the internal iliac or open surgical alternatives. The The GORE EXCLUDER IBE consists of two components (Iliac Branch Component: 1 of 2).</Description>
            <Size>CEB231010 - Internal Iliac Diameter:  6.50-9mm&#xD;
CEB231210 - Internal Iliac Diameter: 10-11mm&#xD;
CEB231410 - Internal Iliac Diameter: 12 - 13.5mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1629</GroupID>
            <ARTGs>
                <ARTG>232968</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC233</BillingCode>
            <Name>Zenith Branch Endovascular Graft - Iliac Bifurcation</Name>
            <Description>Bifurcated branch vessel stent graft with openings to connect the common iliac, sidebranch, and external iliac segments. Made of stainless steel and nitinol z-stents and woven polyester, mounted on H&amp;LB one shot delivery system</Description>
            <Size>Common iliac lengths 45 or 61mm, external iliac lengths 41 or 58mm and distal cuff diameters 10 or 12mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1629</GroupID>
            <ARTGs>
                <ARTG>138930</ARTG>
            </ARTGs>
            <MinimumBenefit>6769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC263</BillingCode>
            <Name>Zenith Fenestrated AAA Endovascular Graft with Flexor</Name>
            <Description>Proximal Fenestrated body with Flexor sheath</Description>
            <Size>1 or 2 internal stents, 24 - 36mm Diameter, 73 - 129mm Length</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1630</GroupID>
            <ARTGs>
                <ARTG>138797</ARTG>
            </ARTGs>
            <MinimumBenefit>7726</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC274</BillingCode>
            <Name>Zenith TX2 TAA Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (thoracic body extension)</Name>
            <Description>Thoracic Proximal Extension</Description>
            <Size>Diameter - 22mm - 42mm Length - 77mm - 81mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4447</SubGroupID>
            <ARTGs>
                <ARTG>164328</ARTG>
            </ARTGs>
            <MinimumBenefit>5686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC306</BillingCode>
            <Name>Zenith TX2 Dissection Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (thoracic body extension)</Name>
            <Description>Thoracic Proximal Extension</Description>
            <Size>Diameter 22mm - 42mm; Length 79mm - 83mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4447</SubGroupID>
            <ARTGs>
                <ARTG>197412</ARTG>
            </ARTGs>
            <MinimumBenefit>5686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC328</BillingCode>
            <Name>Zenith Alpha Thoracic Endovascular Graft Distal Extension</Name>
            <Description>Thoracic Distal Extension</Description>
            <Size>Diameter: 18-46mm.  Length: 91-160mm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4447</SubGroupID>
            <ARTGs>
                <ARTG>281256</ARTG>
            </ARTGs>
            <MinimumBenefit>5686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT189</BillingCode>
            <Name>GORE EXCLUDER AAA Endoprosthesis</Name>
            <Description>Abdominal Stent Graft Nitinol &amp; ePTFE - Aortic Extender</Description>
            <Size>Diameters: 23, 26, 28.5mm&#xD;
Lengths: 3.3cm&#xD;
Diameters: 32mm&#xD;
Length: 4.5cm&#xD;
Diameter: 36mm&#xD;
Length: 4.5cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>158681</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Incraft AAA Stent Graft System - Aortic Extension</Name>
            <Description>Aortic Extension</Description>
            <Size>Aortic Extension Diameter (mm): 22, 26, 30, 34</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>231895</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI061</BillingCode>
            <Name>Endurant II AAA Aortic Extension</Name>
            <Description>Endurant II Endoluminal Stent Graft System - Aortic Extension</Description>
            <Size>Proximal diameter: 23 to 36mm; distal diameter: 23 to 36mm; Covered length: 49mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>202372</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU003</BillingCode>
            <Name>Anaconda Endovascular Graft System</Name>
            <Description>Aortic Extension Cuff. Ultrathin woven polyester, nitinol ring stents, tantalum markers</Description>
            <Size>18 - 34mm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>172404</ARTG>
                <ARTG>173321</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC045</BillingCode>
            <Name>Zenith Endovascular Graft</Name>
            <Description>Converter</Description>
            <Size>Diameter 20 through 36   Length 80-85</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>205724</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC048</BillingCode>
            <Name>Zenith Endovascular Graft</Name>
            <Description>Body Extensions</Description>
            <Size>Diameter 22 through 36</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>206326</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC302</BillingCode>
            <Name>Zenith Low Profile AAA Endovascular Graft - Converter</Name>
            <Description>Converter</Description>
            <Size>Proximal Diameter: 24-36mm, Distal Diameter: 12mm, Working Length: 66mm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>227127</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC303</BillingCode>
            <Name>Zenith Low Profile AAA Endovascular Graft - Main Body Extension</Name>
            <Description>Main Body Extension</Description>
            <Size>Diameter: 22-36mm, Working Length: 45-58mm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1631</GroupID>
            <SubGroupID>4448</SubGroupID>
            <ARTGs>
                <ARTG>227126</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC996</BillingCode>
            <Name>Endurant II AAA Contralateral Iliac Limb</Name>
            <Description>Endurant II Endoluminal Stent Graft System - Contralateral Iliac Limb</Description>
            <Size>Proximal diameter: 16mm; Distal diameter: 10 to 28mm; Covered length: 156mm, 199mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <Suffix>L (long length, &gt;150mm)</Suffix>
            <ARTGs>
                <ARTG>197541</ARTG>
            </ARTGs>
            <MinimumBenefit>3926</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU057</BillingCode>
            <Name>Anaconda AAA Stent Graft System</Name>
            <Description>Ultrathin woven polyester, nitinol ring stents, tantalum markers (longer legs lengths &gt;150mm).&#xD;
&#xD;
Long limbs have not got ARTG, but the Anaconda Stent Graft System does with regular limbs (ARTG173321 and 172404).&#xD;
&#xD;
The Anaconda AAA Stent Graft System is a device support structure that expands and stays in place inside a blood carrying vessel for isolated iliac aneurysm repair and a component of the  AAA stent graft system.  It is delivered to the intended landing zone by a delivery system, where the stent is expanded to provide support for the vessel   The stent graft remains in place as a permanent implant.&#xD;
&#xD;
The patient is hospitalised and undergoing invasive surgery of implantation of the stent graft.</Description>
            <Size>Tapered Legs&#xD;
Outer Diameter (Proximal 12mm; Distal 10mm) x  Length 150mm&#xD;
Outer Diameter (Proximal 12mm; Distal 10mm) x  Length 170mm&#xD;
&#xD;
Flared Legs&#xD;
Outer Diameter (Proximal 12mm; Distal 13mm) x  Length 150mm&#xD;
Outer Diameter (Proximal 12mm; Distal 13mm) x  Length 170mm&#xD;
Outer Diameter (Proximal 12mm; Distal 15mm) x  Length 150mm&#xD;
Outer Diameter (Proximal 12mm; Distal 15mm) x  Length 170mm&#xD;
Outer Diameter (Proximal 12mm; Distal 17mm) x  Length 150mm&#xD;
Outer Diameter (Proximal 12mm; Distal 17mm) x  Length 170mm&#xD;
Outer Diameter (Proximal 12mm; Distal 19mm) x  Length 150mm&#xD;
Outer Diameter (Proximal 12mm; Distal 19mm) x  Length 170mm &#xD;
Outer Diameter (Proximal 12mm; Distal 21mm) x  Length 150mm&#xD;
Outer Diameter (Proximal 12mm; Distal 21mm) x  Length 170mm &#xD;
Outer Diameter (Proximal 12mm; Distal 23mm) x  Length 150mm&#xD;
Outer Diameter (Proximal 12mm; Distal 23mm) x  Length 170mm &#xD;
&#xD;
Straight Legs&#xD;
Outer Diameter 12mm x  Length 160mm&#xD;
Outer diameter 12mm x  Length 180mm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <Suffix>L (long length, &gt;150mm)</Suffix>
            <ARTGs>
                <ARTG>172404</ARTG>
            </ARTGs>
            <MinimumBenefit>3926</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT188</BillingCode>
            <Name>EXCLUDER AAA Endovascular Prostheses</Name>
            <Description>AAA Stent Graft Nitinol &amp; ePTFE Two piece system (2/2) Contralateral Limb</Description>
            <Size>Diameters: 12, 14.5, 23, 27mm&#xD;
Lenghts: 10, 12, 14cm&#xD;
Diameters: 16, 18, 20mm&#xD;
Lenghts: 9.5, 11.5, 13.5cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>158680</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT190</BillingCode>
            <Name>Excluder AAA Endovascular Prostheses</Name>
            <Description>Abdominal Stent Graft Nitinol &amp; ePTFE - Iliac Extender</Description>
            <Size>Diameters: 10, 12, 14.5mm&#xD;
Lengths: 7cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>158682</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT277</BillingCode>
            <Name>GORE EXCLUDER Iliac Branch Endoprosthesis</Name>
            <Description>The GORE EXCLUDER IBE provides an endovascular option for treatment allowing for preservation of perfusion to the internal iliac, versus occlusion and covering the internal iliac or open surgical procedures. &#xD;
The GORE EXCLUDER IBE consists of two components (Internal Iliac Component: 2 of 2).</Description>
            <Size>HGB 161007 - Internal Iliac Diameter: 6.5 - 9mm&#xD;
HGB 161207 - Internal Iliac Diameter: 10-11mm&#xD;
HGB 161407 - Internal Iliac Diameter: 12 - 13.5mm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>232968</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>InCraft AAA Stent-Graft System - Iliac Limb/Extension</Name>
            <Description>Contralateral/Ipsilateral lliac limbs and extensions</Description>
            <Size>10-24mm diameter, 80-140mm length</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>231895</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC994</BillingCode>
            <Name>Endurant II AAA Contralateral Iliac Limb</Name>
            <Description>Endurant II Endoluminal Stent Graft System - Contralateral Iliac Limb</Description>
            <Size>Proximal diameter: 16mm; Distal diameter: 10 to 28mm; Covered length: 82mm; 93mm; 124mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>197541</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC995</BillingCode>
            <Name>Endurant II AAA Iliac Extension</Name>
            <Description>Endurant II AAA Iliac Extension</Description>
            <Size>Proximal diameter: 10 to 28mm; Distal diameter: 10 to 28mm; Covered length: 82mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>197654</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU004</BillingCode>
            <Name>Anaconda Endovascular Graft System</Name>
            <Description>Iliac Extension Cuff. Ultrathin woven polyester, nitinol ring stents, tantalum markers

</Description>
            <Size>8 - 18mm

</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>172404</ARTG>
                <ARTG>173321</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU005</BillingCode>
            <Name>Anaconda Endovascular Graft System</Name>
            <Description>Iliac Leg, Ultrathin woven polyester, nitinol ring stents, tantalum markers</Description>
            <Size>8 - 23mm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>172404</ARTG>
                <ARTG>173321</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU041</BillingCode>
            <Name>Anaconda Endovascular Graft System</Name>
            <Description>Flared iliac limb, Ultrathin woven polyester, nitinol ring stents, tantalum markers</Description>
            <Size>Diameter: Proximal end 10-17mm, distal end 12-23mm: Length 80-130mm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>172404</ARTG>
                <ARTG>173321</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC259</BillingCode>
            <Name>Zenith AAA Endovascular Graft Contralateral/Ipsilateral Iliac Legs</Name>
            <Description>Leg extension with Captor valve</Description>
            <Size>Diameters from 8 to 24mm, lengths from 37 to 122mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>161932</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC286</BillingCode>
            <Name>Zenith® Spiral-Z AAA lliac Legs with Z-Trak™ Introduction System</Name>
            <Description>Zenith® Spiral-Z AAA lliac Leg</Description>
            <Size>Proximal Diameter - 13mm&#xD;
Distal Diameter - 9mm to 24 mm&#xD;
Working Length - 39 mm to 122 mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>184456</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC330</BillingCode>
            <Name>Zenith Alpha Spiral-Z Endovascular Leg</Name>
            <Description>Iliac leg graft</Description>
            <Size>Distal Diameters: 9-24mm.  Graft lengths: 42-125mm.</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1632</GroupID>
            <ARTGs>
                <ARTG>229923</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC203</BillingCode>
            <Name>Talent Occluder System</Name>
            <Description>Nitinol stents attached to polyester graft sealed both ends</Description>
            <Size>Standard Sizes, 8 - 24mm x 31 - 35mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1633</GroupID>
            <ARTGs>
                <ARTG>197552</ARTG>
            </ARTGs>
            <MinimumBenefit>2306</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT295</BillingCode>
            <Name>GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis</Name>
            <Description>The GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis consists of a 316L surgical grade stainless steel balloon expandable stent and a fluoropolymer graft. The CBAS® Heparin Surface on the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis consists of stable, covalent, end-point attached heparin of porcine origin. The endoprosthesis is premounted on a delivery system equipped with a balloon. The delivery system has two radiopaque balloon markers embedded in the shaft (denoting the effective balloon length) to aid in the placement of the endoprosthesis. The delivery system is compatible with 0.035" (0.89 mm) guidewires. The delivery system can be used for initial stent placement and post stent dilatation. The premounted stent system is available in a variety of endoprosthesis lengths from 15 to 79 mm and in a variety of diameters from 5 to 11 mm (See Table 1). The premounted endoprosthesis system balloon catheter is also offered in two shaft lengths. This product is supplied sterile. It should not be resterilized.</Description>
            <Size>5mm-11mm diameter&#xD;
79mm length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4449</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>311474</ARTG>
            </ARTGs>
            <MinimumBenefit>3867</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT296</BillingCode>
            <Name>GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis</Name>
            <Description>The GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis consists of a 316L surgical grade stainless steel balloon expandable stent and a fluoropolymer graft. The CBAS® Heparin Surface on the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis consists of stable, covalent, end-point attached heparin of porcine origin. The endoprosthesis is premounted on a delivery system equipped with a balloon. The delivery system has two radiopaque balloon markers embedded in the shaft (denoting the effective balloon length) to aid in the placement of the endoprosthesis. The delivery system is compatible with 0.035" (0.89 mm) guidewires. The delivery system can be used for initial stent placement and post stent dilatation. The premounted stent system is available in a variety of endoprosthesis lengths from 15 to 79 mm and in a variety of diameters from 5 to 11 mm (See Table 1). The premounted endoprosthesis system balloon catheter is also offered in two shaft lengths. This product is supplied sterile. It should not be resterilized.</Description>
            <Size>5mm-11mm diameter &#xD;
15mm, 19mm, 29mm, 39mm &amp; 59mm lengths</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4449</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>311474</ARTG>
            </ARTGs>
            <MinimumBenefit>3867</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA264</BillingCode>
            <Name>LifeStream Balloon Expandable Covered Stent</Name>
            <Description>The LifeStream Balloon Expandable Vascular Covered Stent is comprised of an ectropolished balloon-expandable stent made from 316L stainless steel, encapsulated between two layers of ePTFE.</Description>
            <Size>Implant Length: 16mm, 26mm, 37/38mm*,58mm&#xD;
Implant Diameter: 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 12mm&#xD;
* Diameters 5-8mm are offered in 37mm length, and diameters 9-12 are offered in 38mm length</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4449</SubGroupID>
            <ARTGs>
                <ARTG>265593</ARTG>
            </ARTGs>
            <MinimumBenefit>3484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advant PTFE V12 Stent Graft System</Name>
            <Description>Balloon Expandable PTFE Encapsulated Stainless Steel Peripheral Vascular Stent</Description>
            <Size>5mm - 12mm Diameter</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4449</SubGroupID>
            <ARTGs>
                <ARTG>156635</ARTG>
                <ARTG>200244</ARTG>
            </ARTGs>
            <MinimumBenefit>3484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY039</BillingCode>
            <Name>BeGraft Peripheral Stent Graft System</Name>
            <Description>Balloon Expandable "One layer" Biocompatible CoCr Alloy and Micro-porous ePTFE Peripheral Vascular Stent</Description>
            <Size>Diameter: 5mm to 12mm&#xD;
Length: 18mm to 58mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4449</SubGroupID>
            <ARTGs>
                <ARTG>280061</ARTG>
            </ARTGs>
            <MinimumBenefit>3484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT294</BillingCode>
            <Name>GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis</Name>
            <Description>The GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis consists of a 316L surgical grade stainless steel balloon expandable stent and a fluoropolymer graft. The CBAS® Heparin Surface on the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis consists of stable, covalent, end-point attached heparin of porcine origin. The endoprosthesis is premounted on a delivery system equipped with a balloon. The delivery system has two radiopaque balloon markers embedded in the shaft (denoting the effective balloon length) to aid in the placement of the endoprosthesis. The delivery system is compatible with 0.035" (0.89 mm) guidewires. The delivery system can be used for initial stent placement and post stent dilatation. The premounted stent system is available in a variety of endoprosthesis lengths from 15 to 79 mm and in a variety of diameters from 5 to 11 mm (See Table 1). The premounted endoprosthesis system balloon catheter is also offered in two shaft lengths. This product is supplied sterile. It should not be resterilized.</Description>
            <Size>8mm expanding to 16mm&#xD;
29mm, 39mm, 59mm, 79mm lengths</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4450</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>311474</ARTG>
            </ARTGs>
            <MinimumBenefit>5230</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advanta V12 Stent Graft System</Name>
            <Description>Balloon Expandable PTFE Encapsulated Stainless Steel Vascular Stent</Description>
            <Size>Large Diameter 12 -16mm. 80 and 120cm catheter lengths</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4450</SubGroupID>
            <ARTGs>
                <ARTG>156635</ARTG>
            </ARTGs>
            <MinimumBenefit>5140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY045</BillingCode>
            <Name>BeGraft Aortic Stent Graft System</Name>
            <Description>Aortic Stent Graft System</Description>
            <Size>Expanded Diameter: 12mm to 30mm&#xD;
Stent Length:  19mm to 59mm&#xD;
Catheter Length: 75cm and 120cm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1634</GroupID>
            <SubGroupID>4450</SubGroupID>
            <ARTGs>
                <ARTG>286040</ARTG>
            </ARTGs>
            <MinimumBenefit>5140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT225</BillingCode>
            <Name>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surface</Name>
            <Description>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surface is a flexible, self expanding endoluminal device consisting of an ePTFE lining with external nitinol support</Description>
            <Size>5mmx2.5cm 120cm 5mmx5cm 120cm 6mmx2.5cm 120cm 6mmx5cm 75cm 6mmx5cm 120cm 7mmx2.5cm 120cm 7mmx5cm 75cm   7mmx5cm 120cm 8mmx2.5cm 120cm 8mmx5cm 75cm 8mmx5cm 120cm 9mmx 5cm 75cm 9mmx 5cm 120cm 10mmx 5cm 75cm   10mmx 5cm 120cm 11mmx 5cm 75cm   11mmx 5cm 120cm 13mmx 5cm 75cm 13mmx 5cm 120cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1635</GroupID>
            <SubGroupID>4451</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>160210</ARTG>
            </ARTGs>
            <MinimumBenefit>3154</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT227</BillingCode>
            <Name>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surface</Name>
            <Description>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surfaceis a flexible, self expandinbg endoluminal device consisting of an ePTFE lining with external nitinol support</Description>
            <Size>5mmx 10cm 120cm 6mmx 10cm 75cm 6mmx 10cm 120cm 7mmx 10cm 75cm 7mmx 10cm 120cm 8mmx 10cm 75cm 8mmx 10cm 120cm   9mmx 10cm 75cm 9mmx 10cm 120cm   10mmx 10cm 75cm 10mmx 10cm 120cm   11mmx 10cm 75cm 11mmx 10cm 120cm   13mmx 10cm 75cm 13mmx 10cm 120cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1635</GroupID>
            <SubGroupID>4451</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>160210</ARTG>
            </ARTGs>
            <MinimumBenefit>3154</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA219</BillingCode>
            <Name>Encapsulated Carbon Lined Stent Graft</Name>
            <Description>PTFE covered nitinol self-expanding stent</Description>
            <Size>4mm - 13.5mm diameter, 2cm - 12cm length</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1635</GroupID>
            <SubGroupID>4451</SubGroupID>
            <ARTGs>
                <ARTG>143665</ARTG>
            </ARTGs>
            <MinimumBenefit>3064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA297</BillingCode>
            <Name>Bard COVERA Vascular Covered Stent</Name>
            <Description>The Covera™ Vascular Covered Stent is a flexible, self-expanding endoprosthesis comprised of expanded ePTFE encapsulating a nitinol stent framework. The inner lumen of the covered stent is carbon impregnated. Available in flared and straight end configurations allow for optimal sizing and adaption to the venous vessel wall. Straight device configurations are intended for use in anatomies where the diameter of the outflow vessel is equal to or smaller than the diameter of the inflow vessel. Flared device configurations are intended for use in anatomies where the diameter of the outflow vessel segment is larger than the inflow segment. The Covera™ Vascular Covered Stent device is an over-the-wire delivery system. The delivery system is compatible with 0.035 inch guidewires and 8F or 9F introducer sheaths. The delivery system is available in working lengths of 80 cm and 120 cm. Triaxial delivery system thumb wheel delivery facilitates accurate placement control.</Description>
            <Size>Implant diameter: 6mm, 7mm, 8mm, 9mm,10 mm    Implant lengths: 30mm*, 40 mm, 60 mm, 80 mm, 100 mm      *30 mm length available in straight configurations</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1635</GroupID>
            <SubGroupID>4451</SubGroupID>
            <ARTGs>
                <ARTG>321442</ARTG>
            </ARTGs>
            <MinimumBenefit>3064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT029</BillingCode>
            <Name>Gore Tips Endoprosthesis</Name>
            <Description>ePTFE</Description>
            <Size>8-12mm Diameter 4-8cm Graft-Lined Length 2cm Unlined Length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1635</GroupID>
            <SubGroupID>4451</SubGroupID>
            <ARTGs>
                <ARTG>94146</ARTG>
            </ARTGs>
            <MinimumBenefit>3064</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT226</BillingCode>
            <Name>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surface</Name>
            <Description>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surface is a flexible, self expanding endoluminal device consisting of an ePTFE lining with external nitinol support</Description>
            <Size>5mmx 15cm 120cm, 6mmx 15cm 75cm 6mmx 15cm 120cm 7mmx 15cm 75cm 7mmx 15cm 120cm 8mmx 15cm 75cm 8mmx 15cm 120cm 9mmx 15cm 75cm 9mmx 15cm 120cm 10mmx 15cm 75cm, 10mmx 15cm 120cm 11mmx 15cm 75cm 11mmx 15cm 120cm 13mmx 15cm  75cm 13mmx 15cm 120cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1635</GroupID>
            <SubGroupID>4452</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>160210</ARTG>
            </ARTGs>
            <MinimumBenefit>3723</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT262</BillingCode>
            <Name>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surface</Name>
            <Description>GORE® VIABAHN® Endoprosthesis with Propaten Bioactive Surface  is a flexible, self expanding endoluminal device consisting of an ePTFE lining with external nitinol support</Description>
            <Size>5mm x 25cm x 120CATH  6mm x 25cm x 120CATH  7mm x 25cm x 120CATH  8mm x 25cm x 120CATH</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>207</SubCategoryID>
            <GroupID>1635</GroupID>
            <SubGroupID>4453</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>160210</ARTG>
            </ARTGs>
            <MinimumBenefit>5077</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB025</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>10cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4454</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER168</BillingCode>
            <Name>LifeSpan ePTFE vascular grafts-straight, regular or thin wall-10cm</Name>
            <Description>LifeSpan ePTFE vascular grafts-straight, regular or thin wall-5-8 mm dia x length 10cm</Description>
            <Size>5-8 mm dia x 10 cm long</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4454</SubGroupID>
            <ARTGs>
                <ARTG>216528</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT287</BillingCode>
            <Name>GORE-TEX® Vascular Grafts</Name>
            <Description>Vascular Grafts - Aorto - Pulmonary &amp; Systemic Pulmonary Shunts (ePTFE) Stretch &amp; Non Stretch Standard Wall &amp; Thin Wall</Description>
            <Size>Diameter 3 - 12mm, Length 5-10cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4454</SubGroupID>
            <ARTGs>
                <ARTG>137803</ARTG>
                <ARTG>137804</ARTG>
            </ARTGs>
            <MinimumBenefit>221</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BN004</BillingCode>
            <Name>Omniflow II Vascular Prosthesis</Name>
            <Description>Bioengineered Vascular Prosthesis</Description>
            <Size>3-8 mm x 20 cm</Size>
            <SupplierCode>BN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <Suffix>Biologically Engineered</Suffix>
            <ARTGs>
                <ARTG>155500</ARTG>
            </ARTGs>
            <MinimumBenefit>1332</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA019</BillingCode>
            <Name>Impra PTFE Vascular Grafts</Name>
            <Description>ePTFE graft - radially supported, thin wall, 10 - 50cm long</Description>
            <Size>4mm - 8mm diameter</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>23171</ARTG>
            </ARTGs>
            <MinimumBenefit>1164</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA022</BillingCode>
            <Name>Impra PTFE Vascular Grafts</Name>
            <Description>ePTFE graft - radially supported, regular wall, 10-50cm long</Description>
            <Size>4 - 19mm diameter</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>23171</ARTG>
            </ARTGs>
            <MinimumBenefit>1164</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB120</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Straight Standard Wall with Helix Support</Description>
            <Size>Dia 6 - 10mm, length 10 - 50cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1164</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advanta PTFE Vascular Graft</Name>
            <Description>Trilaminate PTFE Graft with Graft Deployment System</Description>
            <Size>4mm - 8mm  11cm - 20cm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>1164</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advanta PTFE Vascular Graft with Graft Deployment System</Name>
            <Description>Trilaminate PTFE. Vascular Access PTFE</Description>
            <Size>4mm - 8mm diameter  11cm - 20cm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <Suffix>R, ID</Suffix>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>1316</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA020</BillingCode>
            <Name>Impra PTFE Vascular Grafts</Name>
            <Description>ePTFE graft - thin wall, 10 - 50cm long</Description>
            <Size>3mm - 10mm diameter</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>23171</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA025</BillingCode>
            <Name>Impra PTFE Vascular Grafts</Name>
            <Description>ePTFE graft - regular wall, 10-50cm long</Description>
            <Size>3 - 19mm diameter</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>23171</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB023</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>20cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB024</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>15cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB126</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Straight</Description>
            <Size>Dia 3 - 8mm, length10 - 40cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB127</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Straight</Description>
            <Size>Dia 3 - 8mm, length 10 - 40cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER169</BillingCode>
            <Name>LifeSpan ePTFE vascular grafts-straight-regular or thin wall-20cm</Name>
            <Description>LifeSpan ePTFE vascular grafts-straight-regular or thin wall; 5-8mm dia x 20 cm long</Description>
            <Size>5-8 mm dia x 20 cm long</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>216528</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT290</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GT009</PriorBillingCode>
                <PriorBillingCode>GT146</PriorBillingCode>
                <PriorBillingCode>GT283</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GORE-TEX ® Stretch Vascular Graft</Name>
            <Description>E-PTFE Vascular Graft</Description>
            <Size>Diameters: 3 to 24mm&#xD;
Lengths: 11-20cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>137804</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Intergard W - Woven Straight</Name>
            <Description>Woven Straight</Description>
            <Size>15cm</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4455</SubGroupID>
            <ARTGs>
                <ARTG>145512</ARTG>
            </ARTGs>
            <MinimumBenefit>612</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BN029</BillingCode>
            <Name>Omniflow II Vascular Prosthesis</Name>
            <Description>Bioengineered Vascular Prosthesis</Description>
            <Size>5-8 mm x 30-45 cm</Size>
            <SupplierCode>BN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>Biologically engineered</Suffix>
            <ARTGs>
                <ARTG>155500</ARTG>
                <ARTG>215035</ARTG>
            </ARTGs>
            <MinimumBenefit>2147</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT221</BillingCode>
            <Name>Gore ® Propaten ® Vascular Graft</Name>
            <Description>Stretch and Non Stretch ePTFE Graft&#xD;
Standard Wall and Thin Wall Stretch  &#xD;
Heparin Bonded</Description>
            <Size>4 to 8 mm diameters&#xD;
21 to 49cm lengths</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>160152</ARTG>
            </ARTGs>
            <MinimumBenefit>876</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB132</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Centre Helix</Description>
            <Size>Dia 6mm, length 45cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB133</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Centre Helix</Description>
            <Size>Dia 5 - 6mm, length 45 - 50cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB146</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Easy Glide - Thin Wall Straight with Helix Support</Description>
            <Size>Dia 6 - 8mm, length 40 - 80cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT211</BillingCode>
            <Name>Gore-Tex Intering Vascular Graft</Name>
            <Description>Internally radially supported vascular graft (ePTFE)</Description>
            <Size>Diameter 6-8mm, 40cm radial supported length x 40cm length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>143262</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT252</BillingCode>
            <Name>GORE-TEX ® Stretch Vascular Graft</Name>
            <Description>Standard Wall and Thin Wall ePTFE Vascular Grafts&#xD;
Removable Rings</Description>
            <Size>4 to 10 mm diameter&#xD;
21 to 49cm lengths&#xD;
various removable ring sections</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>137805</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advanta PTFE Vascular Graft</Name>
            <Description>Trilaminate PTFE Graft with Graft Deployment System</Description>
            <Size>4mm - 8mm diameter 21cm - 49cm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU019</BillingCode>
            <Name>Gelsoft Plus Graft</Name>
            <Description>Femoro-femoral, Polyester, Knitted, Externally reinforced</Description>
            <Size>6mmx30cm to  8mmx40cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>125679</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT264</BillingCode>
            <Name>Gore ® PROPATEN ® Vascular Graft</Name>
            <Description>Standard Wall and Thin Wall ePTFE Vascular Graft&#xD;
Removable Rings &#xD;
Heparin Bonded</Description>
            <Size>4 to 8mm diameter&#xD;
21 to 49cm length&#xD;
30cm ringed length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R, H</Suffix>
            <ARTGs>
                <ARTG>160152</ARTG>
            </ARTGs>
            <MinimumBenefit>1462</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advanta PTFE Vascular Graft with Graft Deployment System</Name>
            <Description>Trilaminate PTFE. Vascular Access PTFE</Description>
            <Size>4mm - 8mm diameter  21cm - 49cm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <Suffix>R, ID</Suffix>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>1552</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB021</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>40cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB022</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>30cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB119</BillingCode>
            <Name>Vascugraft</Name>
            <Description>PTFE, Straight Standard Wall</Description>
            <Size>Dia 4 - 10mm, length 40 - 50cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB142</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Easy Glide - Standard Wall Straight</Description>
            <Size>Dia 6mm, length 40 - 60cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB144</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Easy Glide - Thin Wall Straight</Description>
            <Size>Dia 6 - 8mm, length 40 - 70cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BN026</BillingCode>
            <Name>Omniflow II Vascular Prosthesis</Name>
            <Description>Biosynthetic vascular prosthesis for peripheral revascularisation and vascular access</Description>
            <Size>9 and 10mm internal diameter, 20 to 40cm length</Size>
            <SupplierCode>BN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>155500</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BN028</BillingCode>
            <Name>Omniflow II Vascular Prosthesis</Name>
            <Description>Biosynthetic vascular prosthesis for peripheral revascularisation and vascular access</Description>
            <Size>9 and 10mm internal diameter; 45 to 85cm length</Size>
            <SupplierCode>BN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>155500</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT291</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GT281</PriorBillingCode>
                <PriorBillingCode>GT282</PriorBillingCode>
            </PriorBillingCodes>
            <Name>GORE-TEX ® Stretch Vascular Graft</Name>
            <Description>E-PTFE Vascular Graft</Description>
            <Size>Diameters: 3 to 24mm&#xD;
Lengths: 21-49cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>137804</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Maquet InterVascular Straight vascular Grafts</Name>
            <Description>Straight Vascular Grafts</Description>
            <Size>5mm - 24mm diameter, 21 -49mm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>145510</ARTG>
                <ARTG>145380</ARTG>
                <ARTG>145512</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU020</BillingCode>
            <Name>Gelsoft Plus Graft</Name>
            <Description>Straight, Polyester, Knitted</Description>
            <Size>6 - 24mm x 12.5 - 30cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4456</SubGroupID>
            <ARTGs>
                <ARTG>125679</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BN027</BillingCode>
            <Name>Omniflow II Vascular Prosthesis</Name>
            <Description>Bioengineered Vascular Prosthesis</Description>
            <Size>5-8 mm x 50-65 cm</Size>
            <SupplierCode>BN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>Biologically engineered</Suffix>
            <ARTGs>
                <ARTG>155500</ARTG>
                <ARTG>215035</ARTG>
            </ARTGs>
            <MinimumBenefit>2736</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT222</BillingCode>
            <Name>Gore ® Propaten ® Vascular Graft</Name>
            <Description>Standard Wall and Thin Wall ePTFE Graft&#xD;
Stretch and Non Stretch  &#xD;
Heparin Bonded</Description>
            <Size>4 to 8mm diameter &#xD;
≥ 50cm length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>H (heparin)</Suffix>
            <ARTGs>
                <ARTG>160152</ARTG>
            </ARTGs>
            <MinimumBenefit>966</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA255</BillingCode>
            <Name>Bard Vascular Grafts</Name>
            <Description>PFTE Graft - radial support</Description>
            <Size>50cm or &gt; 50cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>134552</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB121</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Straight Standard Wall with Helix Support</Description>
            <Size>Dia 6 - 10mm, length 60 - 80cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB122</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Straight Standard Wall with Helix Support</Description>
            <Size>Dia 5 - 8mm, length 90cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB128</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Straight Standard Wall with Helix Support</Description>
            <Size>Dia 6mm x  length 100cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB129</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Straight Standard Wall with Helix Support</Description>
            <Size>Dia 5 - 8mm, length 80 - 90cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB130</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Straight Standard Wall with Helix Support</Description>
            <Size>Dia 4 - 6mm, length 50 - 70cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB134</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Centre Helix</Description>
            <Size>Dia 4 - 8mm, length 70 - 80cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB137</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Standard with Centred Helix</Description>
            <Size>Dia 4 - 8mm, length 70 - 90cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER171</BillingCode>
            <Name>LifeSpan ePTFE vascular grafts-straight-supported-regular or thin wall, 50-80 cm</Name>
            <Description>LifeSpan ePTFE vascular grafts-straight-supported; regular and thin wall; 6-10 mm dia x 50-80 cm length; 10-80 cm external spiral support length</Description>
            <Size>6-10 mm dia x 50-80 cm length; 10-80 cm external spiral support length</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>216528</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT278</BillingCode>
            <Name>GORE-TEX ® Stretch Vascular Graft</Name>
            <Description>Standard Wall and Thin Wall&#xD;
Removable Rings&#xD;
ePTFE Vascular Graft</Description>
            <Size>4 to 10 mm diameters&#xD;
≥ 50cm lengths</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>137805</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT286</BillingCode>
            <Name>GORE® INTERING® Vascular Graft</Name>
            <Description>Stretch Thin Walled ePTFE graft with Integrated Rings</Description>
            <Size>6-8mm diameter, 60-80 cm integrated ringed section, ≥50cm length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>143262</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Atrium PTFE Vascular Graft</Name>
            <Description>Ringed PTFE</Description>
            <Size>4mm - 10mm; 50cm - 100cm</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Maquet InterVascular redially Supported Vascular Grafts</Name>
            <Description>Radially Supported Vascular Grafts</Description>
            <Size>5mm - 24mm diameter, 50 -100m length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>145506</ARTG>
                <ARTG>145511</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU045</BillingCode>
            <Name>Gelsoft Plus Graft</Name>
            <Description>Polyester, Externally Reinforced, Knitted</Description>
            <Size>6 to 10cm x 75 to 100cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>125679</ARTG>
            </ARTGs>
            <MinimumBenefit>1441</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT285</BillingCode>
            <Name>GORE® PROPATEN® Vascular Graft</Name>
            <Description>Standard Wall and Thin Wall ePTFE Vascular Graft&#xD;
Removable Rings&#xD;
Heparin Bonded</Description>
            <Size>6-8mm diameter&#xD;
30-70cm ringed section, &#xD;
≥ 50cm length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <Suffix>R, H</Suffix>
            <ARTGs>
                <ARTG>160152</ARTG>
            </ARTGs>
            <MinimumBenefit>1561</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA254</BillingCode>
            <Name>Bard Vascular Graft</Name>
            <Description>PTFE graft</Description>
            <Size>50 cm or &gt; 50cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>134452</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB018</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>100cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB019</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>60cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB020</BillingCode>
            <Name>Vascular Uni - Graft</Name>
            <Description>Vascular graft</Description>
            <Size>50cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB123</BillingCode>
            <Name>Vascugraft</Name>
            <Description>PTFE - Straight Standard Wall</Description>
            <Size>Dia 5 - 10mm, length 80cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB124</BillingCode>
            <Name>Vascugraft</Name>
            <Description>PTFE - Straight Standard Wall</Description>
            <Size>Dia 5 - 8mm, length 90 - 100cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB125</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Straight</Description>
            <Size>Dia 3 - 8mm, length 70 - 100cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB141</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Easy Glide - Standard Wall Straight</Description>
            <Size>Dia 6mm, length 70 - 80cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER170</BillingCode>
            <Name>LifeSpan ePTFE vascular grafts-straight-regular or thin wall, 50-100 cm</Name>
            <Description>LifeSpan ePTFE vascular grafts-straight-regular or thin wall, 5-10 mm dia x length 50-100 cm</Description>
            <Size>5-10 mm dia x length 50-100 cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>216528</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT288</BillingCode>
            <Name>GORE-TEX® Vascular Grafts</Name>
            <Description>Standard Wall, Thin Wall and Stretch Technology (eptfe)</Description>
            <Size>Diameters: 3-12mm&#xD;
Lengths: ≥   50 cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>137803</ARTG>
                <ARTG>137804</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advanta PTFE Vascular Graft</Name>
            <Description>Straight PTFE Vascular Graft</Description>
            <Size>6mm - 10mm; 50cm - 90cm</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Maquet InterVascular Straight Vascular Grafts</Name>
            <Description>Straight Vascular Grafts</Description>
            <Size>6mm - 24mm Diameter, 50-100cm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>145380</ARTG>
                <ARTG>145512</ARTG>
                <ARTG>145510</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU021</BillingCode>
            <Name>Gelsoft Plus Graft</Name>
            <Description>Straight, Polyester, Knitted</Description>
            <Size>6-24mm x 50-60cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1636</GroupID>
            <SubGroupID>4457</SubGroupID>
            <ARTGs>
                <ARTG>125679</ARTG>
            </ARTGs>
            <MinimumBenefit>767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB027</BillingCode>
            <Name>Vascular Uni - Graft - Bifurcated</Name>
            <Description>Vascular graft</Description>
            <Size>12x7 to 12x12</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1637</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>764</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT006</BillingCode>
            <Name>Gore-Tex Stretch Bifurcated Graft</Name>
            <Description>Stretch Bifurcated Graft with Thin Walled Limbs (ePTFE)</Description>
            <Size>12x6mm to 24x12mm 40-50cm long</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1637</GroupID>
            <ARTGs>
                <ARTG>11169</ARTG>
                <ARTG>143264</ARTG>
            </ARTGs>
            <MinimumBenefit>764</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Maquet InterVascular Bifurcated Vascular Grafts</Name>
            <Description>Bifurcated Vascular Grafts</Description>
            <Size>6mm - 24mm diameter, 50cm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1637</GroupID>
            <ARTGs>
                <ARTG>145507</ARTG>
                <ARTG>145515</ARTG>
            </ARTGs>
            <MinimumBenefit>764</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU013</BillingCode>
            <Name>Gelweave Graft</Name>
            <Description>Bifurcated, Polyester, Woven</Description>
            <Size>12mmx 6mmx 45 cm to 24mmx12mm x 45cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1637</GroupID>
            <ARTGs>
                <ARTG>125606</ARTG>
            </ARTGs>
            <MinimumBenefit>764</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU014</BillingCode>
            <Name>Gelsoft Plus Graft</Name>
            <Description>Bifurcated, Polyester, Knitted</Description>
            <Size>12mmx6mmx45cm to 24mmx12mmx45cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1637</GroupID>
            <ARTGs>
                <ARTG>125679</ARTG>
            </ARTGs>
            <MinimumBenefit>764</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT216</BillingCode>
            <Name>Gore-Tex Axillobifemoral Vascular Graft</Name>
            <Description>Stretch vascular graft with removable rings (ePTFE)</Description>
            <Size>Diameter 8mm x 90cm 40cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1638</GroupID>
            <ARTGs>
                <ARTG>143248</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Intergard W</Name>
            <Description>Woven Aortic Arch</Description>
            <Size>Body Diameter 20mm - 36mm  Limbs Diameter 8 - 10mm</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1638</GroupID>
            <ARTGs>
                <ARTG>145514</ARTG>
                <ARTG>145513</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ028</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Intergard K</Name>
            <Description>Knitted Axillobifemoral</Description>
            <Size>Diameter (mm) Length (cm) 8 x 8 100/60; 10 x 10 100/60; 8 x 6 x 6 85/55; 8 x 8 85/55; 8 x 8 100/55</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1638</GroupID>
            <ARTGs>
                <ARTG>145509</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU018</BillingCode>
            <Name>Gelsoft Plus Graft</Name>
            <Description>Axillo-bifemoral, Polyester, Knitted, Externally reinforced</Description>
            <Size>8x8mm/100x60cm; 8x7mm/90x40cm; 10x8mm/90x40cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1638</GroupID>
            <ARTGs>
                <ARTG>125679</ARTG>
            </ARTGs>
            <MinimumBenefit>1760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advantra PTFE Vascular Graft with Graft Deployment System</Name>
            <Description>Trilaminate PTFE. Vascular Access Graft</Description>
            <Size>4mm - 8mm diameter. 50 - 80cm length</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <Suffix>ID (immediate dialysis)</Suffix>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>2294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER173</BillingCode>
            <Name>LifeSpan ePTFE vascular grafts-supported, tapered or end modified 50-80 cm</Name>
            <Description>LifeSpan ePTFE vascular grafts-supported, end modified or tapered, regular or thin wall, 4-7 mm dia x 50-80 cm length; spiral length 5-70 cm</Description>
            <Size>4-7 mm dia x 50-80 cm length; spiral length 5-70 cm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>216528</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT214</BillingCode>
            <Name>Gore-Tex Intering Vascular Graft</Name>
            <Description>Internally radially supported vascular graft (ePTFE)</Description>
            <Size>4-6 tapered diameter 38cm radial support length 45cm length; 4-7 tapered diameter 38cm radial support length 45cm length; 6mm diameter 40cm radial support length 40cm length</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <Suffix>R (ringed)</Suffix>
            <ARTGs>
                <ARTG>143262</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA256</BillingCode>
            <Name>Bard Vascular Graft</Name>
            <Description>PTFE graft</Description>
            <Size>6-10mm diameter, 40 - 80cm length&#xD;
4mm - 8mm diameter, 10cm - 50cm length&#xD;
7 &amp; 8mm diameter. 50, 60, 70, 80cm lengths</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>134452</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB026</BillingCode>
            <Name>Vascular Uni - Graft - Tapered</Name>
            <Description>Vascular graft</Description>
            <Size>12x6 to 24x12</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB131</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Tapered</Description>
            <Size>Dia 4 - 8mm, length 40 - 90cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB136</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Standard Tapered</Description>
            <Size>Dia 4 - 8mm, length 70 - 90cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB138</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Standard with Short Taper</Description>
            <Size>Dia 4 - 8mm, length 30 - 70cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB139</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Standard with Short Taper</Description>
            <Size>Dia 4 - 8mm, length 80cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB143</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Easy Glide - Standard Wall with Helix Short Taper</Description>
            <Size>Dia 6 - 8mm, length 40 - 70cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB145</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Thin Wall Centred Helix Tapered</Description>
            <Size>Dia 4 - 7mm, length 70cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB155</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Standard Tapered</Description>
            <Size>Dia 4 - 7mm, length 30 - 70cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB156</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Standard Wall with Tapered Centre Helix</Description>
            <Size>Dia 4 - 8mm, length 40 - 45cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB157</BillingCode>
            <Name>Vascugraft</Name>
            <Description>Standard Wall Stepped Taper</Description>
            <Size>Dia 4 - 8mm, length 40 - 45cm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>142665</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER172</BillingCode>
            <Name>LifeSpan ePTFE vascular grafts-tapered or end modified-regular or thin wall, 40-70 cm</Name>
            <Description>LifeSpan ePTFE vascular grafts-unsupported, tapered or end modified, 4-7 mm dia x 40-70 cm long  </Description>
            <Size>4-7 mm dia x 40-70 cm long; </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>216528</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT273</BillingCode>
            <Name>Standard Wall Grafts</Name>
            <Description>Standard Wall Grafts Stretch Tapered (ePTFE)</Description>
            <Size>Diameter 4-6mm &amp; 4-7mm, Length 45 48cm</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>137804</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GX024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advantra PTFE Vascular Graft</Name>
            <Description>Tapered Trilaminate PTFE Graft with Graft Deployment System</Description>
            <Size>4mm - 8mm diameter, 10 - 40cm lengths</Size>
            <SupplierCode>GX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>208</SubCategoryID>
            <GroupID>1639</GroupID>
            <ARTGs>
                <ARTG>279716</ARTG>
            </ARTGs>
            <MinimumBenefit>771</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA257</BillingCode>
            <Name>Bard Vascular Graft</Name>
            <Description>Vascular Graft Patch</Description>
            <Size>3x6cm, 2.5x15cm, 2x9cm, 5x7.5cm, 2.5x2.5cm, 10x10cm, 5.1x10.2cm, 6x5.1cm, 1.2x10cm, 5x5cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>209</SubCategoryID>
            <GroupID>1640</GroupID>
            <SubGroupID>4458</SubGroupID>
            <ARTGs>
                <ARTG>150352</ARTG>
                <ARTG>150353</ARTG>
                <ARTG>150354</ARTG>
                <ARTG>150355</ARTG>
                <ARTG>150359</ARTG>
                <ARTG>150360</ARTG>
                <ARTG>150361</ARTG>
                <ARTG>150376</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB017</BillingCode>
            <Name>Vascular Patch</Name>
            <Description>Vascular patch</Description>
            <Size>12x9 to 3x4</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>209</SubCategoryID>
            <GroupID>1640</GroupID>
            <SubGroupID>4458</SubGroupID>
            <ARTGs>
                <ARTG>142664</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BN020</BillingCode>
            <Name>Omniflow II Vascular Prostheses - Straight</Name>
            <Description>Vascular Patch</Description>
            <Size>1.5cm x 5cm (less than 8 sq. Cm)</Size>
            <SupplierCode>BN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>209</SubCategoryID>
            <GroupID>1640</GroupID>
            <SubGroupID>4458</SubGroupID>
            <ARTGs>
                <ARTG>155500</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BN021</BillingCode>
            <Name>Omniflow II Vascular Prostheses - Straight</Name>
            <Description>Vascular Patch</Description>
            <Size>2.5cm x 10cm (more than 8 sq. cm</Size>
            <SupplierCode>BN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>209</SubCategoryID>
            <GroupID>1640</GroupID>
            <SubGroupID>4458</SubGroupID>
            <ARTGs>
                <ARTG>155500</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA258</BillingCode>
            <Name>Bard Vascular Graft</Name>
            <Description>Vascular Graft Patch</Description>
            <Size>101 - 150sq cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>209</SubCategoryID>
            <GroupID>1640</GroupID>
            <SubGroupID>4459</SubGroupID>
            <ARTGs>
                <ARTG>150354</ARTG>
                <ARTG>150355</ARTG>
                <ARTG>150357</ARTG>
                <ARTG>150359</ARTG>
                <ARTG>150361</ARTG>
                <ARTG>150376</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA259</BillingCode>
            <Name>Bard Vascular Graft</Name>
            <Description>Vascular Graft Patch</Description>
            <Size>15 x 15cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>209</SubCategoryID>
            <GroupID>1640</GroupID>
            <SubGroupID>4460</SubGroupID>
            <ARTGs>
                <ARTG>150352</ARTG>
                <ARTG>150354</ARTG>
                <ARTG>150355</ARTG>
                <ARTG>150357</ARTG>
                <ARTG>150359</ARTG>
                <ARTG>150360</ARTG>
                <ARTG>150361</ARTG>
                <ARTG>150376</ARTG>
            </ARTGs>
            <MinimumBenefit>324</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA039</BillingCode>
            <Name>Grafts Vascular</Name>
            <Description>Polyester pledgets</Description>
            <Size>Rectangle, Oval, Circle, Square 2.9mm-8mm x 6mm - 9.5mm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>209</SubCategoryID>
            <GroupID>1640</GroupID>
            <SubGroupID>4461</SubGroupID>
            <ARTGs>
                <ARTG>24168</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VA001</BillingCode>
            <Name>Venous Valve Ring</Name>
            <Description>Dacron/silicone variable diameter ring</Description>
            <Size>52mmx15mmx0.09 mm</Size>
            <SupplierCode>VA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>210</SubCategoryID>
            <GroupID>1641</GroupID>
            <ARTGs>
                <ARTG>64017</ARTG>
            </ARTGs>
            <MinimumBenefit>922</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA010</BillingCode>
            <Name>Bard Inferior Vena Cava Filter</Name>
            <Description>Nitinol self expanding vena cava filter</Description>
            <Size>For IVC with a diameter less than or equal to 28mm diameter</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1642</GroupID>
            <ARTGs>
                <ARTG>150739</ARTG>
                <ARTG>150742</ARTG>
                <ARTG>198865</ARTG>
                <ARTG>198866</ARTG>
            </ARTGs>
            <MinimumBenefit>2059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB169</BillingCode>
            <Name>Vena Cava Filter System</Name>
            <Description>PHYNOX Introducer system, 'J' Guidewire, Seldinger needle, disposable scalpel</Description>
            <Size>Diameter 28 mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1642</GroupID>
            <ARTGs>
                <ARTG>135820</ARTG>
            </ARTGs>
            <MinimumBenefit>2059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CB019</BillingCode>
            <Name>Option ELITE Vena Cava Filter</Name>
            <Description>The Option ELITE Vena Cava Filter is designed for the prevention of recurrent pulmonary embolism via percutaneous delivery in the inferior vena cava.</Description>
            <Size>Suitable for vessels up to 32mm</Size>
            <SupplierCode>CB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1642</GroupID>
            <ARTGs>
                <ARTG>283794</ARTG>
                <ARTG>284696</ARTG>
            </ARTGs>
            <MinimumBenefit>2059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IZ001</BillingCode>
            <Name>ALN Vena Cava Filter</Name>
            <Description>The ALN Vena Cava Filter is implanted into the SVC via the femoral, brachial and jugular vein to prevent pulmonary emboli (PEs).</Description>
            <Size>One size, diameter up to 32mm</Size>
            <SupplierCode>IZ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1642</GroupID>
            <ARTGs>
                <ARTG>184695</ARTG>
                <ARTG>184696</ARTG>
                <ARTG>184697</ARTG>
                <ARTG>184698</ARTG>
                <ARTG>184699</ARTG>
                <ARTG>184700</ARTG>
                <ARTG>185255</ARTG>
            </ARTGs>
            <MinimumBenefit>2059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>OPTEASE retrievable vena cava filter</Name>
            <Description>OPTEASE is a laser cut nitinol vena cava filter, used to treat patients at high risk of pulmonary embolisation</Description>
            <Size>Suitable for vessels up to 30mm</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1642</GroupID>
            <ARTGs>
                <ARTG>186230</ARTG>
            </ARTGs>
            <MinimumBenefit>2059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC329</BillingCode>
            <Name>Cook Celect Platinum Vena Cava Filter</Name>
            <Description>The Cook Celect Platinum Vena Cava Filter is made of a biocompatible cobalt chromium alloy.  Platinum markers are located on the end of the primary legs for increased radiopacity.</Description>
            <Size>Length: 49mm&#xD;
Diameter: 30mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1642</GroupID>
            <ARTGs>
                <ARTG>219274</ARTG>
                <ARTG>219275</ARTG>
                <ARTG>219276</ARTG>
            </ARTGs>
            <MinimumBenefit>2059</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS364</BillingCode>
            <Name>Sentinel Cerebral Protection System</Name>
            <Description>The device Sentinel Cerebral Protection System (Sentinel) is percutaneously delivered to capture and remove debris dislodged during endovascular procedures. The system utilises an embolic filter delivered to the brachiocephalic artery (Proximal Filter), and a second embolic filter delivered to the left common carotid artery (Distal Filter). The Sentinel Cerebral Protection System consists of 6 French catheter, with deployable proximal and distal filters, articulating sheath and integral handle assembly.</Description>
            <Size>Proximal filter 15mm, Distal filter 7-10mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <Suffix>Multi filter</Suffix>
            <ARTGs>
                <ARTG>319101</ARTG>
            </ARTGs>
            <MinimumBenefit>3288</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS192</BillingCode>
            <Name>Spider FX Embolic Protection Device</Name>
            <Description>The Spider FX is a rapid exchange device percutaneously delivered distal embolic protection device with components designed to capture and remove debris from vessels during interventional procedures in the vasculature.</Description>
            <Size>Filter:  3.0 - 7.0mm; Capture Wire:  190 and 320cm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <ARTGs>
                <ARTG>151258</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS085</BillingCode>
            <Name>Filterwire EZ</Name>
            <Description>Embolic Protection Device</Description>
            <Size>Vessel compatibility 3.5mm - 5.5mm and delivery system lengths up to 300cm.</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <ARTGs>
                <ARTG>167933</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DL003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MB026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>WIRION Embolic Protection System</Name>
            <Description>Temporary arterial embolic protection system</Description>
            <Size>Blood vessel diameter: 3.5 - 6.0mm&#xD;
Filter unit length: 22.5mm&#xD;
Pore size: 120μ&#xD;
Crossing profile: 3.2F&#xD;
Guide catheter/Sheath: 6F&#xD;
Delivery catheter length: 145cm&#xD;
Retrieval catheter length: 146cm</Size>
            <SupplierCode>DL</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <ARTGs>
                <ARTG>280883</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Angioguard RX Emboli Capture Guidewire System</Name>
            <Description>Distal protection device and delivery system</Description>
            <Size>Length 180cm, Diameter 0.014"; basket sizes 4mm, 5mm, 6mm, 7mm and 8mm</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <ARTGs>
                <ARTG>116900</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ449</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Emboshield</Name>
            <Description>Embolic Protection Device, including delivery system, device specific procedural wire, filter for capturing embolic matter and retrieval system</Description>
            <Size>Large and small. Two wire lengths: 190cm for Monorail system and 315cm for Over the wire</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <ARTGs>
                <ARTG>168012</ARTG>
                <ARTG>142453</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ450</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Accunet</Name>
            <Description>Embolic Protection Device, including delivery system, device specific procedural wire, filter for capturing embolic matter and retrieval system.</Description>
            <Size>4.5 - 7.5; 190cm, 300cm length catheter</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <ARTGs>
                <ARTG>141869</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VD006</BillingCode>
            <Name>ROBIN Neuroprotection System</Name>
            <Description>The ROBIN Neuroprotection System is an emboli capture guidewire intended to collect embolic material during carotid artery angioplasty procedures including stent placement. The device consists of a nitinol "filtering basket" structure, attached to a guidewire.</Description>
            <Size>Filtering Basket Diameter: 4-8mm  Guidewire Length: 170cm, 300cm</Size>
            <SupplierCode>VD</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>211</SubCategoryID>
            <GroupID>1643</GroupID>
            <ARTGs>
                <ARTG>321802</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS034</BillingCode>
            <Name>Contour PVA</Name>
            <Description>Polyvinyl Alcohol (PVA) embolization particles spherical-shaped PVA</Description>
            <Size>Up to 1200 micron, volume up to 2ml.</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1645</GroupID>
            <ARTGs>
                <ARTG>289243</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS374</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE294</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bead Block</Name>
            <Description>Polyvinyl Alcohol hydrogel microspheres in pre-loaded syringe</Description>
            <Size>2ml- (100 - 300, 300 - 500, 500 - 700, 700 - 900, 900 - 1200 microns</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1645</GroupID>
            <ARTGs>
                <ARTG>271535</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW012</BillingCode>
            <Name>Bearing nsPVA</Name>
            <Description>Bearing nsPVA are non-bioabsorbable embolization particles used for the embolization of peripheral hypervascularized tumors, including leiomyoma and&#xD;
peripheral arteriovenous malformations (AVMs).</Description>
            <Size>45-150 microns&#xD;
150-250 microns&#xD;
250-355 microns&#xD;
355-500 microns&#xD;
500-710 microns&#xD;
710-1000 microns&#xD;
1000-1180 microns</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1645</GroupID>
            <ARTGs>
                <ARTG>285716</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC044</BillingCode>
            <Name>PVA Embolisation particles</Name>
            <Description>Embolisation &amp; Occlusion</Description>
            <Size>Particle Size Ranges (microns) 50-100, 100-200, 200-300,300-500, 500-700, 700-1000, 1000-1500, 1500-2000, 2000-2800</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1645</GroupID>
            <ARTGs>
                <ARTG>216797</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS026</BillingCode>
            <Name>VortX and Pushable Coils</Name>
            <Description>Pushable coils</Description>
            <Size>Diameters up to 30mm and lengths up to 60mm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P (Platinum)</Suffix>
            <ARTGs>
                <ARTG>293646</ARTG>
            </ARTGs>
            <MinimumBenefit>116</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY008</BillingCode>
            <Name>Platinum Spirale and Cirrus embolisation coils &lt;100mm</Name>
            <Description>Embolisation coils with or without fibers</Description>
            <Size>Spiral diameter 2mm to 16mm&#xD;
Length: 25mm to 80mm&#xD;
Coil diameter: 0.27mm to 0.82mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P (Platinum)</Suffix>
            <ARTGs>
                <ARTG>175423</ARTG>
                <ARTG>175567</ARTG>
            </ARTGs>
            <MinimumBenefit>116</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY009</BillingCode>
            <Name>Platinum Spirale and Cirrus embolisation coils 100-150mm</Name>
            <Description>Embolisation coils with or without fibers</Description>
            <Size>Spiral diameter: 4mm to 11mm&#xD;
Length: 100mm to 150mm&#xD;
Coil diameter:  0.27mm to 0.82mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P (Platinum)</Suffix>
            <ARTGs>
                <ARTG>175567</ARTG>
                <ARTG>175423</ARTG>
            </ARTGs>
            <MinimumBenefit>116</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC038</BillingCode>
            <Name>Coil - Embolisation Coils MWCE-TORNADO</Name>
            <Description>Tornado Platinum</Description>
            <Size>Diameters: .018, .035 and .038, Coil Taper Diameters: 2mm to 10mm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P (Platinum)</Suffix>
            <ARTGs>
                <ARTG>372277</ARTG>
            </ARTGs>
            <MinimumBenefit>116</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC039</BillingCode>
            <Name>Cook Embolization Coil</Name>
            <Description>Hilal Platinum</Description>
            <Size>Diameters: .018, Extended Lengths: .5cm to 6cm, Coil Diameters: Straight to 10mm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P (Platinum)</Suffix>
            <ARTGs>
                <ARTG>142651</ARTG>
            </ARTGs>
            <MinimumBenefit>116</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC173</BillingCode>
            <Name>Cook Embolisation Coils</Name>
            <Description>Nester Platinum</Description>
            <Size>Recommended catheter ID and end hole  diameter inch: .018 and .035inch. Coiled embolus diameters:  2mm to 20mm. Extended embolus lengths: 30 to 200mm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P (Platinum)</Suffix>
            <ARTGs>
                <ARTG>372277</ARTG>
            </ARTGs>
            <MinimumBenefit>116</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU053</BillingCode>
            <Name>AZUR Peripheral HydroCoil</Name>
            <Description>AZUR Peripheral Coil, detachable</Description>
            <Size>3-20mm diameter, length 3-50cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, Gel, repositionable (Platinum, Gel, repostionable)</Suffix>
            <ARTGs>
                <ARTG>190399</ARTG>
            </ARTGs>
            <MinimumBenefit>997</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS021</BillingCode>
            <Name>Interlock Detachable Coils</Name>
            <Description>Platinum-tungsten, Fibered Occlusion System</Description>
            <Size>Coil diameters up to 30mm and lengths up to 100cm. Delivery system lengths up 200cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, ids (Platinum, integral delivery system)</Suffix>
            <ARTGs>
                <ARTG>293646</ARTG>
                <ARTG>322240</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS400</BillingCode>
            <Name>EMBOLD Fully Retractable Coils</Name>
            <Description>Platinum-tungsten, Fibered Occlusion System </Description>
            <Size>Coil diameters up to 32mm and lengths up to 60cm, Delivery system lengths up to 200 cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, repositionable (Platinum, repositionable)</Suffix>
            <ARTGs>
                <ARTG>322240</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EE034</BillingCode>
            <Name>Concerto Detachable Coil System</Name>
            <Description>Platinum alloy coils (including coils enlaced with PGLA filaments and Nylon Fibers)  attached to a composite implant delivery pusher with a radiopaque positioning marker. The proximal end of the pusher is loaded into the Actuator which detaches the coil.</Description>
            <Size>Diameter:  1.5 - 25mm; Length:  1 - 50cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, repositionable (Platinum, repositionable)</Suffix>
            <ARTGs>
                <ARTG>205313</ARTG>
                <ARTG>337400</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI453</BillingCode>
            <Name>Concerto Versa Detachable Coil</Name>
            <Description>Platinum-tungsten embolization coil (enlaced with nylon fibers) attached to a composite delivery pusher, and a hand-held Instant Detacher.</Description>
            <Size>Diameters 3–32 mm, Length 5-65 cm.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, repositionable (Platinum, repositionable)</Suffix>
            <ARTGs>
                <ARTG>337400</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN012</BillingCode>
            <Name>Penumbra Ruby Coil System</Name>
            <Description>The Ruby Coil System is comprised of a platinum embolisation coil attached to a composite pusher with a radiopaque positioning marker. The coil is transferred onto the microcatheter and the coil should be advanced under fluoroscopic guidance. The detachment handle is attached and advanced over the proximal end of the delivery pusher and then the coil is detached by using the retraction button on the handle into the preferred site.</Description>
            <Size>Diameter.mm. - Length .cm.     3 x 5   3 x 12    3 x 20     4 x 10    4 x 15     4 x 20   4 x 30     4 x 35    5 x 12     5 x 20    5 x 30   6 x 12    6 x 20      6 x 30     7 x 25      7  x40   8 x 25      8 x 40    9 x 30     10 x 35    12 x 40    12 x 60    14 x 40     14 x 60    16 x 60     18 x 57    20 x 60     24 x 57    28 x 60     32 x 60    36 x 60  40 x 60  2 x 1     2 x 2    2 x 4     3 x 5    3 x 15     4 x 6    4 x 15    6 x 20    6 x 30    8 x 35   8 x 60     10 x 35    12 x 40     16 x 50    20 x 60    </Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, repositionable (Platinum, repositionable)</Suffix>
            <ARTGs>
                <ARTG>227196</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY051</BillingCode>
            <Name>Prestige Plus Detachable Coil</Name>
            <Description>Implantable embolization Coil comprised of platinum-tungsten alloy attached to a proximal stainless steel hypo-tube and distal body coil delivery pusher with a radiopaque distal positioning marker and a proximal fluorosafe marker.  </Description>
            <Size>Diameter 2mm-24mm  Length 2cm-65cm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, repositionable (Platinum, repositionable)</Suffix>
            <ARTGs>
                <ARTG>377475</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU052</BillingCode>
            <Name>AZUR Peripheral Framing Coil</Name>
            <Description>AZUR Peripheral Coil,detachable, Framing Coil three dimensional complex shape</Description>
            <Size>8-20mm diameter, length 20-50cm</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, repositionable (Platinum, repositionable)</Suffix>
            <ARTGs>
                <ARTG>190399</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC320</BillingCode>
            <Name>Retracta Detachable Embolization Coil</Name>
            <Description>The Retracta Detachable Embolization Coil is a platinum coil with spaced synthetic fibers, and is attached to a delivery wire.</Description>
            <Size>Coiled embolus diameters: 4-20mm&#xD;
Length: 7-14cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <Suffix>P, repositionable (Platinum, repositionable)</Suffix>
            <ARTGs>
                <ARTG>210182</ARTG>
            </ARTGs>
            <MinimumBenefit>916</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC190</BillingCode>
            <Name>MReye Embolization Coil</Name>
            <Description>Standard MReye</Description>
            <Size>Diameters: .035 and .038, Extended Lengths: 1cm to 20cm, Coil Diameters: 2mm to 20mm</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5472</SubGroupID>
            <ARTGs>
                <ARTG>372278</ARTG>
            </ARTGs>
            <MinimumBenefit>53</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY010</BillingCode>
            <Name>Platinum Spirale and Cirrus embolisation coils 200-450mm</Name>
            <Description>Embolisation coils with and without fibers</Description>
            <Size>Spiral diameter: 5mm to 16mm&#xD;
Length: 200mm to 450mm&#xD;
Coil diameter: 0.82mm</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1646</GroupID>
            <SubGroupID>5473</SubGroupID>
            <Suffix>P (Platinum)</Suffix>
            <ARTGs>
                <ARTG>175423</ARTG>
                <ARTG>175567</ARTG>
            </ARTGs>
            <MinimumBenefit>231</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW002</BillingCode>
            <Name>Embospheres</Name>
            <Description>-</Description>
            <Size>1ml per implant</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1647</GroupID>
            <SubGroupID>4466</SubGroupID>
            <ARTGs>
                <ARTG>144426</ARTG>
            </ARTGs>
            <MinimumBenefit>268</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OW011</BillingCode>
            <Name>Embospheres</Name>
            <Description>-</Description>
            <Size>2ml per implant</Size>
            <SupplierCode>OW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1647</GroupID>
            <SubGroupID>4467</SubGroupID>
            <ARTGs>
                <ARTG>144426</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU065</BillingCode>
            <Name>Embolization Microsphere</Name>
            <Description>HydroPearl™ microspheres are part of a family of embolic materials based on MicroVention’s&#xD;
proprietary microsphere technology. These spheres are designed to offer controlled,&#xD;
targeted embolisation. HydroPearl™ is made using Poly-Ethylene Glycol and comprises&#xD;
of a range of microspheres that are pre-formed, compressible, calibrated, spherical and&#xD;
biocompatible.</Description>
            <Size>75-1100 micron</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1647</GroupID>
            <SubGroupID>4467</SubGroupID>
            <ARTGs>
                <ARTG>292403</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VN003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BS314</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Embozene Microspheres</Name>
            <Description>Uniquely colour-coded microspheres used in the embolization of hypervascular tumours and arteriovenous malformations</Description>
            <Size>In between the range of 40 - 1130 micron -  2ml</Size>
            <SupplierCode>VN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1647</GroupID>
            <SubGroupID>4467</SubGroupID>
            <ARTGs>
                <ARTG>289243</ARTG>
            </ARTGs>
            <MinimumBenefit>402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DL006</BillingCode>
            <Name>IMPEDE Embolization Plug</Name>
            <Description>The IMPEDE Embolization Plug is a pushable embolization device comprised of a self-expanding porous Shape Memory Polymer (SMP) Plug and a proximal platinum/iridium markerband or distal pre-shaped helical Anchor Coil comprised of nitinol and platinum, and a proximal platinum marker band..  The device is supplied pre-loaded in an Introducer with the SMP Plug in a crimped state. It is designed to be delivered to the target vessel using a guidewire through a standard catheter/sheath. Upon deployment in the target vessel and exposure to an aqueous environment and body temperature, the SMP Plug will self-expand to embolize the target vessel.  The IMPEDE Embolization Plug System is packaged as a single unit and is provided sterile, non-pyrogenic, and is intended for single use only.  </Description>
            <Size>5mm, 6 mm, 7mm, 8 mm, 10mm, 12 mm</Size>
            <SupplierCode>DL</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <Suffix>Microcatheter</Suffix>
            <ARTGs>
                <ARTG>386855</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI185</BillingCode>
            <Name>MVP Microvascular Plug System</Name>
            <Description>MVP Microvascular Plug can be delivered through a microcatheter to enable rapid occlusion.</Description>
            <Size>Unconstrained device diameter (mm): 5.3, 6.5, 9.2, &amp; 13.0</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <Suffix>Microcatheter</Suffix>
            <ARTGs>
                <ARTG>332241</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ266</BillingCode>
            <Name>AMPLATZER Vascular Plug - II</Name>
            <Description>The AMPLATZER Vascular Plug II is a self-expandable, multi-lobed cylindraical device made from a nitinol wire mesh.</Description>
            <Size>3mm-22mm Diameter, 6mm-18mm Plug Length</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <Suffix>ids (integral delivery system)</Suffix>
            <ARTGs>
                <ARTG>156560</ARTG>
                <ARTG>345217</ARTG>
            </ARTGs>
            <MinimumBenefit>1895</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IZ002</BillingCode>
            <Name>EOS Endoluminal Occlusion System</Name>
            <Description>EOS is made of self-expandable Nitinol flat wire, serving as a supportive scaffold with significant radial strength, covered by impermeable ePTFE membrane for achievement of immediate occlusion of a peripheral vessel. This implant is pre-loaded on a delivery catheter with 2 deployment handles. This System will be inserted through a standard guide catheter (not included) up to the targeted segment.</Description>
            <Size>3 to 5 mm of vessel diameter (6.1 mm diameter unconstrained)&#xD;
4.5 to 8 mm of vessel diameter (9.1 mm diameter unconstrained)&#xD;
7.5 to 11 mm of vessel diameter (12.2 mm diameter unconstrained)</Size>
            <SupplierCode>IZ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <ARTGs>
                <ARTG>229075</ARTG>
            </ARTGs>
            <MinimumBenefit>1487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PN016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>POD Packing Coil</Name>
            <Description>POD Packing coil is a soft shapeless coil up to 60cm in length designed to pack very densely behind POD to occlude arteries and veins throughout the peripheral vasculature.</Description>
            <Size>15cm, 30cm, 45cm, 60cm lengths</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <ARTGs>
                <ARTG>235149</ARTG>
            </ARTGs>
            <MinimumBenefit>1487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN024</BillingCode>
            <Name>Penumbra POD Occlusion Device</Name>
            <Description>The Peripheral Occlusion Device (POD) is compromised of a specifically designed platinum enbolisation coil with varied diameter and is attache to a composite pusher with a radiopaque positioning marker. The distal Anchor segment has a larger diameter to secure the coil in a straight or fast flowing vessel. The proximal segment has a softer and smaller diameter to ensure occlusion and stasis of the vessel. The device is transferred into the microcatheter and advanced under fluoroscopic guidance. The device may be fully deployed prior to detachment. the detachment handle is attached and advanced over the proximal ned of the delivery pusher and the the device is detached by using the retraction button on the handle for accurate placement</Description>
            <Size>20cm Length - 3mm diameter  30cm Length - 3.25 - 4mm diameter  30cm Length - 4-5mm diameter  50cm Length - 5-6mm diameter  60cm Length - 6-8mm diameter  60cm Length - 8-10mm diameter  60cm Length - 10-12mm diameter  60cm Length - 12-14mm diameter</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <ARTGs>
                <ARTG>235149</ARTG>
            </ARTGs>
            <MinimumBenefit>1487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN025</BillingCode>
            <Name>Penumbra POD Packing Coil</Name>
            <Description>Platinum coil designed in a WAVE shape to behave like a liquid to compliment the Plug effect of the POD and pack densely, reducing reliance on thrombus formation. This packing coil does not have the traditional 3D shape formation of other coils so only has a measurement of length</Description>
            <Size>5cm length  15cm length  30cm length  45cm length  60cm length</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <ARTGs>
                <ARTG>235149</ARTG>
            </ARTGs>
            <MinimumBenefit>1487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ265</BillingCode>
            <Name>Amplatzer Vascular Plug</Name>
            <Description>Self expandable nitinol wire mesh</Description>
            <Size>Diameter 4mm - 16mm, Length 7 &amp; 8mm</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <ARTGs>
                <ARTG>114855</ARTG>
                <ARTG>345216</ARTG>
            </ARTGs>
            <MinimumBenefit>1487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ268</BillingCode>
            <Name>Amplatzer Vascular Plug III</Name>
            <Description>AVP III is a self-expanding, Nitinol mesh occlusion device.</Description>
            <Size>Size: (mm): 4, 6, 8, 10, 10, 12, 12, 14, 14  Long Axis (mm): 4, 6, 8, 10, 10, 12, 12, 14, 14 Length (mm): 6.5</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <ARTGs>
                <ARTG>169352</ARTG>
            </ARTGs>
            <MinimumBenefit>1487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ269</BillingCode>
            <Name>AMPLATZER Vascular Plug 4</Name>
            <Description>The AMPLATZER Vascular Plug 4 (AVP4) is a self-expanding, Nitinol mesh occlusion device. The Device has a radiopaque marker band at each end and a micro screw attachment at one end for attaching to the delivery wire. The AVP4 fits through a 0.038 guidewire compatible diagnostic catheter allowing the use of the same catheter throughout the procedure rather than having to exchange the diagnostic catheter for a second delivery catheter to place a plug.</Description>
            <Size>4mm 4 diameter 10.0 length  5mm 5 diameter 10.5 length  6mm 6 diameter 11.0 length  7mm 7 diameter 12.5 length  8mm 8 diameter 13.5 length</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1648</GroupID>
            <ARTGs>
                <ARTG>168673</ARTG>
                <ARTG>345218</ARTG>
            </ARTGs>
            <MinimumBenefit>1487</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DL004</BillingCode>
            <Name>VenaBlock Venous Closure System</Name>
            <Description>VenaBlock is an n-Butyy Cyanoacrylate-polymer structure which was modified by adding a monomer synthesized by the producing company. It is a ready for use, blue colored, transparent liquid. The product exhibits a polymerization effect with embolization. When in contact with living tissue and in humid environments, it rapidly polymerises  by forming a thin, flexible membrane with high tension resistance that adheres firmly to the tissues.</Description>
            <Size>One size</Size>
            <SupplierCode>DL</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1692</GroupID>
            <SubGroupID>7041</SubGroupID>
            <ARTGs>
                <ARTG>283020</ARTG>
            </ARTGs>
            <MinimumBenefit>713</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI285</BillingCode>
            <Name>VenaSeal™ Closure System</Name>
            <Description>Cyanoacrylate liquid embolic material</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1692</GroupID>
            <SubGroupID>7041</SubGroupID>
            <ARTGs>
                <ARTG>301722</ARTG>
            </ARTGs>
            <MinimumBenefit>713</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS191</BillingCode>
            <Name>Onyx System</Name>
            <Description>DSMO Liquid Embolic Material</Description>
            <Size>500 Formulation</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1692</GroupID>
            <Suffix>ids (integral delivery system)</Suffix>
            <ARTGs>
                <ARTG>151837</ARTG>
            </ARTGs>
            <MinimumBenefit>4468</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS190</BillingCode>
            <Name>Onyx</Name>
            <Description>DSMO/Liquid Embolic Material</Description>
            <Size>18, 20, 34 (formulations)</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1692</GroupID>
            <ARTGs>
                <ARTG>151837</ARTG>
            </ARTGs>
            <MinimumBenefit>2076</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME229</BillingCode>
            <Name>SQUID LIQUID EMBOLIC AGENT</Name>
            <Description>SQUID is a non-adhesive, liquid embolic agent consisting of an ethylene vinyl alcohol (EVOH ) copolymer dissolved in DMSO (dimethyl sulfoxide), and suspended micronized tantalum powder to provide contrast for visualisation under fluoroscopy.  The SQUID Liquid Embolic System consists of a vial of SQUID, a vial of DMSO, two SQUID delivery syringes, one DMSO delivery syringe, two syringe adapters and 8 stickers to identify the vials of SQUID.  A SQUID-compatible delivery micro-catheter, the use of which is indicated for the neurovascular system (Sonic, Balt catheters) is used to access the embolization site.  The adapter is an interface between the SQUID delivery syringe and the delivery catheter.</Description>
            <Size>12, 12LD, 18, 18LD formulations</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1692</GroupID>
            <ARTGs>
                <ARTG>262852</ARTG>
                <ARTG>262853</ARTG>
            </ARTGs>
            <MinimumBenefit>2076</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI208</BillingCode>
            <Name>Onyx 6ml Kit</Name>
            <Description>DMSO Liquid Embolic Material</Description>
            <Size>6ml Kit</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1692</GroupID>
            <ARTGs>
                <ARTG>151837</ARTG>
            </ARTGs>
            <MinimumBenefit>7265</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS028</BillingCode>
            <Name>GDC and PVA Delivery Catheters</Name>
            <Description>Microcatheter Delivery Systems</Description>
            <Size>Delivery system lengths up to 175cm</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1693</GroupID>
            <SubGroupID>5506</SubGroupID>
            <ARTGs>
                <ARTG>275748</ARTG>
            </ARTGs>
            <MinimumBenefit>599</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC296</BillingCode>
            <Name>Cantata Microcatheter</Name>
            <Description>Microcatheter</Description>
            <Size>2.5-2.9Fr. Length: 100-150cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1693</GroupID>
            <SubGroupID>5506</SubGroupID>
            <ARTGs>
                <ARTG>184996</ARTG>
                <ARTG>219277</ARTG>
            </ARTGs>
            <MinimumBenefit>599</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN017</BillingCode>
            <Name>Penumbra Ruby Coil System, Detachment Handle</Name>
            <Description>The Ruby Coil System is comprised of a platinum embolisation coil attached to a composite pusher with a radiopaque positioning marker and a Detachment Handle. The coil is transferred onto the microcatheter and the coil should be advanced under fluoroscopic guidance. The detachment handle is attached and advanced over the proximal end of the delivery pusher and then the coil is detached by using the retraction button on the handle into the preferred site.</Description>
            <Size>N/A</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1693</GroupID>
            <SubGroupID>5507</SubGroupID>
            <ARTGs>
                <ARTG>220462</ARTG>
            </ARTGs>
            <MinimumBenefit>251</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PN021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>PN016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>POD Detachmnet Handle</Name>
            <Description>The POD Detachment handle is a plastic handle used to mechanically detach the POD Implant. Sterile Single use patient device</Description>
            <Size>N/A</Size>
            <SupplierCode>PN</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1693</GroupID>
            <SubGroupID>5507</SubGroupID>
            <ARTGs>
                <ARTG>233485</ARTG>
            </ARTGs>
            <MinimumBenefit>251</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PY052</BillingCode>
            <Name>Ultra, Prestige Plus Coil Detachment Controller</Name>
            <Description>Handheld battery powered coil detachment controller  </Description>
            <Size>One Size only</Size>
            <SupplierCode>PY</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1693</GroupID>
            <SubGroupID>5507</SubGroupID>
            <ARTGs>
                <ARTG>376881</ARTG>
            </ARTGs>
            <MinimumBenefit>251</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU054</BillingCode>
            <Name>AZUR Peripheral Coil Detachment Controller</Name>
            <Description>Hand held battery powered coil detachment controller</Description>
            <Size>One size only</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>213</SubCategoryID>
            <GroupID>1693</GroupID>
            <SubGroupID>5507</SubGroupID>
            <ARTGs>
                <ARTG>190400</ARTG>
            </ARTGs>
            <MinimumBenefit>251</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX339</BillingCode>
            <Name>GamCath Dolphin Protect HighFlow Haemodialysis Catheter Kit</Name>
            <Description>Haemodialysis catheter with a modified anti-thrombogenic surface (polymer system of polydimethysilxane blocks) and a non-release anti-microbial coating (Bismith copolymer film) on internal and external surfaces of catheter.</Description>
            <Size>109585 - 13Fr x 15cm double lumen: 109584 - 13FRx 20cm double lumen, 109705 - 13Fr x 25cm double lumen; 109706 - 13Fr x 15cm curved double lumen; 109707 - 13Fr x 20cm curved double lumen.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>120507</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX029</BillingCode>
            <Name>ARROWg+ard Blue Haemodialysis Catheters</Name>
            <Description>Haemodialysis Catheters (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter material.</Description>
            <Size>CS-22122 - 12Fr 16cm, Dual Lumen CS-22123 – 12Fr 16cm, Triple Lumen CS-25122 – 12Fr x 20cm, Dual Lumen CS-22142CF – 14Fr x 15cm, Dual Lumen, Curved, Firm CS-22142F – 14Fr x 15cm, Dual Lumen Firm CS-25122 – 12Fr x 20cm, Double Lumen CS-25123 – 12Fr x 20cm, Triple Lumen CS- 25142CF – 14Fr x 20cm, Double Lumen, Curve, Firm CS-25142F – 14Fr x 20cm, Double Lumen, Firm CS-26142F – 14Fr x 25cm, Double Lumen, Firm  CU-22122 – 12Fr x 16cm, Double Lumen, Curved CU-23122 – 12Fr x 13cm, Double Lumen, Curved CU-25122 – 12Fr x 20cm, Double Lumen, Curved, Dueal Lumen CS-22142CF - 14Fr x 15cm, Dual Lumen, Curved, Firm CS-22142F - 14Fr x 15cm, Dual Lumen Firm CS-25122 - 12Fr x 20cm</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>158708</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA140</BillingCode>
            <Name>Haemodialysis Catheters</Name>
            <Description>Dialysis Catheter, Multiple Lumen</Description>
            <Size>12.5Fr - 16FR</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>107195</ARTG>
                <ARTG>117986</ARTG>
                <ARTG>145482</ARTG>
                <ARTG>156250</ARTG>
                <ARTG>170529</ARTG>
                <ARTG>277925</ARTG>
            </ARTGs>
            <MinimumBenefit>267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KA018</BillingCode>
            <Name>Palindrome</Name>
            <Description>Haemodialysis catheter</Description>
            <Size>14.5Fr, 15 Fr, 16Fr; 19, 23, 28, 33, 55cm Insertion Lengths, with 36, 40, 45, 50, 72cm Overall length, with side slots, symmetric tip</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>184449</ARTG>
                <ARTG>217352</ARTG>
            </ARTGs>
            <MinimumBenefit>267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI238</BillingCode>
            <Name>Palindrome Precision</Name>
            <Description>Haemodialysis catheter</Description>
            <Size>14 Fr-16 Fr. 19-55cm (implant length) with 19-72cm overall length with side slots, symmetric tip</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>270192</ARTG>
                <ARTG>270194</ARTG>
            </ARTGs>
            <MinimumBenefit>267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS070</BillingCode>
            <Name>BioFlo DuraMax</Name>
            <Description>Percutaneous Catheter for Haemodialysis, Dual Lumen, Cuffed</Description>
            <Size>French Size: 15.5 Fr   Catheter Length: 20 - 55 cm  Tip-to-Cuff Length: 15 - 50 cm</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>283676</ARTG>
                <ARTG>283677</ARTG>
                <ARTG>283678</ARTG>
                <ARTG>283679</ARTG>
                <ARTG>283680</ARTG>
            </ARTGs>
            <MinimumBenefit>267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TK005</BillingCode>
            <Name>Medcomp Long Term Catheter sets for Haemodialysis</Name>
            <Description>ASH, TESIO-BioFlex with cuff</Description>
            <Size>10, 14 French   24,28,32 &amp; 36cm lengths</Size>
            <SupplierCode>TK</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>145174</ARTG>
            </ARTGs>
            <MinimumBenefit>267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TK006</BillingCode>
            <Name>Medcomp Long Term Catheter sets for Haemodialysis</Name>
            <Description>HemoFlow HFS-Carbothane with cuff</Description>
            <Size>14.5 French   24,28,32 &amp; 36cm lengths</Size>
            <SupplierCode>TK</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>145174</ARTG>
            </ARTGs>
            <MinimumBenefit>267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX054</BillingCode>
            <Name>Arrow-Clark(TM) VectorFlow(TM) Chronic Haemodialysis Catheter</Name>
            <Description>The Arrow-Clark VectorFlow Catheter is indicated for use in attaining long-term vascular access for hemodialysis and apheresis.</Description>
            <Size>15Fr x 19cm, 15Fr x 23cm, 15Fr x 27cm, 15Fr x 31cm, 15Fr x 42cm, 15Fr x 55cm,</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>289583</ARTG>
                <ARTG>289730</ARTG>
            </ARTGs>
            <MinimumBenefit>267</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA215</BillingCode>
            <Name>Haemodialysis Catheter</Name>
            <Description>Power Injectable, Triple Lumen Haemodialysis Catheter</Description>
            <Size>13Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>141187</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA211</BillingCode>
            <Name>Haemodialysis Catheters</Name>
            <Description>Haemodialysis Catheters, multiple lumen</Description>
            <Size>11Fr - 13.5Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <ARTGs>
                <ARTG>141187</ARTG>
            </ARTGs>
            <MinimumBenefit>103</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX338</BillingCode>
            <Name>GamCath High Flow Catheter Kit</Name>
            <Description>GamCath High Flow Catheter is a polyurethane, kidney elliptical multi lumen, staggered tipped catheter kit, which ensures flows up to 430ml/min</Description>
            <Size>11.5fr and 13fr guage.  Available in 150mm, 175mm, 200mm and 250mm length and straight and curved configuration.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <ARTGs>
                <ARTG>120507</ARTG>
            </ARTGs>
            <MinimumBenefit>103</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI229</BillingCode>
            <Name>Mahurkar Elite Triple Lumen Catheter Kit</Name>
            <Description>Triple Lumen Catheter  Straight/Curved/Pre-Curved Exten.</Description>
            <Size>12Fr, 12.5Fr; 13-30 cm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <ARTGs>
                <ARTG>180135</ARTG>
            </ARTGs>
            <MinimumBenefit>103</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI241</BillingCode>
            <Name>Mahurkar Elite Subclavian Dual Lumen Catheter Kit</Name>
            <Description>Acute haemodialysus, short term vascular access. Catheters constructed of radiopaque polyurethane. Tips are made of polyvinyl chloride and are more radiopaque than the rest of the catheter.</Description>
            <Size>10 Fr-12Fr, 13cm-30 cm, Straight/Curved/PreCurved Exten.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <ARTGs>
                <ARTG>180135</ARTG>
            </ARTGs>
            <MinimumBenefit>103</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI242</BillingCode>
            <Name>Mahurkar Elite High Flow Dual Lumen Catheter Kit</Name>
            <Description>Mahurkar Elite High Flow Dual Lumen Catheter Kit</Description>
            <Size>13.5 Fr, 13cm-30cm, Straight/Curved/PreCurved Exten.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <ARTGs>
                <ARTG>180135</ARTG>
            </ARTGs>
            <MinimumBenefit>103</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VD003</BillingCode>
            <Name>Balton Dialysis Catheter</Name>
            <Description>The Balton Dialysis Catheter is a multiple lumen percutaneous catheter intended for obtaining access to a large blood vessel for haemodialysis.</Description>
            <Size>Length: 7-30cm  Lumen type: Double Lumen Cannula,Triple Lumen Cannual</Size>
            <SupplierCode>VD</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1651</GroupID>
            <ARTGs>
                <ARTG>313280</ARTG>
            </ARTGs>
            <MinimumBenefit>103</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA181</BillingCode>
            <Name>PowerPort</Name>
            <Description>Titanium or MRI implantable port, Open-ended Catheter, Single Chamber</Description>
            <Size>6Fr - 8Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>149028</ARTG>
                <ARTG>170347</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA208</BillingCode>
            <Name>PowerPort with Groshong Catheter</Name>
            <Description>Titanium or MRI implantable Port, Closed-Ended Catheter, Single Chamber</Description>
            <Size>8Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>170345</ARTG>
                <ARTG>170346</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB366</BillingCode>
            <Name>Celsite Safety Venous Access Port</Name>
            <Description>Celsite Safety is a venous access port that is implanted and is intended to be used for any condition that requires mid to long-term intermittent or continuous central venous infusions.</Description>
            <Size>Standard: 33 x 26mm x 13.7mm: Septum 13.0mm&#xD;
Small: 29 x 22mm x 11.3mm: Septum 10.8mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>285508</ARTG>
                <ARTG>286710</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK007</BillingCode>
            <Name>Ambix Intraport CP Powerflow &amp; Ambix Intraport T Powerflow</Name>
            <Description>Ambix Intraport® systems are completely implantable catheter systems.  They consist of a casing, a medicine compartment with a silicone membrane and a catheter which can be connected to the port casing.</Description>
            <Size>Port: 8086012 Ambix Intraport CP Powerflow&#xD;
Material: PEEK casing with aluminium oxide ceramic medicine compartment&#xD;
Diameter of port base: 30mm&#xD;
Port Weight: 7.8/7.6g&#xD;
Port filling volume: 0.21/0.25ml&#xD;
Port: 8086442&#xD;
Material: Titanium&#xD;
Diameter of port: 30mm&#xD;
Port Height: 13.8mm&#xD;
Port weight: 12.6g&#xD;
Port filling volume: 0.56ml</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>222676</ARTG>
                <ARTG>222677</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JF001</BillingCode>
            <Name>HealthPORT Power Venous Access Port</Name>
            <Description>HealthPORT Power Venous Polysufone/Titanium Implantable Venous Access Systems, for mid and long term intermittent or continuous central venous infusion. Come with Silicon or Polyurethane catheter in multiple French sizes. Kits include Port chamber, Catheter, Connector, Huber needle 22G, Luer connector, Peel-away dilator-introducer, Introducer needle 18G, J-Guidewire 0.89mm, Stainless Steel Tunneler  For Power Injection</Description>
            <Size>5-8 Fr</Size>
            <SupplierCode>JF</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>385351</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS016</BillingCode>
            <Name>Smart Port CT</Name>
            <Description>Power-Injectable, Single Chamber, Titanium, Vascular Access Port with Vortex Technology</Description>
            <Size>Detached or Pre-Attached Catheter: 6.6 Fr - 9.6 Fr</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>169838</ARTG>
                <ARTG>235097</ARTG>
                <ARTG>235098</ARTG>
                <ARTG>235099</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS079</BillingCode>
            <Name>Power Injectable Infusion Port</Name>
            <Description>Single Chamber, MRI Conditional, Vascular Access Port with Vortex Technology</Description>
            <Size>Catheter (French Size): 5Fr - 8Fr, Catheter (Length): 45 cm - 63 cm, Port Body (Height): 10.8 mm - 13.0 mm, Port Septum (Diameter): 10.2 mm - 12.7 mm</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>378930</ARTG>
                <ARTG>378931</ARTG>
                <ARTG>378932</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI054</BillingCode>
            <Name>POWER PORT-A-CATH Single Lumen</Name>
            <Description>PORT-A-CATH® POWER PAC Polysulfone/Titanium Implantable Venous Access Systems, Single Lumen with Multiple French sizes</Description>
            <Size>6 -10 fr</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>161540</ARTG>
                <ARTG>161541</ARTG>
                <ARTG>175619</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TK008</BillingCode>
            <Name>Pro-Fuse CT Power Injectable Infusion Port</Name>
            <Description>Power injectable implantable infusion port, open-ended catheter, single chamber, MRI compatible</Description>
            <Size>5F - 8F</Size>
            <SupplierCode>TK</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>159639</ARTG>
            </ARTGs>
            <MinimumBenefit>510</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA057</BillingCode>
            <Name>Groshong Subcutaneous Ports</Name>
            <Description>Titanium or MRI Implatable Port, Closed-Ended Catheter, Single Chamber</Description>
            <Size>7Fr - 8 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <ARTGs>
                <ARTG>156248</ARTG>
                <ARTG>157391</ARTG>
                <ARTG>157393</ARTG>
                <ARTG>157396</ARTG>
                <ARTG>157399</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA221</BillingCode>
            <Name>Implanted infusion Port</Name>
            <Description>Titanium or MRI Implanted Port, Open-Ended Catheter, Single Chamber</Description>
            <Size>6Fr - 9.6Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <ARTGs>
                <ARTG>156249</ARTG>
                <ARTG>157392</ARTG>
                <ARTG>157394</ARTG>
                <ARTG>157395</ARTG>
                <ARTG>157397</ARTG>
                <ARTG>157398</ARTG>
                <ARTG>157400</ARTG>
                <ARTG>157401</ARTG>
                <ARTG>157402</ARTG>
                <ARTG>157403</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB170</BillingCode>
            <Name>Celsite Access Port for pain relief</Name>
            <Description>Composition - polysulphone.  Kit includes tunnelling rod, filter, connectors, needles, syringe, tuohy needle</Description>
            <Size>Diameter of septum:11.7mm.  Height: 11.5mm.  Dimension: 25.8 x 37.8mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <ARTGs>
                <ARTG>133738</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JF002</BillingCode>
            <Name>HealthPORT  Venous Access Port</Name>
            <Description>HEALTHPORT Venous   Polysufone/Titanium Implantable Venous Access Systems, for mid and long term intermittent or continuous central venous infusion. Come with Silicon or Polyurethane catheter in multiple French sizes. Kits include Port chamber, Catheter, Connector, Huber needle 22G, Luer connector, Peel-away dilator-introducer, Introducer needle 18G, J-Guidewire 0.89mm, Stainless Steel Tunneler</Description>
            <Size>5-8 Fr</Size>
            <SupplierCode>JF</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <ARTGs>
                <ARTG>385351</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS014</BillingCode>
            <Name>Vortex Implantable Port</Name>
            <Description>Implantable access device for administration of medications, fluids, etc. and for blood sampling</Description>
            <Size>Catheter Size (Fr): 6.6 - 9.6</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <ARTGs>
                <ARTG>155910</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI053</BillingCode>
            <Name>PORT-A-CATH Single Lumen</Name>
            <Description>PORT-A-CATH® Polysulfone/Titanium Implantable Venous Access Systems, Single Lumen with Multiple French sizes</Description>
            <Size>6 - 10 fr</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1652</GroupID>
            <ARTGs>
                <ARTG>154982</ARTG>
                <ARTG>154988</ARTG>
                <ARTG>169403</ARTG>
                <ARTG>175617</ARTG>
                <ARTG>175621</ARTG>
                <ARTG>154989</ARTG>
            </ARTGs>
            <MinimumBenefit>400</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA059</BillingCode>
            <Name>Dual Lumen Subcutaneous Ports</Name>
            <Description>Silicone, Polyurethane or ChronoFlex Open-ended Catheter</Description>
            <Size>7 - 10 French Catheter</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1653</GroupID>
            <ARTGs>
                <ARTG>156247</ARTG>
                <ARTG>157389</ARTG>
                <ARTG>157390</ARTG>
            </ARTGs>
            <MinimumBenefit>636</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS015</BillingCode>
            <Name>Injection/Infusion Ports Sterile</Name>
            <Description>Plastic/titanium, dual lumen</Description>
            <Size>10, 10.5, 12F</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1653</GroupID>
            <ARTGs>
                <ARTG>155909</ARTG>
            </ARTGs>
            <MinimumBenefit>636</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI055</BillingCode>
            <Name>PORT-A-CATH Double Lumen</Name>
            <Description>PORT-A-CATH® Polysulfone/Titanium Implantable Venous Access Systems.  Dual Lumen with Multiple French sizes</Description>
            <Size>7-10Fr</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1653</GroupID>
            <ARTGs>
                <ARTG>175618</ARTG>
                <ARTG>175620</ARTG>
            </ARTGs>
            <MinimumBenefit>636</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KA001</BillingCode>
            <Name>Tenckhoff Peritoneal Catheters</Name>
            <Description>Tenckhoff Peritoneal Dialysis Catheters - includes a variety of catheter lengths and cuff placements </Description>
            <Size>41cm to 47cm length</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>215</SubCategoryID>
            <GroupID>1654</GroupID>
            <ARTGs>
                <ARTG>179006</ARTG>
                <ARTG>178936</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KA002</BillingCode>
            <Name>Paediatric Peritoneal Catheter</Name>
            <Description>Paediatric Peritoneal Dialysis Catheters - includes catheter options: Tenckhoff, Curl Cath, Swan Neck</Description>
            <Size>31cm to 42cm length</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>215</SubCategoryID>
            <GroupID>1654</GroupID>
            <ARTGs>
                <ARTG>179006</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KA006</BillingCode>
            <Name>Curl Cath Peritoneal Catheter</Name>
            <Description>Curl Cath Peritoneal Dialysis Catheters - includes a variety of catheter lengths and cuff placements </Description>
            <Size>57cm to 62cm length</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>215</SubCategoryID>
            <GroupID>1654</GroupID>
            <ARTGs>
                <ARTG>178936</ARTG>
                <ARTG>179006</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI319</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>KA004</PriorBillingCode>
                <PriorBillingCode>KA005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Swan Neck Peritoneal Catheter</Name>
            <Description>Swan Neck Peritoneal Dialysis Catheters - includes catheter options: Tenckhoff, Curl Cath and Presternal</Description>
            <Size>43cm to 113cm length</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>215</SubCategoryID>
            <GroupID>1654</GroupID>
            <ARTGs>
                <ARTG>179006</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB275</BillingCode>
            <Name>Excia Hip Stem</Name>
            <Description>Cemented CoCr Femoral Stem</Description>
            <Size>9mm-18mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>321607</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB386</BillingCode>
            <Name>Excia T Hip Stem</Name>
            <Description>Cemented CoCr Femoral Stem</Description>
            <Size>10 - 20 mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>321608</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ573</BillingCode>
            <Name>Summit Cemented Femoral Stem</Name>
            <Description>CoCr, tapered, unpolished</Description>
            <Size>Sizes 0-10, with various offsets</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>98085</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO181</BillingCode>
            <Name>Lubinus SPII Hip Prosthesis Stem cemented</Name>
            <Description>anatomical shaped hip prosthesis stem for cemented fixation in the human body.&#xD;
· Minimal bone resection&#xD;
· Uniform cement mantle around the whole stem&#xD;
· Anatomically shaped stem resists rotational forces&#xD;
Modular system allows adjustment to suit anatomical conditions</Description>
            <Size>Stem Length: 130mm - 170mm&#xD;
Throat Length: Short; Medium; XL&#xD;
CCD Angle: 117 degrees; 126 degrees; 135 degrees&#xD;
Shape: Left; Right</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>212075</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA016</BillingCode>
            <Name>CCA Cemented Femoral Stem</Name>
            <Description>SS, straight, not polished</Description>
            <Size>7.50mm -17.5mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>274203</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN273</BillingCode>
            <Name>Echelon/Spectron</Name>
            <Description>Revision Hip Stem - Non-porous</Description>
            <Size>165mm - 200mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>220103</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN301</BillingCode>
            <Name>Spectron and Synergy</Name>
            <Description>Femoral Stem Non Porous Offset</Description>
            <Size>1- 20</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>220401</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST576</BillingCode>
            <Name>Stryker Omnifit Cemented Stem</Name>
            <Description>Cemented  femoral component Cobal Chrome </Description>
            <Size>Stem sizes 4-11</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3939</SubGroupID>
            <ARTGs>
                <ARTG>216632</ARTG>
                <ARTG>217008</ARTG>
            </ARTGs>
            <MinimumBenefit>1422</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG014</BillingCode>
            <Name>Furlong Hemi Range</Name>
            <Description>Cemented femoral stem</Description>
            <Size>XXS, XS, S, M &amp; L</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3940</SubGroupID>
            <ARTGs>
                <ARTG>132591</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV034</BillingCode>
            <Name>Profemur Xm Femoral Stem</Name>
            <Description>Femoral Stem, CoCr, Cemented, Polished</Description>
            <Size>0-4</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <Suffix>Removable Neck</Suffix>
            <ARTGs>
                <ARTG>234445</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP546</BillingCode>
            <Name>C- Stem &amp; C- Stem AMT Femoral Stems</Name>
            <Description>Stainless steel Ortron 90, highly polished, triple taper</Description>
            <Size>Size 1-8 standard, Size 1-8 High Offset, CDH and 0A to 3A sizes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>208307</ARTG>
                <ARTG>208843</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW041</BillingCode>
            <Name>Exeter Hip System</Name>
            <Description>Stainless Steel (Orthinox)</Description>
            <Size>Stem Sizes 0-6, Offsets 30, 33, 35.5, 37.5, 44, 50 &amp; 56mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>205392</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN268</BillingCode>
            <Name>CPCS</Name>
            <Description>Femoral Stem Polished Non Porous, Std and High Offset</Description>
            <Size>XSM, 0-5</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>220355</ARTG>
                <ARTG>225651</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI009</BillingCode>
            <Name>Zimmer CPT Hip Systems Femoral Stem</Name>
            <Description>Co Cr (Zimaloy), polished and tapered</Description>
            <Size>Sizes 1 - 5</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>208688</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI373</BillingCode>
            <Name>MS-30 Hip prosthesis</Name>
            <Description>Stainless steel, polished tapered</Description>
            <Size>6 to 16</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>210391</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR024</BillingCode>
            <Name>Taperfit Femoral Stem</Name>
            <Description>Double taper stainless steel femoral stem</Description>
            <Size>sizes 0-4 with 4 different offsets</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>106747</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR279</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO164</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Absolut Cemented Femoral Stem</Name>
            <Description>CoCr, Polished, Double Taper,</Description>
            <Size>Sizes 000 - 4, with various offsets</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>248972</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG014</BillingCode>
            <Name>Korus Stem Cemented</Name>
            <Description>A straight femoral stem for use in hip prostheses systems.</Description>
            <Size>125 and 135 degrees; sizes 1 to 9; offset 37 to 50 mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>368330</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ786</BillingCode>
            <Name>Corail Hip System Cemented Femoral Stem</Name>
            <Description>Stainless steel cemented, polished femoral stem, standard and high offsets</Description>
            <Size>Size 8 - 20</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>127055</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC005</BillingCode>
            <Name>Friendly Femoral Stem</Name>
            <Description>Femoral Stem Cemented Tapered Polished FeCrNiMnMoNbN</Description>
            <Size>0, 1, 2, 3</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>210666</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC026</BillingCode>
            <Name>Lima Accent Hip System</Name>
            <Description>Femoral Stem Cemented, tapered, polished</Description>
            <Size>1 -6</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>168581</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI100</BillingCode>
            <Name>E2 Cemented Stem</Name>
            <Description>Cemented Femoral Stems</Description>
            <Size>size 0 - 4</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>228276</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA463</BillingCode>
            <Name>twinSys Cemented Femoral Stem</Name>
            <Description>stainless steel, highly polished, triple tapered</Description>
            <Size>8 sizes in standard and lateral version (Size 9, 10, 11, 12, 13, 14, 15, 16)</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>274206</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU001</BillingCode>
            <Name>CONE Cemented Femoral Stem</Name>
            <Description>CoCr, highly polished, triple taper</Description>
            <Size>Standard sizes 1 to 8, Lateralized sizes 2 to 7</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>208874</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU004</BillingCode>
            <Name>Quadra Hip Cemented Femoral Stem</Name>
            <Description>High nitrogen stainless steel alloy, highly polished, double taper</Description>
            <Size>Std 0 to 8. Lat 0 to 8  Std short neck 0 to 7.  Lat short neck 1 to 7.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>210442</ARTG>
                <ARTG>356196</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU110</BillingCode>
            <Name>X-Acta Femoral Stems</Name>
            <Description>Stainless Steel Femoral Stems</Description>
            <Size>Sizes 0 - 4 / Offsets 35.5 - 50 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>229510</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF041</BillingCode>
            <Name>Evolve ™ Cemented Stem</Name>
            <Description>Polished Stem</Description>
            <Size>Sizes 0-5, various offsets</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>279502</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL156</BillingCode>
            <Name>Polarstem Cemented</Name>
            <Description>Cemented femoral stems</Description>
            <Size>0 to 8</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>3941</SubGroupID>
            <ARTGs>
                <ARTG>297722</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT033</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Cemented Stem</Name>
            <Description>Ti6Al4V Mirror polished</Description>
            <Size>Diameter 10-16mm Length 115</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1404</GroupID>
            <SubGroupID>7374</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>389894</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP550</BillingCode>
            <Name>C- Stem &amp; C- Stem AMT Femoral Stem</Name>
            <Description>Stainless steel Ortron 90, highly polished, triple taper, long stem</Description>
            <Size>Size 3-8 x 200-240mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>208637</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW040</BillingCode>
            <Name>Exeter Hip System</Name>
            <Description>Stainless Steel (Orthinox) polished long</Description>
            <Size>37.5 and 44mm offsets</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <ARTGs>
                <ARTG>205392</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH683</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO173</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Femoral Stem Cemented with TiN and HA Collar</Name>
            <Description>MUTARS Femoral Stem Cemented with TiN and HA Collar</Description>
            <Size>11/13/15/17 &#xD;
120/160/200/240mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <ARTGs>
                <ARTG>244313</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF032</BillingCode>
            <Name>Adapter GHE Femoral Long Stem Cemented </Name>
            <Description>CoCr, non polished, long stem</Description>
            <Size>200mm - 350mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <ARTGs>
                <ARTG>175346</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN271</BillingCode>
            <Name>Spectron</Name>
            <Description>Revision Hip Stem - Non-porous</Description>
            <Size>225mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <ARTGs>
                <ARTG>220103</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST584</BillingCode>
            <Name>Osteonics omnifit cemented long stem</Name>
            <Description>cobalt chrome unpolished long </Description>
            <Size>Stem sizes  5-11, stem length 200, 250 AND 300mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <ARTGs>
                <ARTG>217480</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI025</BillingCode>
            <Name>Zimmer VerSys CRC Hip Systems Femoral Stem</Name>
            <Description> Cobalt Chrome, unpolished long stem with calcar attachment option</Description>
            <Size>13 - 19</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <ARTGs>
                <ARTG>208884</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI301</BillingCode>
            <Name>CPT Hip System</Name>
            <Description>Cobalt Chrome, polished, tapered, long stems </Description>
            <Size>Sizes 1 - 4</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1405</GroupID>
            <SubGroupID>3944</SubGroupID>
            <ARTGs>
                <ARTG>208688</ARTG>
            </ARTGs>
            <MinimumBenefit>2980</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI462</BillingCode>
            <Name>Alloclassic Hip Stem</Name>
            <Description>Titanium, grit blast, non HA, standard and high offset</Description>
            <Size>1 - 14</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3945</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>206912</ARTG>
            </ARTGs>
            <MinimumBenefit>3026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI463</BillingCode>
            <Name>Alloclassic Hip Stem</Name>
            <Description>Zweymuller, Ti alloy, Short Cone, Slender Neck</Description>
            <Size>01, 0, 1, 10-13</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3945</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>206912</ARTG>
            </ARTGs>
            <MinimumBenefit>3026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI468</BillingCode>
            <Name>CLS Cementless Hip</Name>
            <Description>Titanium, grit blast, non HA</Description>
            <Size>5 - 20</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3945</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>206682</ARTG>
            </ARTGs>
            <MinimumBenefit>3026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC011</BillingCode>
            <Name>C2 Femoral Stem</Name>
            <Description>C2 Femoral Stem Standard / Lateralised / Revision 12/14 Taper Ti6AI4V</Description>
            <Size>02 to 12</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3945</SubGroupID>
            <ARTGs>
                <ARTG>210716</ARTG>
                <ARTG>210720</ARTG>
            </ARTGs>
            <MinimumBenefit>3026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL092</BillingCode>
            <Name>REDAPT</Name>
            <Description>Revision stem with standard and high offset options.</Description>
            <Size>190mm x 12-27mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3945</SubGroupID>
            <ARTGs>
                <ARTG>293662</ARTG>
            </ARTGs>
            <MinimumBenefit>3026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI376</BillingCode>
            <Name>Cone Hip prosthesis</Name>
            <Description>Titanium, grit blast, non HA</Description>
            <Size>13 to 24mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3945</SubGroupID>
            <ARTGs>
                <ARTG>210381</ARTG>
            </ARTGs>
            <MinimumBenefit>3026</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ813</BillingCode>
            <Name>Summit Femoral Hip</Name>
            <Description>Titanium, beaded proximally, distal grit blast</Description>
            <Size>0-12</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3946</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>208216</ARTG>
            </ARTGs>
            <MinimumBenefit>2986</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ777</BillingCode>
            <Name>Tri-Lock Gription Femoral Stem</Name>
            <Description>Titanium, Femoral stem, GRIPTION coated</Description>
            <Size>Size 0-12 standard and high offset</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3947</SubGroupID>
            <ARTGs>
                <ARTG>217546</ARTG>
            </ARTGs>
            <MinimumBenefit>3294</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI074</BillingCode>
            <Name>Biomet Taperloc Hip System</Name>
            <Description>Titanium unpolished</Description>
            <Size>4mm- 25mm diameter</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3948</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>223294</ARTG>
                <ARTG>237027</ARTG>
                <ARTG>237028</ARTG>
                <ARTG>257352</ARTG>
                <ARTG>257354</ARTG>
                <ARTG>257356</ARTG>
            </ARTGs>
            <MinimumBenefit>3424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB393</BillingCode>
            <Name>Excia T Hip Stem</Name>
            <Description>Cementless CoCr Plasma Femoral Stem</Description>
            <Size>8 - 20 mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3948</SubGroupID>
            <ARTGs>
                <ARTG>321609</ARTG>
            </ARTGs>
            <MinimumBenefit>3424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI981</BillingCode>
            <Name>Echo Hip System Bi Metric Femoral Stem</Name>
            <Description>Echo Bi Metric Cementless Titanium Femoral Component</Description>
            <Size>7 - 17mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3948</SubGroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>3424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV024</BillingCode>
            <Name>Profemur Hip System</Name>
            <Description>Primary stem, tapered wedge, plasma coated</Description>
            <Size>1-12&#xD;
Standard, Extended</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3948</SubGroupID>
            <ARTGs>
                <ARTG>224478</ARTG>
                <ARTG>240572</ARTG>
            </ARTGs>
            <MinimumBenefit>3424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV040</BillingCode>
            <Name>Profemur Hip System</Name>
            <Description>Primary stem, tapered wedge, plasma coated, fixed neck</Description>
            <Size>1-10&#xD;
Extended, Neutral</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3948</SubGroupID>
            <ARTGs>
                <ARTG>240573</ARTG>
            </ARTGs>
            <MinimumBenefit>3424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU182</BillingCode>
            <Name>Masterloc Stems - Ti</Name>
            <Description>Cementless Femoral Stem - Ti Coated</Description>
            <Size>1 to 12 - Std   1 to 14 - Lat  4 to 14 - Lat Plus</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1406</GroupID>
            <SubGroupID>3948</SubGroupID>
            <ARTGs>
                <ARTG>286794</ARTG>
            </ARTGs>
            <MinimumBenefit>3424</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI054</BillingCode>
            <Name>Acor Anatomic Femoral Stem for Modular Neck</Name>
            <Description>Anodised titanium, fully HA Coated, curved stem and used with separate neck</Description>
            <Size>7 Sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <Suffix>Removable Neck</Suffix>
            <ARTGs>
                <ARTG>210109</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI056</BillingCode>
            <Name>Integrale Femoral Stem</Name>
            <Description>Anodised titanium, fully HA Coated,straight stem and used with separate neck</Description>
            <Size>7 Sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <Suffix>Removable Neck</Suffix>
            <ARTGs>
                <ARTG>210194</ARTG>
                <ARTG>210195</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP943</BillingCode>
            <Name>Corail Femoral Stem</Name>
            <Description>Titanium, grit blast, full HA coating,</Description>
            <Size>Size 6 to 20 or in lengths 110 -190mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>143073</ARTG>
                <ARTG>268792</ARTG>
                <ARTG>268793</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB405</BillingCode>
            <Name>Trend Hip Cementless Femoral Stem</Name>
            <Description>Trend Hip Cementless Femoral Stem</Description>
            <Size>1 - 8, Stem Length 134mm - 169mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>392930</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV031</BillingCode>
            <Name>Profemur L</Name>
            <Description>Profemur L Hip Stem</Description>
            <Size>1 - 11&#xD;
Standard, Extended</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>218787</ARTG>
                <ARTG>234444</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR117</BillingCode>
            <Name>Metafix Femoral Stem</Name>
            <Description>Titanium femoral stem striated and fully coated with HA</Description>
            <Size>standard, lateralised, short neck and 125 and 135 degree</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>207831</ARTG>
                <ARTG>281110</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY514</BillingCode>
            <Name>Corail Revision Femoral Stem</Name>
            <Description>Titanium, grit blast, full HA coating, fluted distally</Description>
            <Size>Size ≤13, (length less than 200mm)</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>173831</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX002</BillingCode>
            <Name>Novation Element HA</Name>
            <Description>Novation Press-Fit Element Stems are intended for press-fix fixation and manufactured from Titanium 6A1-4V and have rectangular cross-sectional geometry with transverse proximal grooves and distal parallell grooves.</Description>
            <Size>collarless: standard offset, 12/14, sizes 8-18 Extended offset 12/14, sizes 8-18, collarless: standard reduced offset, 12/14, sizes 8-12 Extended reduced offset 12/14, sizes 8-12 &#xD;
collared: standard offset 12/14, sizes 8-18&#xD;
collared: standard reduced offset 12/14, sizes 8-12</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>287412</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FD005</BillingCode>
            <Name>Stemsys Cementless HA Coated Stems</Name>
            <Description>Uncemented Femoral Stem with HA Coating - Collared and Collarless</Description>
            <Size>Sizes 7 to 20 - Standard and Laterlised</Size>
            <SupplierCode>FD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>356300</ARTG>
                <ARTG>356301</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FD006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LI108</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HACTIV Uncemented Stem</Name>
            <Description>Titanium, gritblast, HA coated, collared, collarless and high offset</Description>
            <Size>Sizes 7 to 20</Size>
            <SupplierCode>FD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>232289</ARTG>
                <ARTG>268272</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG009</BillingCode>
            <Name>Cementless Korus Stem</Name>
            <Description>A straight femoral stem, with or without collar, for use in hip prostheses systems.</Description>
            <Size>125 and 135 degrees; sizes 1 to 9; ; offset 37 to 50 mm; with and without collar</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>312760</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hydra Hip Stem</Name>
            <Description>Tapered, Titanium, HA Coated, Modular Uncemented Femoral Stem</Description>
            <Size>Sizes 9 - 18</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>315264</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC013</BillingCode>
            <Name>FIT Femoral Stem</Name>
            <Description>FIT Femoral Stem 12/14 Taper Ti6AI4V HA Coated</Description>
            <Size>Size 1-7, Left &amp; Right</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>210717</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC144</BillingCode>
            <Name>ColloMis Femoral Stem</Name>
            <Description>The COLLO-MIS Femoral Stem</Description>
            <Size>Sizes 1 to 9</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>219427</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC159</BillingCode>
            <Name>H-Max S Femoral Stem</Name>
            <Description>H-Max S Femoral Stem HA Coated Ti6AI4V</Description>
            <Size>9 - 18</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>218784</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI095</BillingCode>
            <Name>CL2 Cementless Femoral Stem</Name>
            <Description>Titanium, grit plast full HA coating</Description>
            <Size>8 - 18</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>228604</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI119</BillingCode>
            <Name>EVOK Stem</Name>
            <Description>Cementless Stem with HA</Description>
            <Size>Sizes 7 to 20  Collared and Collarless</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>315774</ARTG>
                <ARTG>315775</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO034</BillingCode>
            <Name>CFP Hip Stem</Name>
            <Description>Titanium, grit blast,  HA</Description>
            <Size>Extra small to Extra Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>223134</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO111</BillingCode>
            <Name>Beta-Cone Cementless Hip Prosthesis</Name>
            <Description>Titanium, grit blast, with HA</Description>
            <Size>9 Stem sizes 1-9 plus additional 9 stems with XL neck length.  Total 18 Sizes</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>114169</ARTG>
                <ARTG>51002</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA462</BillingCode>
            <Name>twinSys Non Cemented Femoral Stem</Name>
            <Description>Titanium, grit blast, fully HA</Description>
            <Size>Various offsets and sizes under 200mm length</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>274437</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN256</BillingCode>
            <Name>Corail Femoral Stem</Name>
            <Description>Titanium, grit blast, full HA coating</Description>
            <Size>Size 11 to 14; Offset Low, Standard; Angle (In degrees) 125-135</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>306751</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU003</BillingCode>
            <Name>Quadra Hip Femoral Stem</Name>
            <Description>Titanium, grit blast, fully HA,</Description>
            <Size>Std 0 to 10&#xD;
Std (shortneck) 00 to 10&#xD;
Lat 1 to 7&#xD;
Lat (shortneck) 1 to 7</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>204336</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU128</BillingCode>
            <Name>AMIStem H Femoral Stem</Name>
            <Description>Titanium, grit blast, HA coated</Description>
            <Size>STD 00 to 9; LAT 0 to 8</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>218795</ARTG>
                <ARTG>287484</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF029</BillingCode>
            <Name>Origin™ Stem</Name>
            <Description>Cementless Stems are inteded for press-fit fixation and manufactured from titanium 6AI-4V and are fully HA coated</Description>
            <Size>collarless: standard offset, 12/14, sizes 8-18 Extended offset 12/14, sizes 8-18, reduced offset 8-18, collared: standard offset 12/14, sizes 8-18, reduced offset sizes 8-18 Extended offset, all available in collared option and coxa vera 125 degree</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>277417</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI556</BillingCode>
            <Name>Avenir- Muller Stem</Name>
            <Description>Titanium, grit blast, with HA</Description>
            <Size>Standard sizes 1-8;  Lateral sizes 1-8</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3949</SubGroupID>
            <ARTGs>
                <ARTG>216175</ARTG>
            </ARTGs>
            <MinimumBenefit>3352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY134</BillingCode>
            <Name>Summit Femoral Stem</Name>
            <Description>Titanium, beaded proximally with HA, duofix distal grit blast</Description>
            <Size>Size 1-10</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3950</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>215936</ARTG>
            </ARTGs>
            <MinimumBenefit>3488</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN303</BillingCode>
            <Name>Synergy</Name>
            <Description>Femoral Stem HA Coated beaded Titanium Alloy, Std and High offset</Description>
            <Size>9 - 18</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3950</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>225532</ARTG>
            </ARTGs>
            <MinimumBenefit>3488</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN275</BillingCode>
            <Name>ACTIS Femoral Stem</Name>
            <Description>Collared, proximal beaded with HA </Description>
            <Size>Size 0-12</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3950</SubGroupID>
            <ARTGs>
                <ARTG>346130</ARTG>
            </ARTGs>
            <MinimumBenefit>3488</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN678</BillingCode>
            <Name>Echelon with HA</Name>
            <Description>Cobalt Chromium with Hyrdoxyapetite Coating, beaded</Description>
            <Size>11-20</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3950</SubGroupID>
            <ARTGs>
                <ARTG>222602</ARTG>
                <ARTG>253854</ARTG>
                <ARTG>257395</ARTG>
                <ARTG>262520</ARTG>
                <ARTG>262521</ARTG>
                <ARTG>262974</ARTG>
            </ARTGs>
            <MinimumBenefit>3488</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN843</BillingCode>
            <Name>Anthology Hip System</Name>
            <Description>Titanium, Beaded and HA</Description>
            <Size>0-20</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3950</SubGroupID>
            <ARTGs>
                <ARTG>218143</ARTG>
            </ARTGs>
            <MinimumBenefit>3488</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB295</BillingCode>
            <Name>Metha - modular short stem</Name>
            <Description>Short stem, plasma, HA</Description>
            <Size>1 -6</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <Suffix>Removable Neck</Suffix>
            <ARTGs>
                <ARTG>126457</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI075</BillingCode>
            <Name>Biomet Taperloc Hip System</Name>
            <Description>titanium, plasma, HA</Description>
            <Size>4mm - 25mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>222180</ARTG>
                <ARTG>257353</ARTG>
                <ARTG>257355</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL004</BillingCode>
            <Name>Permedica Exacta Femoral Stem HaX-Pore -Press-fit hip femur</Name>
            <Description>The Permedica Exacta HaX-Pore Femoral stem is a press-fit stem with pure titanium and hydroxyapatite coating.  It is a self-locking stem with longitudinal and transverse grooves on the anterior and posterior surface to provide axial and rotational stability.  The stem is manufactured using Titanium Aluminium Niobium forged alloy (Ti6AI7Nb) ISO5832/11 with a surface finish of 300 micron pure Titanium and a 50 micron hydroxyapatite plasma sprayed coating.</Description>
            <Size>Sized 1-12  Angle (in degrees) 127 degrees and 135 degrees</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>220150</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST541</BillingCode>
            <Name>SecurFit Plus Max</Name>
            <Description>Titanium, plasma, HA </Description>
            <Size>Stem sizes 7-14</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>152399</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST574</BillingCode>
            <Name>SecurFit HA Max Hip Stem</Name>
            <Description>Titanium, plasma coated, HA</Description>
            <Size>Stem sizes 4-14 in 127 and 132 degree neck angles</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>152397</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG024</BillingCode>
            <Name>JRI Furlong Total Hip System</Name>
            <Description>Uncemented Femoral Stem, titanium, plasma sprayed, with HA</Description>
            <Size>12 /14 Taper, and 5mm offset, short and standard spigot</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>302538</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB274</BillingCode>
            <Name>Excia Hip System</Name>
            <Description>plasma titanium, HA</Description>
            <Size>8mm-18mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>123313</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR086</BillingCode>
            <Name>TriFit  System</Name>
            <Description>Titanium stem proximally coated with plasma spray and HA</Description>
            <Size>Sizes 1- 11</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>207830</ARTG>
                <ARTG>342332</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR157</BillingCode>
            <Name>MiniHip Stem</Name>
            <Description>Short stem, Titanium, Plasma Spray with HA</Description>
            <Size>9 sizes</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>106747</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR294</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO285</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Paragon Hip Stem PCHA</Name>
            <Description>Paragon Femoral Stem, Porous and HA coated</Description>
            <Size>1-12, STD, High Offset, Coxa Vara, Collared</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>296139</ARTG>
                <ARTG>296134</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Corae</Name>
            <Description>Uncemented Femoral Hip Stem with HA Coating</Description>
            <Size>9 to 18 with Standard and Offset stems</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>216269</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Hydra-Fix  </Name>
            <Description>Forged titanium alloy stems with HA coating 12/14 taper  </Description>
            <Size>8 - 18, standard, offset </Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>325181</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW529</BillingCode>
            <Name>Accolade II Femoral Hip System</Name>
            <Description>Femoral Hip Stem (127 &amp; 132 neck angle)</Description>
            <Size>Size 0 - 11</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>198383</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC015</BillingCode>
            <Name>Sam-Fit modular stem</Name>
            <Description>Modular stem</Description>
            <Size>1 - 7</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>210760</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH627</BillingCode>
            <Name>Mutars RS revision system - cementless stem HA</Name>
            <Description>RS Cementless stem HA</Description>
            <Size>12 - 22mm dia stems, 150 - 190mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>236460</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA541</BillingCode>
            <Name>optimys Stem</Name>
            <Description>Ti with Ti Plasma spray and CaP coating</Description>
            <Size>XS, 0 to 12, standard and lateral</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>287920</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF018</BillingCode>
            <Name>Hip and Go</Name>
            <Description>Femoral Stem Component</Description>
            <Size>Size 1-10, standard and lateralized</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>141168</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM122</BillingCode>
            <Name>Polarstem</Name>
            <Description>Titanium Stem, Plasma Spray &amp; Full HA coating</Description>
            <Size>01-11, various offsets</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>225533</ARTG>
                <ARTG>302532</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM127</BillingCode>
            <Name>SL Plus MIA Femoral Stem</Name>
            <Description>Titanium, Plasma spray, proximal HA coating</Description>
            <Size>01-12, various offsets</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>225534</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN900</BillingCode>
            <Name>NANOS Neck Preserving Stem</Name>
            <Description>.Neck preserving femoral stem with vacuum plasma spray titanium porous coating and Calcium Phosphate electro chemical deposition process coating (Bonit Coating) for use without modular femoral neck choices</Description>
            <Size>Size 0 to Size 9</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>233103</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG021</BillingCode>
            <Name>Furlong Evolution</Name>
            <Description>Collarless and collared 126-133 (degree)</Description>
            <Size>6-17</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>132478</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI493</BillingCode>
            <Name>M/L Taper   Stem</Name>
            <Description>Plasma sprayed titanium with HA </Description>
            <Size>Sizes 5 to 22 with standard and extended offsets</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1407</GroupID>
            <SubGroupID>3952</SubGroupID>
            <ARTGs>
                <ARTG>207912</ARTG>
            </ARTGs>
            <MinimumBenefit>3727</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC160</BillingCode>
            <Name>C2 Revision Stem</Name>
            <Description>C2 Revision Stem</Description>
            <Size>Size 7-9 x 202 to 213mm Length</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1408</GroupID>
            <SubGroupID>3953</SubGroupID>
            <ARTGs>
                <ARTG>210716</ARTG>
            </ARTGs>
            <MinimumBenefit>4540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL093</BillingCode>
            <Name>REDAPT</Name>
            <Description>Revision stem with standard and high offset options.</Description>
            <Size>240-300mm x 12-27mm.</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1408</GroupID>
            <SubGroupID>3953</SubGroupID>
            <ARTGs>
                <ARTG>293662</ARTG>
            </ARTGs>
            <MinimumBenefit>4540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY515</BillingCode>
            <Name>Kar (Corail Revision) Femoral Stem</Name>
            <Description>Titanium, grit blast, full HA coating, fluted distally</Description>
            <Size>Sizes 14 - 20, (length 200mm &amp; greater)</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1409</GroupID>
            <SubGroupID>3957</SubGroupID>
            <ARTGs>
                <ARTG>143074</ARTG>
                <ARTG>173831</ARTG>
            </ARTGs>
            <MinimumBenefit>4826</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA475</BillingCode>
            <Name>twinSys Non Cemented Long Femoral Stem</Name>
            <Description>Titanium, grit blast, fully HA, long</Description>
            <Size>Various offsets and sizes &gt; 200mm length (14 &amp; 15)</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1409</GroupID>
            <SubGroupID>3957</SubGroupID>
            <ARTGs>
                <ARTG>122260</ARTG>
            </ARTGs>
            <MinimumBenefit>4826</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU058</BillingCode>
            <Name>Quadra-R Hip Revision Stem</Name>
            <Description>Uncemented revision stem, HA Coated</Description>
            <Size>From size 0 to size 9`</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1409</GroupID>
            <SubGroupID>3957</SubGroupID>
            <ARTGs>
                <ARTG>204290</ARTG>
            </ARTGs>
            <MinimumBenefit>4826</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH628</BillingCode>
            <Name>Mutars RS revision system - cementless stem HA long</Name>
            <Description>RS Cementless stem HA long</Description>
            <Size>12 - 20mm dia stems, 200 to 250mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1409</GroupID>
            <SubGroupID>3960</SubGroupID>
            <ARTGs>
                <ARTG>236460</ARTG>
            </ARTGs>
            <MinimumBenefit>5371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG013</BillingCode>
            <Name>JRI Total Hip System</Name>
            <Description>JRI Furlong Revision Plus Stem, Titanium Alloy with Supravit Zoned Coating, 12 / 14 Taper</Description>
            <Size>12 / 14 Taper, 200mm long and 200ml long with 5mm offset</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1409</GroupID>
            <SubGroupID>3960</SubGroupID>
            <ARTGs>
                <ARTG>132478</ARTG>
            </ARTGs>
            <MinimumBenefit>5371</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG010</BillingCode>
            <Name>SMR Modular Femoral Stem Proximal Body</Name>
            <Description>Titanium, grit blast, non HA,</Description>
            <Size>40 to 70mm, Standard and Filling</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>277843</ARTG>
            </ARTGs>
            <MinimumBenefit>2401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC009</BillingCode>
            <Name>Modulus Femoral Body</Name>
            <Description>Femoral Body 12/14 Taper CCD 125* to 130* - Ti6AI4V</Description>
            <Size>A &amp; B x Small to Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>210669</ARTG>
            </ARTGs>
            <MinimumBenefit>2401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC027</BillingCode>
            <Name>Revision Modular Femoral Body</Name>
            <Description>Revision Modular Femoral Body 12/14 Taper with Locking Screw Ti6AI4V</Description>
            <Size>Std &amp; Lat x 50-70mm - Body Height</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>210642</ARTG>
            </ARTGs>
            <MinimumBenefit>2401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO020</BillingCode>
            <Name>Link MP Reconstruction Hip Prosthesis</Name>
            <Description>Titanium, Grit blast, femoral Body</Description>
            <Size>Length 35-65 mm   Offset Standard, XXL lateral</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>223282</ARTG>
            </ARTGs>
            <MinimumBenefit>2401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA524</BillingCode>
            <Name>Modular Revision Stem</Name>
            <Description>Proximal body, grit Blasted Titanium</Description>
            <Size>50-70mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>274207</ARTG>
            </ARTGs>
            <MinimumBenefit>2401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG003</BillingCode>
            <Name>MRP Titan Neck</Name>
            <Description>Proximal femoral component</Description>
            <Size>Small, Medium &amp; Large with standard 130º &amp; lateralised 123º options</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>327900</ARTG>
            </ARTGs>
            <MinimumBenefit>2401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG007</BillingCode>
            <Name>MRP Trochanter</Name>
            <Description>Body for Trochanteric attachment</Description>
            <Size>Small &amp; Large</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>327880</ARTG>
            </ARTGs>
            <MinimumBenefit>2401</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO026</BillingCode>
            <Name>Link spacer</Name>
            <Description>Titanium, grit blast, non HA </Description>
            <Size>10mm - 40mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Spacer</Suffix>
            <ARTGs>
                <ARTG>114169</ARTG>
                <ARTG>51002</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO187</BillingCode>
            <Name>Link MP Reconstruction Proximal Spacer</Name>
            <Description>MP Reconstruction Proximal Spacer, CoCrMO</Description>
            <Size>10 mm; 20 mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Spacer</Suffix>
            <ARTGs>
                <ARTG>245855</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG006</BillingCode>
            <Name>MRP Titan Sleeve</Name>
            <Description>Modular extension sleeve </Description>
            <Size>Ø16mm x 30mm, Ø18mm x 30mm, Ø20mm x 30mm, Ø22mm x 30mm, Ø24mm x 30mm</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Spacer</Suffix>
            <ARTGs>
                <ARTG>327849</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI081</BillingCode>
            <Name>ARCOS Modular Revision Hip System</Name>
            <Description>Grit Blast Distal Stems, non HA</Description>
            <Size>150mm - 200mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG011</BillingCode>
            <Name>SMR Femoral Stem</Name>
            <Description>SMR Distal Component less than 200mm</Description>
            <Size>SMR Distal Components:  14 x 100mm, 15 x 100mm, 16 x 100mm, 17 x 100mm, 18 x 100mm, 19 x 100mm, 20 x 100mm, 21 x 100mm, 22 x 100mm, 24 x 100mm, 14 x 160mm, 15 x 160mm, 16 x 160mm, 17 x 160mm, 18 x 160mm, 19 x 160mm,  20 x 160mm,  21 x 160mm, 22 x 160mm,  24 x 160mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>277980</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ841</BillingCode>
            <Name>Reclaim Revision Hip System - Standard Distal Stem</Name>
            <Description>Standard distal stem</Description>
            <Size>14-31mm x 140-190mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>219278</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC010</BillingCode>
            <Name>Modulus Modular Femoral Stem</Name>
            <Description>Modulus Modular Femoral Stem</Description>
            <Size>Size A &amp; B x 13 to 26mm diameter</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>210668</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC030</BillingCode>
            <Name>Revision Modular Femoral Stem</Name>
            <Description>Revision Modular Femoral Stem Ti6A4I</Description>
            <Size>14-26mm Diameter x 140mm Length</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>210670</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO021</BillingCode>
            <Name>Link MP Reconstruction Hip Prosthesis</Name>
            <Description>Stem, grit blast, titanium non HA</Description>
            <Size>12 - 25mm x 160mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>114169</ARTG>
                <ARTG>51002</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA500</BillingCode>
            <Name>Modular Revision Stem</Name>
            <Description>Titanium, grit blast, non HA</Description>
            <Size>14mm x 140mm - 24mm x 140mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>274204</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG008</BillingCode>
            <Name>MRP Stems</Name>
            <Description>Femoral stem component of a modular hip system</Description>
            <Size>Ø13mm - Ø34mm    80mm - 140mm long</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>327850</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK059</BillingCode>
            <Name>Stryker Modular Revision Hip System</Name>
            <Description>Titanium Alloy Bowed Conical Distal Stems</Description>
            <Size>Restoration Modular bowed conical distal stem 195mm, 235mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>217729</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI613</BillingCode>
            <Name>ZMR Modular Revision Hip System - Stem</Name>
            <Description>Titanium, grit blast, non HA</Description>
            <Size>115 to 185mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3961</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>208256</ARTG>
                <ARTG>208269</ARTG>
                <ARTG>216778</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY187</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>Beaded, 'Porocoat' Standard &amp; Trochanter Replacement</Description>
            <Size>Neutral, 15deg Left &amp; Right in both styles</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3962</SubGroupID>
            <Suffix>Body, Tumor</Suffix>
            <ARTGs>
                <ARTG>226872</ARTG>
                <ARTG>226873</ARTG>
            </ARTGs>
            <MinimumBenefit>5867</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP982</BillingCode>
            <Name>SROM ZTT Femoral Sleeve</Name>
            <Description>Titanium, beaded without HA, proximal femoral cone</Description>
            <Size>12A-24F</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3962</SubGroupID>
            <Suffix>Cone</Suffix>
            <ARTGs>
                <ARTG>98085</ARTG>
                <ARTG>98086</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI739</BillingCode>
            <Name>Segmental Trabecular Metal Femoral Component</Name>
            <Description>00-5850-032-38 Proximal TM Femur, 38mm offset&#xD;
00-5850-032-46 Proximal TM Femur, 46mm offset</Description>
            <Size>28mm &amp; 46mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3962</SubGroupID>
            <Suffix>Stem, Tumour</Suffix>
            <ARTGs>
                <ARTG>95938</ARTG>
            </ARTGs>
            <MinimumBenefit>4010</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH641</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO099</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars RS revision system- Metaphyseal component</Name>
            <Description>RS metaphyseal component</Description>
            <Size>25mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3964</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>237292</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI971</BillingCode>
            <Name>ARCOS Proximal Body</Name>
            <Description>Plasma spray coated proximal bodies</Description>
            <Size>Sizes A-F</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3964</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>222273</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH132</BillingCode>
            <Name>ARCOS Modular Revision Hip System Short Distal Stems</Name>
            <Description>Distal Stem bullet or slottedtip, porous plasma spray</Description>
            <Size>&lt;200mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3964</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>274396</ARTG>
                <ARTG>274398</ARTG>
            </ARTGs>
            <MinimumBenefit>2954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI889</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Proximal Femoral Component, Letson or Finn, Anatomic, Ti</Description>
            <Size>7cm Left or Right</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Body, Tumour</Suffix>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT032</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Proximal Body</Name>
            <Description>Titanium alloy proximal body for Pantheon limb salvage system</Description>
            <Size>Offset in Short, Medium, Long. Lengths 50 and 90 in Smooth or Flat</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Body, Tumour</Suffix>
            <ARTGs>
                <ARTG>389891</ARTG>
                <ARTG>389892</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW600</BillingCode>
            <Name>METS Smooth Trochanter</Name>
            <Description>Titanium, uncoated</Description>
            <Size>small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Body, Tumour</Suffix>
            <ARTGs>
                <ARTG>276356</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH657</BillingCode>
            <Name>Mutars Proximal Femur</Name>
            <Description>Mutars Proximal Femur</Description>
            <Size>50/70mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Body, Tumour</Suffix>
            <ARTGs>
                <ARTG>227163</ARTG>
                <ARTG>284591</ARTG>
                <ARTG>319680</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO179</BillingCode>
            <Name>MegaSystem-C, Neck Segments</Name>
            <Description>Massive, titanium</Description>
            <Size>(35 - 65mm) length, (135 or 126) degree neck angle</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Body, Tumour</Suffix>
            <ARTGs>
                <ARTG>223281</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK158</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>GMRS Proximal Femoral Component, Cast Chrome Cobalt</Description>
            <Size>Standard, Trochanteric, Smooth</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Body, Tumour</Suffix>
            <ARTGs>
                <ARTG>222995</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Bridging Collar</Name>
            <Description>Ti6Al4V  additive manufactured porous collar  </Description>
            <Size>Collar Diameters 26 - 36mm, for Stem diameters 10 to 24 mm, without or with plate attachment or cylindrical.</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Spacer, Tumour</Suffix>
            <ARTGs>
                <ARTG>340803</ARTG>
                <ARTG>342977</ARTG>
            </ARTGs>
            <MinimumBenefit>3591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW605</BillingCode>
            <Name>METS Principal Shaft</Name>
            <Description>Titanium shaft</Description>
            <Size>45mm-150mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Spacer, Tumour</Suffix>
            <ARTGs>
                <ARTG>246516</ARTG>
            </ARTGs>
            <MinimumBenefit>3591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT034</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Cementless Stem</Name>
            <Description>Titanium Fluted</Description>
            <Size>Diameters 11-24mm, Lengths 115-145mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>389895</ARTG>
            </ARTGs>
            <MinimumBenefit>2954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF004</BillingCode>
            <Name>ESOP HA</Name>
            <Description>ESOP Femoral Stem Diaphyseal Ti polished</Description>
            <Size>Size 9-15</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>141169</ARTG>
            </ARTGs>
            <MinimumBenefit>2954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK022</BillingCode>
            <Name>Modular Revision System Fluted Distal Stems</Name>
            <Description>Titanium, polished, fluted, no HA</Description>
            <Size>Stem Lengths 127 &amp; 167mm straight &amp; bowed. Diameter 11-26mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>217755</ARTG>
            </ARTGs>
            <MinimumBenefit>2954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ749</BillingCode>
            <Name>SROM Femoral Stem</Name>
            <Description>Titanium, fluted, distal polished femoral stem &amp; neck</Description>
            <Size>Sizes 6-21</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Stem, SCP</Suffix>
            <ARTGs>
                <ARTG>98085</ARTG>
            </ARTGs>
            <MinimumBenefit>2954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ750</BillingCode>
            <Name>SROM Calcar Replacement Femoral Stem</Name>
            <Description>Titanium, fluted, distal polished femoral stem &amp; neck, with calcar replacement</Description>
            <Size>Multiple Variants – Standard, Length (mm) 150-175, Diameter (mm) Distal Diameter: 11-19, Diameter (mm) Proximal Diameter: 16-24, Offset 0 to +8</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Stem, SCP</Suffix>
            <ARTGs>
                <ARTG>226914</ARTG>
            </ARTGs>
            <MinimumBenefit>2954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW604</BillingCode>
            <Name>METS Total Femoral Link Component</Name>
            <Description>Curved titanium link shaft</Description>
            <Size>165mm, 225mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1410</GroupID>
            <SubGroupID>3965</SubGroupID>
            <Suffix>Stem, Tumour</Suffix>
            <ARTGs>
                <ARTG>259943</ARTG>
            </ARTGs>
            <MinimumBenefit>3591</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP005</BillingCode>
            <Name>Reef Hip Proximal Body &amp; Neck</Name>
            <Description>Titanium neck combined with small proximal body of varying size, grit blast, HA. With locking screw</Description>
            <Size>25-35mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3966</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>143075</ARTG>
            </ARTGs>
            <MinimumBenefit>2353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO133</BillingCode>
            <Name>Link MP Reconstruction Hip Prosthesis</Name>
            <Description>Link body, Titanium, grit blast, HA</Description>
            <Size>35-65mm IN 126 &amp; 135 degrees</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3966</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>222181</ARTG>
            </ARTGs>
            <MinimumBenefit>2353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO186</BillingCode>
            <Name>Link MP Reconstruction Neck Segment, Tilastan, HX-coated</Name>
            <Description>MP Reconstruction Prosthesis, Neck Segment, Tilastan, HX-coated</Description>
            <Size>35 mm - 65 mm; 126° - 135°CCD</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3966</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>222181</ARTG>
            </ARTGs>
            <MinimumBenefit>2353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF003</BillingCode>
            <Name>ESOP HA</Name>
            <Description>Esop Femoral body Metaphyseal grit blast Ti/HA, </Description>
            <Size>Left and Right Size 5-20</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3966</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>141169</ARTG>
            </ARTGs>
            <MinimumBenefit>2353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG018</BillingCode>
            <Name>Securus Modular Revision Hip System</Name>
            <Description>Modular Proximal Body</Description>
            <Size>Std &amp; 5mm offset</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3966</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>132478</ARTG>
            </ARTGs>
            <MinimumBenefit>2353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT031</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Cementless Stem HA</Name>
            <Description>Ti6Al4V stem with HA Coating</Description>
            <Size>Diameters 11-24mm, Length 115-145mm </Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3966</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>389893</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC158</BillingCode>
            <Name>H-Max M Femoral Stem Ti6AI4V</Name>
            <Description>H-Max M Femoral Stem HA Coated Ti6AI4V</Description>
            <Size>9 - 18</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3966</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>210634</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN896</BillingCode>
            <Name>MDF Revision System</Name>
            <Description>Modular Sleeve with HA coating</Description>
            <Size>Sizes 10-27</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3967</SubGroupID>
            <Suffix>Spacer</Suffix>
            <ARTGs>
                <ARTG>303781</ARTG>
            </ARTGs>
            <MinimumBenefit>2619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH626</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars RS revision system - metaphyseal component</Name>
            <Description>RS metaphyseal component</Description>
            <Size>0mm, 50mm, 40mm tapered, 50mm tapered</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3969</SubGroupID>
            <Suffix>Cone</Suffix>
            <ARTGs>
                <ARTG>223511</ARTG>
            </ARTGs>
            <MinimumBenefit>2954</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK058</BillingCode>
            <Name>Stryker Modular Revision Hip System</Name>
            <Description>Porous Distal Stems Titanium Plasma Spray</Description>
            <Size>Stem Lengths 127 &amp; 167mm straight &amp; bowed. Diameter 11-26mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3969</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>145599</ARTG>
            </ARTGs>
            <MinimumBenefit>3290</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW601</BillingCode>
            <Name>METS Spiked Trochanter</Name>
            <Description>Titanium, HA coated</Description>
            <Size>Small and Standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3970</SubGroupID>
            <Suffix>Body, Tumour</Suffix>
            <ARTGs>
                <ARTG>276557</ARTG>
            </ARTGs>
            <MinimumBenefit>3793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW610</BillingCode>
            <Name>METS stippled Integral Shaft and Stem</Name>
            <Description>Titanium, HA coated, shaft and stem with round or oval collar</Description>
            <Size>L=15,30mm; D=27,30mm (round); D=30x38,36x44mm (oval)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1411</GroupID>
            <SubGroupID>3970</SubGroupID>
            <Suffix>Stem, Tumour</Suffix>
            <ARTGs>
                <ARTG>278138</ARTG>
            </ARTGs>
            <MinimumBenefit>4128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ843</BillingCode>
            <Name>reclaim Revision Hip System - Proximal Body</Name>
            <Description>Proximal Body</Description>
            <Size>20-28 x 75-105mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>191615</ARTG>
            </ARTGs>
            <MinimumBenefit>3239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA525</BillingCode>
            <Name>Modular Revision Stem</Name>
            <Description>Proximal Body, Long, Grit Blasted Titanium</Description>
            <Size>80mm-110mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>274207</ARTG>
            </ARTGs>
            <MinimumBenefit>3239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG012</BillingCode>
            <Name>SMR Femoral Stem</Name>
            <Description>SMR Distal Component 200mm and greater.</Description>
            <Size>SMR distal component 14 x 240mm, SMR distal component 15 x 240mm, SMR distal component 16 x 240mm, SMR distal component 17 x 240mm, SMR distal component 18 x 240mm, SMR distal component 19 x 240mm, SMR distal component 20 x 240mm,  SMR distal component 21 x 240mm, SMR distal component 22 x 240mm, SMR distal component 24 x 240mm  SMR distal component 14 x 200mm, SMR distal component 15 x 200mm, SMR distal component 16 x 200mm, SMR distal component 17 x200mm, SMR distal component 18 x 200mm, SMR distal component 19 x 200mm, SMR distal component 20 x 200mm, SMR distal component 21 x 200mm, SMR distal component 22 x 200mm, SMR distal component 24 x 200mm.</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>277980</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ842</BillingCode>
            <Name>Reclaim Revision Hip System - Long Distal Stem</Name>
            <Description>Long distal stem</Description>
            <Size>16-31mm x 240-290mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>219278</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC161</BillingCode>
            <Name>Revision Modular Stem</Name>
            <Description>Revision Modular Stem Ti6AI4V</Description>
            <Size>14 - 26mm Diameter x 200mm Length</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>210670</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO185</BillingCode>
            <Name>Link MP Reconstruction Prosthesis Stem, cementless</Name>
            <Description>Link MP Reconstruction Prosthesis Stem, with Microporous surface, cementless</Description>
            <Size>180 mm - 330 mm;   12 mm - 25 mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>234224</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA501</BillingCode>
            <Name>Modular Revision Stem - Long</Name>
            <Description>Titanium, grit blast, non HA</Description>
            <Size>14mm x 200mm - 24 x 200mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>274204</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG009</BillingCode>
            <Name>MRP Long Stems</Name>
            <Description>Femoral stem component of modular revision hips system</Description>
            <Size>Ø11mm - Ø34mm  200mm - 340mm long</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>327850</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST011</BillingCode>
            <Name>Stryker Modular Hip System</Name>
            <Description>Conical distal stems titanium, grit blasted</Description>
            <Size>Length 155mm, Diameter 14 - 28mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>217729</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI614</BillingCode>
            <Name>ZMR Modular Revision Hip System - Stem</Name>
            <Description>Titanium, grit blast, non HA</Description>
            <Size>Stems ≥200mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3971</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>208256</ARTG>
                <ARTG>208269</ARTG>
                <ARTG>208296</ARTG>
                <ARTG>216778</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI049</BillingCode>
            <Name>'ZMR Taper System Modular Revision Hip </Name>
            <Description>Titanium body, plasma coating, non HA</Description>
            <Size>A - F</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3974</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>208275</ARTG>
                <ARTG>208295</ARTG>
                <ARTG>208654</ARTG>
                <ARTG>216777</ARTG>
            </ARTGs>
            <MinimumBenefit>3793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH133</BillingCode>
            <Name>ARCOS Modular Revision Hip System Distal Stems</Name>
            <Description>Distal Stems</Description>
            <Size>Stems ≥200mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3974</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>274396</ARTG>
                <ARTG>274397</ARTG>
                <ARTG>274398</ARTG>
                <ARTG>274605</ARTG>
                <ARTG>274608</ARTG>
            </ARTGs>
            <MinimumBenefit>4633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Shaft</Name>
            <Description>Ti6Al4V Smooth Shaft Extension Pieces</Description>
            <Size>35 - 140mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3975</SubGroupID>
            <Suffix>Spacer, Tumour</Suffix>
            <ARTGs>
                <ARTG>340801</ARTG>
            </ARTGs>
            <MinimumBenefit>3054</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR046</BillingCode>
            <Name>Stryker Modular Revision Hip System</Name>
            <Description>Modular Long Bowed Titanium Polished Fluted Stem</Description>
            <Size>Length 217mm, 267mm and 317mm. Diamter 11mm-26mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3975</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>217755</ARTG>
            </ARTGs>
            <MinimumBenefit>4633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY510</BillingCode>
            <Name>SROM  Femoral  Calcar Replacement Stem, long</Name>
            <Description>Titanium, fluted, distal polished femoral long stem &amp; neck, bowed and straight with Calcar Replacement</Description>
            <Size>9 -21mm diameter, greater than 200mm length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3975</SubGroupID>
            <Suffix>Stem, SCP</Suffix>
            <ARTGs>
                <ARTG>226914</ARTG>
            </ARTGs>
            <MinimumBenefit>4633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY511</BillingCode>
            <Name>SROM Femoral Stem Long</Name>
            <Description>Titanium, fluted, distal polished femoral long stem &amp; neck, bowed and straight</Description>
            <Size>9 -21mm diameter, greater than 200mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1412</GroupID>
            <SubGroupID>3975</SubGroupID>
            <Suffix>Stem, SCP</Suffix>
            <ARTGs>
                <ARTG>98085</ARTG>
            </ARTGs>
            <MinimumBenefit>4633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP009</BillingCode>
            <Name>Reef Hip Femoral Stem</Name>
            <Description>Titanium modular femoral stem with optional distal locking, grit blast and full HA coating</Description>
            <Size>Length 225 - 375mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1413</GroupID>
            <SubGroupID>3976</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>143075</ARTG>
            </ARTGs>
            <MinimumBenefit>4213</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI049</BillingCode>
            <Name>Extreme Hip System Femoral Stem</Name>
            <Description>Stem component of modular femoral stem, titanium, HA, with distal screw holes</Description>
            <Size>4 lengths - 250 to 400mm, 6 diameters</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1413</GroupID>
            <SubGroupID>3976</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>210347</ARTG>
            </ARTGs>
            <MinimumBenefit>4213</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG023</BillingCode>
            <Name>Securus Modular Revision Hip System</Name>
            <Description>Curved Femoral Stem</Description>
            <Size>250 - 300mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1413</GroupID>
            <SubGroupID>3976</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>132478</ARTG>
            </ARTGs>
            <MinimumBenefit>4213</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW523</BillingCode>
            <Name>Restoration Modular Body</Name>
            <Description>Milled, Broached, Cone and Calcar body options</Description>
            <Size>Milled: Dia 19-25mm with 2 mill Depths; 27-29mm with Mill Depths  Broach: 1-8  Cone: Diam 19-31mm, Heights +0, +10, +20, +30  Calcar: Diameter 19-29mm, 3 Heights each</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1413</GroupID>
            <SubGroupID>3979</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>145600</ARTG>
                <ARTG>145601</ARTG>
                <ARTG>145602</ARTG>
                <ARTG>145603</ARTG>
            </ARTGs>
            <MinimumBenefit>3793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI050</BillingCode>
            <Name>Extreme Revision Hip Monobloc Epiphysis Metaphyseal Section</Name>
            <Description>Combined metaphyseal and epiphyseal sections, adjustable rotation, anodized titanium with HA coating</Description>
            <Size>4 sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1413</GroupID>
            <SubGroupID>3979</SubGroupID>
            <Suffix>Body</Suffix>
            <ARTGs>
                <ARTG>217486</ARTG>
            </ARTGs>
            <MinimumBenefit>3793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI051</BillingCode>
            <Name>Optimal Revision Stem</Name>
            <Description>Cementless, modular revision / reconstruction stem</Description>
            <Size>Sizes 1-5</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1413</GroupID>
            <SubGroupID>3979</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>135326</ARTG>
            </ARTGs>
            <MinimumBenefit>4968</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR045</BillingCode>
            <Name>Stryker Modular Revision Hip System</Name>
            <Description>Modular Long Bowed Titanium Plasma HA Stem</Description>
            <Size>Length 217mm, 267mm and 317mm. Diameter 11mm - 26mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1413</GroupID>
            <SubGroupID>3979</SubGroupID>
            <Suffix>Stem</Suffix>
            <ARTGs>
                <ARTG>145599</ARTG>
            </ARTGs>
            <MinimumBenefit>4968</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK196</BillingCode>
            <Name>Exeter Hip System - ETS (endoprosthesis trauma stem)</Name>
            <Description>Orthinox Stainless Steel Endoprosthesis unipolar monoblock</Description>
            <Size>40mm Offset body with monoblock head sizes 38mm, 40mm, 41mm, 42mm, 43mm, 44mm, 45mm, 46mm, 47mm, 48mm, 49mm, 50mm, 52mm, 54mm, 56mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1416</GroupID>
            <ARTGs>
                <ARTG>255313</ARTG>
            </ARTGs>
            <MinimumBenefit>517</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH658</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO118</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars RS revision system - Proximal component</Name>
            <Description>RS proximal component</Description>
            <Size>127 degrees, 32/42mm, 135 degrees, 32/42mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1417</GroupID>
            <Suffix>Complex (Neck)</Suffix>
            <ARTGs>
                <ARTG>238834</ARTG>
                <ARTG>284587</ARTG>
            </ARTGs>
            <MinimumBenefit>1449</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB296</BillingCode>
            <Name>Metha - Modular neck adaptors</Name>
            <Description>Modular neck adaptors made from CoCr</Description>
            <Size>CCD - 130°, 135 °, 140°; Offset  - 0mm, -5mm ,+5mm; Version - 7.5° left ante/right retro, 0 °, 7.5 ° left retro/right ante</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1417</GroupID>
            <ARTGs>
                <ARTG>126457</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV041</BillingCode>
            <Name>Profemur Modular Neck</Name>
            <Description>Titanium, CoCr Femoral Necks</Description>
            <Size>Neutral, Ante/Retro&#xD;
Varus/ Valgus 1,2&#xD;
Short, X-Long&#xD;
Angle 0-15 Degrees</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1417</GroupID>
            <ARTGs>
                <ARTG>234443</ARTG>
                <ARTG>234446</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>S.F Modula Neck</Name>
            <Description>S.F Modula Neck. Titanium for use with Adler Modular Hip Stems</Description>
            <Size>OX, OY, OZ, OA, OB, OC, 9X, 9Y, 9Z, 9A, 9B, 9C, 9AA, 9BB, 9CC</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1417</GroupID>
            <ARTGs>
                <ARTG>289075</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC029</BillingCode>
            <Name>Modular Neck</Name>
            <Description>Modular Neck Segment - CoCrMo</Description>
            <Size>Size 1-6, Sm &amp; Lg in STD, LAT, AVR/RVL, AVL/RVR</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1417</GroupID>
            <ARTGs>
                <ARTG>210671</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI052</BillingCode>
            <Name>Modular Neck for Acor &amp; Integrale Femoral Stems</Name>
            <Description>Titanium neck, with varying alignments &amp; tapers</Description>
            <Size>4 sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1417</GroupID>
            <ARTGs>
                <ARTG>210537</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI553</BillingCode>
            <Name>M/L Taper Kinectiv Neck</Name>
            <Description>Neck component for M/L taper stem</Description>
            <Size>size K, S, A, E, P, X, B, G, R, C, J, D, K1, S1, AA, E1, P1, X1, K2, E2, BB, G1, R1 ,S2, P2, G2, CC, J1, X2, R2, J2, DD</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>161</SubCategoryID>
            <GroupID>1417</GroupID>
            <ARTGs>
                <ARTG>208721</ARTG>
            </ARTGs>
            <MinimumBenefit>1029</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW038</BillingCode>
            <Name>V40 Orthinox Head</Name>
            <Description>Stainless Steel</Description>
            <Size>22 - 28mm dia</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3988</SubGroupID>
            <ARTGs>
                <ARTG>211859</ARTG>
                <ARTG>211869</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC195</BillingCode>
            <Name>BioBall Femoral Head</Name>
            <Description>Femoral Head Vivium ≤ 32mm</Description>
            <Size>28mm,  32mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3988</SubGroupID>
            <ARTGs>
                <ARTG>227096</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI058</BillingCode>
            <Name>metallic femoral head</Name>
            <Description>M30NW femoral head with 10/12 taper</Description>
            <Size>22.2mm - 32mm short, medium, long</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3988</SubGroupID>
            <ARTGs>
                <ARTG>210159</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA028</BillingCode>
            <Name>Mathys Stainless Steel Femoral Heads</Name>
            <Description>Stainless Steel, </Description>
            <Size>22-32mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3988</SubGroupID>
            <ARTGs>
                <ARTG>210158</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN697</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Stainless steel</Description>
            <Size>22-32mm,+0-+16mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3988</SubGroupID>
            <ARTGs>
                <ARTG>218184</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR026</BillingCode>
            <Name>Stryker CoCr Femoral Head</Name>
            <Description>Cobal Chrome with LFIT Treatment</Description>
            <Size>22.2-32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <Suffix>Low Frequency Ion Treatment</Suffix>
            <ARTGs>
                <ARTG>211867</ARTG>
                <ARTG>211868</ARTG>
            </ARTGs>
            <MinimumBenefit>1517</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB246</BillingCode>
            <Name>Metal Head</Name>
            <Description>Isodur CoCr Femoral Head</Description>
            <Size>22.5mm, 26mm, 28mm, 32mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>123313</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI973</BillingCode>
            <Name>Modular Head Implants</Name>
            <Description>Femoral Modular Head</Description>
            <Size>22 - 32mm diameter, - 6 to =12mm neck, collared, no collar</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV035</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Femoral Head CoCr</Description>
            <Size>22.25-32mm&#xD;
Short-XLong&#xD;
-3.5-+10.5mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>262372</ARTG>
                <ARTG>263792</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR029</BillingCode>
            <Name>CoCr Femoral Head</Name>
            <Description>CoCr femoral head</Description>
            <Size>Dia 22,26,28,32mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>220077</ARTG>
                <ARTG>224980</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR312</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO310</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Femoral Heads</Name>
            <Description>CoCr Femoral Heads 32mm or less</Description>
            <Size>22.2mm, 28mm, 32mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>305165</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD050</BillingCode>
            <Name>FMP Acetabular System - CoCro Femoral Heads</Name>
            <Description>CoCro femoral heads in 22mm and 32mm diameters to fit with FMP acetabular liners and FMP acetabular shells</Description>
            <Size>22mm in +0,+4,+8mm and 32mm in -4.0, +4, +8, +12mm, diameters</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>210902</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP124</BillingCode>
            <Name>DePuy Femoral Head</Name>
            <Description>CoCr Femoral Head Various Tapers &amp; Neck Lengths</Description>
            <Size>22-32 mm </Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>211855</ARTG>
                <ARTG>222991</ARTG>
                <ARTG>224613</ARTG>
                <ARTG>224755</ARTG>
                <ARTG>231693</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX022</BillingCode>
            <Name>Exactech Femoral Head</Name>
            <Description>Cobalt Chrome Head</Description>
            <Size>-3.5mm to +10mm, 22mm to 32mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>293800</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FD001</BillingCode>
            <Name>Evolutis CoCr Femoral Head</Name>
            <Description>CoCr Femoral Head</Description>
            <Size>22mm, 28mm and 32mm diameter</Size>
            <SupplierCode>FD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>268273</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG005</BillingCode>
            <Name>SMR Femoral Head</Name>
            <Description>CoCr</Description>
            <Size>22 to 40mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>280608</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW032</BillingCode>
            <Name>Stryker CoCr Femoral Head</Name>
            <Description>Hip - Femoral Head</Description>
            <Size>22, 26, 28, 30, 32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>211858</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW648</BillingCode>
            <Name>METS CoCr Femoral Head</Name>
            <Description>CoCr</Description>
            <Size>28mm-32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>330362</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC032</BillingCode>
            <Name>Modular Head</Name>
            <Description>Modular Head CoCrMo</Description>
            <Size>28-32mm Diameter Small to XXXLarge</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>210718</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH621</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC-Head CoCrMo</Name>
            <Description>IC Head, CoCrMo</Description>
            <Size>22,28,32mm - S-M-L-XL</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>291215</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI094</BillingCode>
            <Name>Ampllitude CoCr Femoral Head</Name>
            <Description>Femoral Heads, CoCr</Description>
            <Size>Diameter 22.2mm, 28mm, 32mm  Short, Medium, Long and XLong.</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>389273</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO022</BillingCode>
            <Name>Link Prosthesis Femoral Head</Name>
            <Description>Prosthesis Head "B" CoCrMo</Description>
            <Size>Short/medium-short/medium/Long/X-long  22mm - 32mm: Length -3.5 to +10.5</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>212089</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA469</BillingCode>
            <Name>Mathys CoCr Femoral Head </Name>
            <Description>Hip Prosthesis Femoral Head CoCrMo ≤32mm</Description>
            <Size>28 mm &amp; 32mm, (S,M,L,XL,XXL)</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>274272</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU005</BillingCode>
            <Name>Quadra Hip Femoral Head</Name>
            <Description>CoCr</Description>
            <Size>Dia 22mm (S to M)  Dia 28mm (S to XXL)  Dia 32mm (S to XXL)</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>210392</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH434</BillingCode>
            <Name>Samo acetabular cup femoral head</Name>
            <Description>CoCr femoral head</Description>
            <Size>S, M, L and XL</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF005</BillingCode>
            <Name>ESOP HA</Name>
            <Description>Femoral Head CoCr</Description>
            <Size>22.2 -32mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>141169</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF033</BillingCode>
            <Name>Metal Femoral Head</Name>
            <Description>Cobalt Chrome</Description>
            <Size>28mm - 32mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>272594</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF046</BillingCode>
            <Name>Signature Femoral Head &lt;=32mm</Name>
            <Description>Cobalt Chrome Femoral head</Description>
            <Size>Offsets S, M, L &amp; XL</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>272594</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN280</BillingCode>
            <Name>Femoral Head</Name>
            <Description>CoCr</Description>
            <Size>&lt;=32mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>287135</ARTG>
                <ARTG>218139</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG005</BillingCode>
            <Name>JRI Femoral Head</Name>
            <Description>Cobalt Chrome Femoral; Heads</Description>
            <Size>28mm, and 32mm head sizes</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>132410</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI051</BillingCode>
            <Name>Femoral Head</Name>
            <Description>CoCr Femoral heads</Description>
            <Size>22mm - 32mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>346245</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI358</BillingCode>
            <Name>Durasul Ballhead for Inserts</Name>
            <Description>CoCr femoral head</Description>
            <Size>22, 28, 32</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>216181</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI380</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Head - Metal (Zweymuller Allopro) - CoCr</Description>
            <Size>22mm, 28mm, 32mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3989</SubGroupID>
            <ARTGs>
                <ARTG>216181</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG015</BillingCode>
            <Name>JRI Total Hip System</Name>
            <Description>Ceramic femoral head with sleeve </Description>
            <Size>28, 32, 36mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3990</SubGroupID>
            <Suffix>Sleeve</Suffix>
            <ARTGs>
                <ARTG>132410</ARTG>
            </ARTGs>
            <MinimumBenefit>1752</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX023</BillingCode>
            <Name>Exactech Femoral Head </Name>
            <Description>Ceramic/Femoral Head, Biolox Forte</Description>
            <Size>-2 to -5mm, +0 to +10mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3990</SubGroupID>
            <ARTGs>
                <ARTG>159572</ARTG>
            </ARTGs>
            <MinimumBenefit>1593</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW017</BillingCode>
            <Name>Stryker Biolox Forte Alumina Femoral Head</Name>
            <Description>Hip - Femoral Head</Description>
            <Size>28, 32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3990</SubGroupID>
            <ARTGs>
                <ARTG>206180</ARTG>
                <ARTG>217828</ARTG>
            </ARTGs>
            <MinimumBenefit>1593</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA020</BillingCode>
            <Name>Mathys Ceramic Femoral Head</Name>
            <Description>Ceramic, Bionit (alumina)</Description>
            <Size>diameter 28-32mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3990</SubGroupID>
            <ARTGs>
                <ARTG>210564</ARTG>
            </ARTGs>
            <MinimumBenefit>1593</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH433</BillingCode>
            <Name>Samo acetabular cup ceramic head</Name>
            <Description>Ceramic femoral head</Description>
            <Size>S, M, L, and XL</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3990</SubGroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>1593</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF006</BillingCode>
            <Name>ESOP HA</Name>
            <Description>Femoral Head Alumina Ceramic</Description>
            <Size>28 and 32mm Diameter</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3990</SubGroupID>
            <ARTGs>
                <ARTG>141169</ARTG>
            </ARTGs>
            <MinimumBenefit>1593</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG020</BillingCode>
            <Name>JRI Ceramic femoral Head </Name>
            <Description>Total Hip Replacement (THR) Ceramic Femoral Heads, Biolox Delta Ceramic, and Alumina Oxide</Description>
            <Size>12 / 14 Taper, Biolox Delta Ceramic head sizes 28mm, 32mm. Alumina Oxide head sizes 28mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3990</SubGroupID>
            <ARTGs>
                <ARTG>132410</ARTG>
            </ARTGs>
            <MinimumBenefit>1593</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ818</BillingCode>
            <Name>DePuy Delta TS Heads</Name>
            <Description>Delta ceramic femoral head with titanium sleeve</Description>
            <Size>≤32mm, +1 to +12</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <Suffix>Sleeve</Suffix>
            <ARTGs>
                <ARTG>217543</ARTG>
            </ARTGs>
            <MinimumBenefit>1931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC153</BillingCode>
            <Name>Revision Modular Biolox Delta Head</Name>
            <Description>Revision Modular Biolox Delta Head Ti6AI4V 12/14 Taper</Description>
            <Size>28 - 32mm Small to Xlarge</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <Suffix>Sleeve</Suffix>
            <ARTGs>
                <ARTG>210872</ARTG>
            </ARTGs>
            <MinimumBenefit>1931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA484</BillingCode>
            <Name>Ceramys Ceramic Revision Femoral Head</Name>
            <Description>Ceramic, zirconia alumina combination, supplied with titanium taper sleeve</Description>
            <Size>28 L, 28 M, 28 S, 28 XL, 32 L, 32 M, 32 S, 32 XL, 28, 32</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <Suffix>Sleeve</Suffix>
            <ARTGs>
                <ARTG>274113</ARTG>
            </ARTGs>
            <MinimumBenefit>1931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB250</BillingCode>
            <Name>Biolox Delta Ceramic Hip Prosthesis Head</Name>
            <Description>Biolox Delta Ceramic Head</Description>
            <Size>28 &amp; 32mm diameter</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>291964</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI058</BillingCode>
            <Name>Modular Ceramic System</Name>
            <Description>Ceramic Head, Aluminium Alloy, biolox Delta</Description>
            <Size>28-32mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>224752</ARTG>
                <ARTG>231755</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV038</BillingCode>
            <Name>Delta Modular Heads</Name>
            <Description>Biolox Delta Heads</Description>
            <Size>28-32mm&#xD;
Short, Medium, Long</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>240574</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR180</BillingCode>
            <Name>Ceramic modular head</Name>
            <Description>Biolox Delta Ceramic heads 32mm or less</Description>
            <Size>28 and 32mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>157505</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR193</BillingCode>
            <Name>Biolox Option (≤32mm)</Name>
            <Description>Biolox Option Ceramic Femoral Heads</Description>
            <Size>28mm, 32mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>157505</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR306</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO302</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biolox Delta Ceramic Femoral Heads</Name>
            <Description>Biolox Delta Ceramic Femoral Heads 28mm 32mm</Description>
            <Size>Biolox Delta Femoral Head 28mm - -3.5mm to +3.5mm and Biolox Delta Femoral Head 32mm - 3.5mm to +7mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>305164</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR310</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO308</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioBall Delta Femoral Head, 32mm or less</Name>
            <Description>Femoral Head Biolox Delta Ceramic, 28mm and 32mm</Description>
            <Size>28mm, 32mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>276307</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA002</BillingCode>
            <Name>Ceramic modular head</Name>
            <Description>Biolox Delta Ceramic heads 32mm or less</Description>
            <Size>28 and 32mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>285507</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FD003</BillingCode>
            <Name>Delta Ceramic Femoral Head</Name>
            <Description>Delta Ceramic Head</Description>
            <Size>28mm to 32mm diameter</Size>
            <SupplierCode>FD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>273049</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG006</BillingCode>
            <Name>Biolox Delta Ceramic Femoral Heads</Name>
            <Description>Biolox Delta Ceramic Femoral Heads 28mm 32mm</Description>
            <Size>Biolox Delta Femoral Head 28mm - -3.5mm to +3.5mm and Biolox Delta Femoral Head 32mm - 3.5mm to +7mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>279805</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Adler Ceramic Head</Name>
            <Description>Ceramic Femoral Heads. Biolox Delta</Description>
            <Size>Short, Medium, Long, Extra Long, 22 - 32mm Outer Diameter 12/14 Taper</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>296607</ARTG>
                <ARTG>206143</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ752</BillingCode>
            <Name>DePuy Delta Heads</Name>
            <Description>Delta femoral head various tapers &amp; neck lengths</Description>
            <Size>≤32mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>232415</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC152</BillingCode>
            <Name>Modular Biolox Delta Head</Name>
            <Description>Modular Biolox Delta Head</Description>
            <Size>28 - 32mm Small to Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>210721</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH619</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC- Head Biolox delta</Name>
            <Description>Biolox delta ceramic head</Description>
            <Size>28 and 32mm. Small, medium and large.</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>288475</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI074</BillingCode>
            <Name>Delta Ceramic Head</Name>
            <Description>Biolox Delta Head</Description>
            <Size>28 and 32mm heads&#xD;
10/12 and 12/14</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>281064</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI115</BillingCode>
            <Name>Biolox Delta Ceramic Revision Head</Name>
            <Description>Biolox Delta Femoral Head</Description>
            <Size>28mm and 32mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>281065</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO184</BillingCode>
            <Name>Link Biolox Delta Head, ≤32mm</Name>
            <Description>Link Biolox Delta Head, ≤32mm</Description>
            <Size>28 mm - 32 mm diameter</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>212053</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA482</BillingCode>
            <Name>Ceramys Ceramic Femoral Head</Name>
            <Description>Ceramic, zirconia alumina combination</Description>
            <Size>28 L,  28 M, 28 S, 32 XL, 32 L, 32 M, 32 S</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>236457</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU096</BillingCode>
            <Name>Biolox Delta Ceramic Ball Heads</Name>
            <Description>Ceramic femoral heads, BIOLOX® Delta AI2 O3 -ZrO2</Description>
            <Size>Ball Head 12/14 Ø 28 Sizes: S, M and L&#xD;
Ball Head 12/14 Ø 32 sizes: S, M, L and XL</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>205465</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU117</BillingCode>
            <Name>Mectacer Biolox Option Ceramic Heads (&lt;32)</Name>
            <Description>Biolox Option Ceramic Femoral Heads</Description>
            <Size>28mm &amp; 32mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>206684</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG004</BillingCode>
            <Name>Biolox Delta Head</Name>
            <Description>Zirconia Toughened Alumina Femoral Head</Description>
            <Size>Ø28mm - 32mm, 12/14 &amp; 16/18 Tapers, Short - Extra Long Offset</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>326800</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL002</BillingCode>
            <Name>Mac Surgical BIOLOX Delta ceramic heads 28mm and 32mm</Name>
            <Description>BIOLOX Delta ceramic heads</Description>
            <Size>T28mm and 32mm is available with a diameter of 28 and 32mm. The 28mm diameter is availble in 3 different head-neck lengths ( Short, medium long). The 32mm diameter lengths (short, medium long, X-long)</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>230837</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF044</BillingCode>
            <Name>Signature Delta Femoral Head &lt;=32mm</Name>
            <Description>Ceramtec Delta Ceramic Femoral Head</Description>
            <Size>Offsets S, M, L &amp; XL</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>272595</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM144</BillingCode>
            <Name>Universal Delta Ceramic Femoral Head</Name>
            <Description>Delta Ceramic</Description>
            <Size>&lt;=32 - S, M, L, XL,XXL</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>218138</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM165</BillingCode>
            <Name>Revision Delta Ceramic Femoral Head</Name>
            <Description>Biolox Option Head</Description>
            <Size>≤32mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>236061</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR028</BillingCode>
            <Name>Stryker Delta Ceramic Heads</Name>
            <Description>Femoral Head - Delta Ceramic</Description>
            <Size>&amp;lt;32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>206181</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI538</BillingCode>
            <Name>Ceramic primary &amp; revision femoral head</Name>
            <Description>Biolox Delta Ceramic</Description>
            <Size>28 &amp; 32mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3992</SubGroupID>
            <ARTGs>
                <ARTG>215999</ARTG>
            </ARTGs>
            <MinimumBenefit>1703</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN687</BillingCode>
            <Name>Femoral Head</Name>
            <Description>12/14, 14/16 Taper, Oxinium</Description>
            <Size>22 - 32mm, -3 - +16mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1419</GroupID>
            <SubGroupID>3993</SubGroupID>
            <ARTGs>
                <ARTG>218140</ARTG>
            </ARTGs>
            <MinimumBenefit>1699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR308</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO304</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioBall Femoral Head</Name>
            <Description>Femoral Head Vivium &gt; 32mm</Description>
            <Size>36mm to 58mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>266539</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR314</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO312</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioBall Femoral Head</Name>
            <Description>Femoral DuoHead Vivium &gt; 32mm</Description>
            <Size>36mm to 58mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>266540</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW395</BillingCode>
            <Name>V40 Orthinox Head</Name>
            <Description>Stainless Steel</Description>
            <Size>&gt;32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>211859</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC156</BillingCode>
            <Name>Cephalic Head</Name>
            <Description>Cephalic Head AISI 316L</Description>
            <Size>41 - 57mm Diameter</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>210761</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC191</BillingCode>
            <Name>BioBall Femoral Head</Name>
            <Description>Femoral Head Vivium &gt; 32mm</Description>
            <Size>36mm to 58mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>227097</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC193</BillingCode>
            <Name>BioBall Femoral Head</Name>
            <Description>Femoral Head Vivium &gt; 32mm</Description>
            <Size>36mm to 58mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>227098</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC196</BillingCode>
            <Name>BioBall Femoral Head</Name>
            <Description>Femoral Head Vivium &gt; 32mm</Description>
            <Size>36mm, 38mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>227096</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA467</BillingCode>
            <Name>Mathys Unipolar Femoral Head</Name>
            <Description>Stainless steel, unipolar head</Description>
            <Size>42 mm - 58mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3994</SubGroupID>
            <ARTGs>
                <ARTG>212967</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK405</BillingCode>
            <Name>LFIT Femoral Heads</Name>
            <Description>Femoral head with low friction ion treatment</Description>
            <Size>36mm-44mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <Suffix>Low Frequency Ion Treatment</Suffix>
            <ARTGs>
                <ARTG>211867</ARTG>
                <ARTG>211868</ARTG>
            </ARTGs>
            <MinimumBenefit>1696</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AX103</BillingCode>
            <Name>U2 Femoral Head</Name>
            <Description>Unipolar Femoral heads, CoCr</Description>
            <Size>Size 42 - 56mm</Size>
            <SupplierCode>AX</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>172424</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV027</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Femoral Head CoCr, Superfinished</Description>
            <Size>33-36mm, XS-XXL (neck length), -3.5 to + 10.5 (neck offset)</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>262372</ARTG>
                <ARTG>263792</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR084</BillingCode>
            <Name>CoCr Femoral Head</Name>
            <Description>CoCr Modular Head</Description>
            <Size>Dia 36-62</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>224980</ARTG>
                <ARTG>269352</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR301</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO293</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioBall Femoral Head</Name>
            <Description>Femoral Head Vivium &gt; 32mm</Description>
            <Size>36mm to 58mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>266538</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR313</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO311</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Femoral Heads</Name>
            <Description>CoCr Femoral Heads &gt;32mm</Description>
            <Size>36mm, 40mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>305165</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY402</BillingCode>
            <Name>DePuy Synthes Conventional Metal Femoral Heads</Name>
            <Description> Metal Femoral Head - Articul/eze, M-Spec, Ultamet, Modular M-Spec, Unipolar</Description>
            <Size>36mm to 60mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>261972</ARTG>
                <ARTG>261992</ARTG>
                <ARTG>261993</ARTG>
                <ARTG>264072</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA024</BillingCode>
            <Name>Exactech Femoral Head CoCr</Name>
            <Description>Cobalt Chrome Femoral Head</Description>
            <Size>36mm, -3.5mm to +10mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>293800</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FD002</BillingCode>
            <Name>Evolutis CoCr Femoral Head</Name>
            <Description>CoCr Femoral Heads</Description>
            <Size>36mm diamater</Size>
            <SupplierCode>FD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>268273</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FD007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LI118</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolutis CoCr Femoral Heads</Name>
            <Description>Large Diameter CoCr Femoral Heads</Description>
            <Size>36mm  Short, Medium, Long, Extra Long  12/14 Taper</Size>
            <SupplierCode>FD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>268273</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC157</BillingCode>
            <Name>Modular Head</Name>
            <Description>Modular Head CoCrMo</Description>
            <Size>36mm Diameter Small to XXXLarge</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>210718</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH705</BillingCode>
            <Name>IC-Head</Name>
            <Description>IC-Head, CoCrMo</Description>
            <Size>36mm, S-XL</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>291215</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI096</BillingCode>
            <Name>F2 Large Femoral Head</Name>
            <Description>Femoral heads, CoCr</Description>
            <Size>Diameter 36mm, -4, 0, +4, +8</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>226929</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO183</BillingCode>
            <Name>Link Prosthesis Femoral Head, &gt;32mm</Name>
            <Description>CoCr Femoral Head, &gt;32mm</Description>
            <Size>36mm diameter</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>212089</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA542</BillingCode>
            <Name>Mathys CoCr Femoral Head</Name>
            <Description>CoCr Femoral Head</Description>
            <Size>36mm, S to XXL</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>274272</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU097</BillingCode>
            <Name>Femoral Head</Name>
            <Description>CoCr Femoral Ball Head 12/14</Description>
            <Size>Ø 36mm &amp; Ø 40mm: both of sizes S-M-L-XL-XXL</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>210392</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF025</BillingCode>
            <Name>Unipolar Femoral head</Name>
            <Description>Femoral head manufactured from Cobalt Chrome</Description>
            <Size>40-62mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>298301</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF047</BillingCode>
            <Name>Signature Delta Femoral Head &gt;=36mm</Name>
            <Description>Cobalt Delta Femoral Head</Description>
            <Size>Offsets S, M, L &amp; XL</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>272595</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN308</BillingCode>
            <Name>Unipolar Head</Name>
            <Description>Co Cr</Description>
            <Size>12/14, 40-61mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>242994</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN809</BillingCode>
            <Name>Femoral head</Name>
            <Description>CoCr</Description>
            <Size>&gt;32mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>218139</ARTG>
                <ARTG>218142</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST570</BillingCode>
            <Name>UNITRAX</Name>
            <Description>Vitallium alloy /CoCr</Description>
            <Size>38-64mm OD 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>255133</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA111</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BI877</PriorBillingCode>
                <PriorBillingCode>BI974</PriorBillingCode>
                <PriorBillingCode>ZI359</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Zimmer Biomet Femoral Heads</Name>
            <Description>Modular Femoral Head  </Description>
            <Size>36-44 mm diameter</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>224807</ARTG>
                <ARTG>231255</ARTG>
                <ARTG>237314</ARTG>
                <ARTG>273693</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI054</BillingCode>
            <Name>Femoral Head</Name>
            <Description>Cobalt Chrome Femoral Head</Description>
            <Size>36-57mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3995</SubGroupID>
            <ARTGs>
                <ARTG>346245</ARTG>
                <ARTG>228449</ARTG>
                <ARTG>241192</ARTG>
                <ARTG>241232</ARTG>
                <ARTG>274713</ARTG>
                <ARTG>344990</ARTG>
            </ARTGs>
            <MinimumBenefit>715</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW394</BillingCode>
            <Name>Stryker large ceramic femoral head </Name>
            <Description>Biolox Forte</Description>
            <Size>36mm - 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3996</SubGroupID>
            <ARTGs>
                <ARTG>217828</ARTG>
            </ARTGs>
            <MinimumBenefit>1535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA517</BillingCode>
            <Name>Bionit Ceramic Femoral Head</Name>
            <Description>Femoral Head, Ceramic</Description>
            <Size>36 to 54mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3996</SubGroupID>
            <ARTGs>
                <ARTG>210564</ARTG>
            </ARTGs>
            <MinimumBenefit>1535</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ819</BillingCode>
            <Name>DePuy Delta TS Heads</Name>
            <Description>Delta ceramic femoral head with titanium sleeve</Description>
            <Size>&gt;32mm, +1 to +12</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <Suffix>Sleeve</Suffix>
            <ARTGs>
                <ARTG>217543</ARTG>
            </ARTGs>
            <MinimumBenefit>2097</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC155</BillingCode>
            <Name>Revision Modular Biolox Delta Head</Name>
            <Description>Revision Modular Biolox Delta Head Ti6AI4V 12/14 Taper</Description>
            <Size>36 - 40mm Small to Xlarge</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <Suffix>Sleeve</Suffix>
            <ARTGs>
                <ARTG>210872</ARTG>
            </ARTGs>
            <MinimumBenefit>2097</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA485</BillingCode>
            <Name>Ceramys Large Ceramic Revision Femoral Head</Name>
            <Description>Ceramic, zirconia alumina combination, large diameters, supplied with titanium taper sleeve</Description>
            <Size>36 L, 36 M, 36 S, 36 XL, 36</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <Suffix>Sleeve</Suffix>
            <ARTGs>
                <ARTG>274113</ARTG>
            </ARTGs>
            <MinimumBenefit>2097</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB302</BillingCode>
            <Name>Biolox Delta Ceramic Hip Prosthesis Head</Name>
            <Description>Biolox Delta Ceramic Head</Description>
            <Size>36 &amp; 40mm diameter</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>291964</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH036</BillingCode>
            <Name>Biolox Delta Option Ceramic Femoral Heads</Name>
            <Description>ceramic modular head, biolox delta</Description>
            <Size>36mm to 60mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>117715</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV028</BillingCode>
            <Name>Delta Modular Heads</Name>
            <Description>Biolox Delta Heads</Description>
            <Size>33-40mm&#xD;
Short, Medium, Long</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>240574</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR179</BillingCode>
            <Name>Ceramic Modular head</Name>
            <Description>Biolox Delta Ceramic heads  &gt; 32mm</Description>
            <Size>36, 40 and 44mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>157505</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR194</BillingCode>
            <Name>Biolox Option (&gt;32mm)</Name>
            <Description>Biolox Option Ceramic Femoral Head</Description>
            <Size>36mm and 40mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>157505</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR307</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO303</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Biolox Delta Ceramic Femoral Heads</Name>
            <Description>Biolox Delta Femoral Head 36mm</Description>
            <Size>Biolox Delta Femoral Head 36mm -4.0mm to +8.0mm, 40mm -4.0mm to +8.0mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>305164</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR309</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO307</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioBall Delta Femoral Head, &gt;32mm</Name>
            <Description>Femoral Head Biolox Delta Ceramic, &gt;32mm</Description>
            <Size>36mm, 40mm, 44mm, 48mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>276307</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY464</BillingCode>
            <Name>DePuy Delta Ceramic Femoral Head</Name>
            <Description>Ceramic delta &gt;32mm</Description>
            <Size>&gt;32mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>232415</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA004</BillingCode>
            <Name>Ceramic Modular head</Name>
            <Description>Biolox Delta Ceramic heads  &gt; 32mm</Description>
            <Size>36, 40 and 44mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>285507</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FD004</BillingCode>
            <Name>Delta Ceramic Femoral Head</Name>
            <Description>Delta Femoral Head</Description>
            <Size>36mm to 40mm</Size>
            <SupplierCode>FD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>273049</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG007</BillingCode>
            <Name>Biolox Delta Ceramic Femoral Head 36mm</Name>
            <Description>A sterile implantable component of a hip prostheses system intended to replace the femoral head in total hip arthroplasty procedures.</Description>
            <Size>Diameter: 36mm&#xD;
Taper: 12/14&#xD;
Neck: S, M, L, XL&#xD;
Centre of rotation: -3.5, 0, +3.5, +7.0mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>279805</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT030</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Adler Ceramic Head</Name>
            <Description>Delta Alumina Ceramic Head</Description>
            <Size>Short, Medium, Long, Extra Long; 36mm to 48mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>296607</ARTG>
                <ARTG>206143</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC154</BillingCode>
            <Name>Modular Biolox Delta Head</Name>
            <Description>Modular Biolox Delta Head</Description>
            <Size>36 - 40mm Small to Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>210721</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC192</BillingCode>
            <Name>BioBall Delta Femoral Head</Name>
            <Description>Femoral Head Biolox Delta</Description>
            <Size>28mm, 32mm, 36mm, 40mm, 44mm, 48mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>227095</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI075</BillingCode>
            <Name>Large Delta Ceramic Head</Name>
            <Description>Biolox Delta Head</Description>
            <Size>36mm heads&#xD;
10/12 and 12/14</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>281064</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI116</BillingCode>
            <Name>Biolox Delta Ceramic Revision Head</Name>
            <Description>Biolox Delta Femoral Head</Description>
            <Size>36mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>281065</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO182</BillingCode>
            <Name>Link Biolox Delta Ceramic Head &gt; 32mm</Name>
            <Description>Biolox Delta Ceramic Head &gt; 32mm</Description>
            <Size>36mm - 40mm diameter</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>212053</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA483</BillingCode>
            <Name>Ceramys Large Ceramic Femoral Head</Name>
            <Description>Ceramic, zirconia alumina combination, large diameters</Description>
            <Size>36 XL, 36 L, 36 M, 36 S</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>236457</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU095</BillingCode>
            <Name>Biolox Delta Ceramic Ball heads</Name>
            <Description>Ceramic femoral heads, BIOLOX® Delta Ai2 O3 -ZrO2</Description>
            <Size>Ball Head 12/14 Ø 36 Sizes: S, M, L and XL&#xD;
Ball Head 12/14 Ø 40 Sizes: S, M, L and XL&#xD;
Ball Head 12/14 Ø 44 Sizes: S, M, L and XL</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>205465</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU118</BillingCode>
            <Name>Mectacer Biolox Option Ceramic Heads (&gt;32)</Name>
            <Description>Biolox Option Ceramic Femoral Heads</Description>
            <Size>36mm, 40mm, 44mm, 48mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>206684</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG002</BillingCode>
            <Name>Biolox Delta Head</Name>
            <Description>Zirconia toughened alumina femoral head</Description>
            <Size>Ø36mm, 12/14 &amp; 16/18 tapers, Short - Extra Long Offsets</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>326800</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL001</BillingCode>
            <Name>Mac Surgical BIOLOX Delta Ceramic Heads 36mm and 40mm</Name>
            <Description>BIOLOX Delta Ceramic Heads 36mm and 40mm</Description>
            <Size>36mm and 40mm - both diameters are available in 4 different nead-neck-lengths (short, Medium, Long, X-Long)</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>230837</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF023</BillingCode>
            <Name>Ceramic Femoral Head</Name>
            <Description>Ceramic Femoral Head - Delta</Description>
            <Size>36 to 44mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>272595</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF045</BillingCode>
            <Name>Signature Delta Femoral Head &gt;=36mm</Name>
            <Description>Ceramtec Delta Femoral Head</Description>
            <Size>offsets S, M, L &amp; XL</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>272595</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM095</BillingCode>
            <Name>Universal Delta Ceramic Femoral Head</Name>
            <Description>Delta Ceramic</Description>
            <Size>&gt;32mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>218138</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM167</BillingCode>
            <Name>Revision Delta Ceramic Femoral Head</Name>
            <Description>Biolox Option Head</Description>
            <Size>&gt;32mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>236061</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR029</BillingCode>
            <Name>Stryker Large Femoral Head - Delta Ceramic </Name>
            <Description>Delta Ceramic </Description>
            <Size>36mm - 50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>206181</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG026</BillingCode>
            <Name>JRI Total Hip System</Name>
            <Description>Total Hip Replacement (THR) Ceramic Femoral Heads, Biolox Delta Ceramic, and Alumina Oxide</Description>
            <Size>12 / 14 Taper, Biolox Delta Ceramic head sizes 36mm &amp; 40mm, Alumina Oxide head sizes 28mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>132410</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI539</BillingCode>
            <Name>Ceramic primary &amp; revision femoral head</Name>
            <Description>Biolox Delta Ceramic</Description>
            <Size>36 - 48mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3998</SubGroupID>
            <ARTGs>
                <ARTG>215999</ARTG>
            </ARTGs>
            <MinimumBenefit>1829</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH620</BillingCode>
            <Name>IC-Head Biolox delta</Name>
            <Description>Biolox delta ceramic head</Description>
            <Size>36mm and 40 mm. S, M, L and XL.</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3999</SubGroupID>
            <ARTGs>
                <ARTG>288475</ARTG>
            </ARTGs>
            <MinimumBenefit>1767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN812</BillingCode>
            <Name>Femoral Head</Name>
            <Description>12/14, 14/16 Taper, Oxinium</Description>
            <Size>&gt;32mm, -3 - +16mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1420</GroupID>
            <SubGroupID>3999</SubGroupID>
            <ARTGs>
                <ARTG>218140</ARTG>
                <ARTG>218141</ARTG>
            </ARTGs>
            <MinimumBenefit>1767</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ001</BillingCode>
            <Name>ADEPT MoM Resurfacing Head</Name>
            <Description>Resurfacing Head MoM, Cast CoChr</Description>
            <Size>38-58 going up in 2mm increments</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1422</GroupID>
            <SubGroupID>4000</SubGroupID>
            <ARTGs>
                <ARTG>192533</ARTG>
                <ARTG>192534</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN743</BillingCode>
            <Name>Birmingham Hip Resurfacing Prostheses -  Femoral Component</Name>
            <Description>Cobal Chrome</Description>
            <Size>48-62mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1422</GroupID>
            <SubGroupID>4000</SubGroupID>
            <ARTGs>
                <ARTG>274333</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP188</BillingCode>
            <Name>Self Centering Bipolar Head</Name>
            <Description>Bipolar femoral head, CoCr with UHMWPE insert</Description>
            <Size>39-65mm outer diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>235557</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH622</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bi-polar head</Name>
            <Description>Bipolar head</Description>
            <Size>38mm - 62mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>271212</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO036</BillingCode>
            <Name>LINK Vario bipolar Cup</Name>
            <Description>Shell with unmodified polyethylene plus locking ring</Description>
            <Size>Inner diameter: 28 - 32mm  Outer diameter: 44 - 65mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>212055</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA025</BillingCode>
            <Name>Mathys Bipolar Femoral Head</Name>
            <Description>Stainless steel with fixed UHMWPE insert</Description>
            <Size>28mm Inner diameter, 42-58mm outer diameter</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>212427</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU021</BillingCode>
            <Name>Medacta Bipolar Head</Name>
            <Description>Stainless Steel, with UHMWPE insert</Description>
            <Size>Ball head diameter 22.2mm, sizes: from 39 to 52mm.&#xD;
Ball head diameter 28mm, sizes: from 42 to 60mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>217252</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN267</BillingCode>
            <Name>Tandem/Convene</Name>
            <Description>Shell/Liner</Description>
            <Size>22 - 64mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>242993</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST566</BillingCode>
            <Name>Osteonics hip prostheses</Name>
            <Description>Bipolar shell and polyethylene insert (factory Assembled)</Description>
            <Size>ID 22, 26, 28, 32mm dia </Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>247373</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI286</BillingCode>
            <Name>Zimmer Acetabular Cup</Name>
            <Description>Multipolar (Bipolar) Cup-Co Chr W/WHMWPE</Description>
            <Size>Outer Diameter 38 - 72mm, Inner Diameter 22,28, or 32mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4004</SubGroupID>
            <ARTGs>
                <ARTG>95692</ARTG>
            </ARTGs>
            <MinimumBenefit>676</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC162</BillingCode>
            <Name>Lock Bipolar Head and Liner</Name>
            <Description>Self Centering Head CoCrMo and UHMWPE Liner</Description>
            <Size>Diameter x 28mm x OD 41-57mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4005</SubGroupID>
            <ARTGs>
                <ARTG>216354</ARTG>
            </ARTGs>
            <MinimumBenefit>953</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC197</BillingCode>
            <Name>Delta Mobile Liner UHMWPE</Name>
            <Description>The Mobile Liner UHMWPE functions as part of a double mobility system. It is coupled with an outer liner before being fitted onto the head of a femoral stem. The inner liner provides the articulating surface within the outer liner and the coupled liner provides the articulating surface with the acetabular shell after insertion into the acetabular shell/Cup as part of a total hip arthroplasty.</Description>
            <Size>Diameter (mm) 40 - 42 Outer</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4005</SubGroupID>
            <ARTGs>
                <ARTG>294077</ARTG>
            </ARTGs>
            <MinimumBenefit>953</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC198</BillingCode>
            <Name>2M Cups Double Mobility System Mobile Liners (UHMWPE)</Name>
            <Description>The liner functions as part of a double mobility system. The liner articulates with an acetabular cup and femoral head as part of a total hip arthroplasty. The liner has an inner clearance of 0.3 mm with respect to the femoral head. The outer clearance has been increased to 0.6 mm to avoid locking of the outer joint due to the interposition of fibrous tissue. The centre of the inner head is cranialized with respect to the centre of the liner (1,5 mm), to permit the self-centring of the system.</Description>
            <Size>Diameter (mm)&#xD;
Outer 42 to 58&#xD;
Diameter (mm)&#xD;
Inner 22 to 28</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>162</SubCategoryID>
            <GroupID>1424</GroupID>
            <SubGroupID>4005</SubGroupID>
            <ARTGs>
                <ARTG>294065</ARTG>
            </ARTGs>
            <MinimumBenefit>953</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI384</BillingCode>
            <Name>Low Profile Cup - Cups cemented</Name>
            <Description>UHMPE unmodified</Description>
            <Size>22/36 to 32/64</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>230852</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB236</BillingCode>
            <Name>Polyethylene Acetabular Cup</Name>
            <Description>Unmodified Polyethylene</Description>
            <Size>22.2mm-32mm articulations; 40mm-64mm diameters</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>297032</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG003</BillingCode>
            <Name>Contile Fin II Acetabular, Mueller Cup 28mm and 32mm</Name>
            <Description>Mueller Cup</Description>
            <Size>28mm Neutral and 10 Degree, 32mm Neutral and 10 Degree</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>284657</ARTG>
                <ARTG>285462</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC020</BillingCode>
            <Name>Lima Cemented Cup</Name>
            <Description>UHMWPE Cemented Cup Unmodified</Description>
            <Size>28-36mm OD x 44-58mm OD 20*</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>213029</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH677</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO138</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC Muller PE Cup</Name>
            <Description>PE acetabulum cup with 0 and10 degree lip - cemented</Description>
            <Size>44-62mm, 28-32mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>234879</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO018</BillingCode>
            <Name>LINK IP Acetabular Cup</Name>
            <Description>UHMWPE unmodified</Description>
            <Size>40 - 64mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>223527</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA027</BillingCode>
            <Name>CCB Cemented UHMWPE Cup</Name>
            <Description>UHMWPE, low &amp; full profile</Description>
            <Size>28/32 ID - 42/64 OD</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>211096</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU144</BillingCode>
            <Name>APRICOT full PE Cemented Cup</Name>
            <Description>Flat edge full PE cemented cup</Description>
            <Size>002, 028, 032</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>230649</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI027</BillingCode>
            <Name>ZCA Acetabular Cup</Name>
            <Description>UHMPE unmodified</Description>
            <Size>47 - 61</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4006</SubGroupID>
            <ARTGs>
                <ARTG>209894</ARTG>
                <ARTG>212781</ARTG>
                <ARTG>230915</ARTG>
            </ARTGs>
            <MinimumBenefit>629</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW030</BillingCode>
            <Name>Contemporary Hip System Range</Name>
            <Description>Exeter Contemporary Flanged modified  Enhanced Polyethylene </Description>
            <Size>ID: 26, 28, 32.  OD 46, 48, 50, 52, 54, 56, 58, 60</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <Suffix>Flange</Suffix>
            <ARTGs>
                <ARTG>205344</ARTG>
            </ARTGs>
            <MinimumBenefit>618</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW029</BillingCode>
            <Name>Duration Polyethelene cemented acetabular component</Name>
            <Description>Duration Poly Cup -  Enhanced Polyethylene</Description>
            <Size>26 - 32 mm ID</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <ARTGs>
                <ARTG>205343</ARTG>
            </ARTGs>
            <MinimumBenefit>786</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ689</BillingCode>
            <Name>Marathon Cup System Cemented Acetabular Cup</Name>
            <Description>Cemented modified UHMWPE acetabular cup with flange</Description>
            <Size>Inner diameter 22-36mm, outer diameter 38-53mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <ARTGs>
                <ARTG>97696</ARTG>
            </ARTGs>
            <MinimumBenefit>786</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU143</BillingCode>
            <Name>APRICOT full PE HC Cemented Cup</Name>
            <Description>Flat Edge full High-Cross PE cemented Cup</Description>
            <Size>022, 028, 032, 036</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <ARTGs>
                <ARTG>281575</ARTG>
            </ARTGs>
            <MinimumBenefit>786</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK460</BillingCode>
            <Name>Exeter Rim Fit Flanged X3 Cup</Name>
            <Description>X3 Highly crosslinked Cup</Description>
            <Size>40-60mm OD, 22.2-40mm ID</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <ARTGs>
                <ARTG>224769</ARTG>
            </ARTGs>
            <MinimumBenefit>786</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN696</BillingCode>
            <Name>Reflection</Name>
            <Description>Acetabular Cup - XLPE</Description>
            <Size>22-64mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <ARTGs>
                <ARTG>218147</ARTG>
            </ARTGs>
            <MinimumBenefit>786</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI314</BillingCode>
            <Name>ZCA All Poly Acetabular Cup - XLPE</Name>
            <Description>UHMPE modified </Description>
            <Size>22, 26, 28 &amp; 32 mm heads; 47-61mm diameter; flanged and non-flanged</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <ARTGs>
                <ARTG>213175</ARTG>
            </ARTGs>
            <MinimumBenefit>786</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI957</BillingCode>
            <Name>Exceed ABT Cemented Cup</Name>
            <Description>Cemented UHMWPE Cup</Description>
            <Size>46-60 outer diameter</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4007</SubGroupID>
            <ARTGs>
                <ARTG>233756</ARTG>
                <ARTG>233757</ARTG>
            </ARTGs>
            <MinimumBenefit>786</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH676</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO137</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC Muller PE snap lock cup</Name>
            <Description>PE acetabulum cup , constrained</Description>
            <Size>44 – 62mm, 28 or 32mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4008</SubGroupID>
            <ARTGs>
                <ARTG>234880</ARTG>
            </ARTGs>
            <MinimumBenefit>699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO019</BillingCode>
            <Name>Lubinus Eccentric Acetabular Cup</Name>
            <Description>UHMWPE constrained</Description>
            <Size>44 - 68mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4008</SubGroupID>
            <ARTGs>
                <ARTG>223209</ARTG>
                <ARTG>223210</ARTG>
                <ARTG>234119</ARTG>
            </ARTGs>
            <MinimumBenefit>699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK430</BillingCode>
            <Name>Trident Constrained All Poly Acetabular Cup</Name>
            <Description>UHMWPE constrained cemented cup</Description>
            <Size>40-70mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4008</SubGroupID>
            <ARTGs>
                <ARTG>225310</ARTG>
            </ARTGs>
            <MinimumBenefit>699</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH040</BillingCode>
            <Name>Avantage Dual Mobility Cemented Acetabular Cup</Name>
            <Description>Acetabular shell, polished inner surface, Stainless Steel</Description>
            <Size>44mm - 60mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4009</SubGroupID>
            <ARTGs>
                <ARTG>223850</ARTG>
            </ARTGs>
            <MinimumBenefit>1511</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR232</BillingCode>
            <Name>Dual Mobility Cup (MobiliT), Shell Cemented</Name>
            <Description>Acetabular Shell, Cemented stainless steel with groove, internal mirror polished</Description>
            <Size>42mm to 60mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4009</SubGroupID>
            <ARTGs>
                <ARTG>210207</ARTG>
            </ARTGs>
            <MinimumBenefit>1511</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI059</BillingCode>
            <Name>Saturne Cemented Tripolar Cup</Name>
            <Description>Stainless steel cemented acetabular cup with an anatomical anti-disloction profile</Description>
            <Size>Sizes 44 - 60 in 2mm increments</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4009</SubGroupID>
            <ARTGs>
                <ARTG>210137</ARTG>
            </ARTGs>
            <MinimumBenefit>1511</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN349</BillingCode>
            <Name>BI-MENTUM Dual Mobility System</Name>
            <Description>Cemented metal acetabular dual mobility cup designed to be used with a polyethylene liner</Description>
            <Size>43-63 mm diameter in 2mm increments</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4009</SubGroupID>
            <ARTGs>
                <ARTG>363211</ARTG>
            </ARTGs>
            <MinimumBenefit>1511</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM133</BillingCode>
            <Name>Polar Cup Cemented Acetabular Shell</Name>
            <Description>Stainless steel, cemented shell that has polished inner surface for dual mobility with constrained UHMWPE liner/head</Description>
            <Size>43-63MM</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4009</SubGroupID>
            <ARTGs>
                <ARTG>231321</ARTG>
            </ARTGs>
            <MinimumBenefit>1511</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO282</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Novae STICK Dual Mobility Cup</Name>
            <Description>A cemented metal acetabular dual mobility cup designed to be used with a polyethylene liner</Description>
            <Size>43-69mm diameter in 2mm increments</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1425</GroupID>
            <SubGroupID>4009</SubGroupID>
            <ARTGs>
                <ARTG>298114</ARTG>
            </ARTGs>
            <MinimumBenefit>1511</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI353</BillingCode>
            <Name>Allofit Cup</Name>
            <Description>Titanium, macro texture, non HA</Description>
            <Size>46 - 68mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4010</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>210092</ARTG>
            </ARTGs>
            <MinimumBenefit>1931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI874</BillingCode>
            <Name>Allofit IT Shell</Name>
            <Description>Titanium Shell, Macro texture, Non HA</Description>
            <Size>Shell outer diameter: 42mm-74mm in 2mm increments</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4010</SubGroupID>
            <ARTGs>
                <ARTG>227881</ARTG>
                <ARTG>232428</ARTG>
            </ARTGs>
            <MinimumBenefit>1931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY521</BillingCode>
            <Name>Pinnacle Acetabular Shell</Name>
            <Description>Titanium, beaded (Porocoat), not HA, acetabular cups</Description>
            <Size>38 - 80mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4011</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>221600</ARTG>
                <ARTG>221679</ARTG>
                <ARTG>223026</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL085</BillingCode>
            <Name>Reflection</Name>
            <Description>Acetabular Cup, Spiked, Beaded, Titanium Alloy</Description>
            <Size>40-68 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4011</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>218205</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV032</BillingCode>
            <Name>Dynasty Acetabular System/ Actebular Shell</Name>
            <Description>Beaded Acetabular shell non HA</Description>
            <Size>46-76mm&#xD;
B-K</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4011</SubGroupID>
            <ARTGs>
                <ARTG>272232</ARTG>
                <ARTG>272252</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD023</BillingCode>
            <Name>FMP Acetabular Shell</Name>
            <Description>Titanium, non HA, beaded, variable screw holes</Description>
            <Size>42-80mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4011</SubGroupID>
            <ARTGs>
                <ARTG>210540</ARTG>
                <ARTG>210541</ARTG>
                <ARTG>210542</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA496</BillingCode>
            <Name>SeleXys Acetabular PC Shell</Name>
            <Description>Uncemented Ti acetabular shell, beaded, non HA</Description>
            <Size>42mm - 72mm in 2mm increments</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4011</SubGroupID>
            <ARTGs>
                <ARTG>274135</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL161</BillingCode>
            <Name>Reflection</Name>
            <Description>Acetabular Shell, Beaded, Titanium Alloy</Description>
            <Size>40 to 80mm </Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4011</SubGroupID>
            <ARTGs>
                <ARTG>220233</ARTG>
                <ARTG>223522</ARTG>
                <ARTG>223524</ARTG>
                <ARTG>223821</ARTG>
                <ARTG>223823</ARTG>
                <ARTG>247733</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH681</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO170</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS RS Cup</Name>
            <Description>Acetabulum reconstruction cup, flange multiple screw holes</Description>
            <Size>46, 50, 54, 58, 62mm&#xD;
right &amp; left</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4012</SubGroupID>
            <ARTGs>
                <ARTG>238836</ARTG>
            </ARTGs>
            <MinimumBenefit>1967</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI386</BillingCode>
            <Name>Fitmore Cup</Name>
            <Description>Titanium mesh non HA </Description>
            <Size>42 to 68mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4012</SubGroupID>
            <ARTGs>
                <ARTG>223627</ARTG>
            </ARTGs>
            <MinimumBenefit>1967</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB378</BillingCode>
            <Name>Plasmafit Acetabular Cup</Name>
            <Description>Acetabular Shell with Plasmapore Coating</Description>
            <Size>40mm - 70mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4013</SubGroupID>
            <ARTGs>
                <ARTG>297206</ARTG>
                <ARTG>297207</ARTG>
            </ARTGs>
            <MinimumBenefit>1857</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH365</BillingCode>
            <Name>G7 Acetabular Shell</Name>
            <Description>Acetabular Shell, porous plasma, non-HA</Description>
            <Size>42mm to 68mm in 2 mm increments</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4013</SubGroupID>
            <ARTGs>
                <ARTG>231249</ARTG>
            </ARTGs>
            <MinimumBenefit>1857</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF028</BillingCode>
            <Name>Cementless Cup plasma coated</Name>
            <Description>Cementless Cup are availbe with No-Hole and Cluster Hole design options, shells manufactured from titanium (Ti) alloy with plasma coating, sphere and taper inner diameter geometry</Description>
            <Size>Shell: No-Hole shell size 48-68, 2mm increments; Cluster Hole Size 48-68, 2mm increments; Multi-Hole Size 48-56, Multi-Hole with Rim Fixation, Size 56-68</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4013</SubGroupID>
            <ARTGs>
                <ARTG>266797</ARTG>
            </ARTGs>
            <MinimumBenefit>1857</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM128</BillingCode>
            <Name>POLAR CUP ACETABULAR Cementless Shell</Name>
            <Description>Stainless steel with titanium plasma spray coating that has polished inner surface for dual mobility with constrained UHMWPE liner/head</Description>
            <Size>43-67MM</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4013</SubGroupID>
            <ARTGs>
                <ARTG>260954</ARTG>
            </ARTGs>
            <MinimumBenefit>1857</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT004</BillingCode>
            <Name>Fixa Ti-Por Cup</Name>
            <Description>Porous Matrix Titanium, Screw Holes with Plugs, Hemispherical Acetabular Cup</Description>
            <Size>42-66mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>207934</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW637</BillingCode>
            <Name>RAS Restoration Anatomical Shell</Name>
            <Description>Cementless Tritanium Acetabular Cup. Multihole screw fixation.</Description>
            <Size>54-80 L and R</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>285188</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW786</BillingCode>
            <Name>Trident II Tritanium Acetabular System</Name>
            <Description>Acetabular Shell, tritanium</Description>
            <Size>Size A-J Diameter (mm) 42-72</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>320142</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ653</BillingCode>
            <Name>Pinnacle Hip System - Gription Cup</Name>
            <Description>Porous metal acetabular cup</Description>
            <Size>38 - 80mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>222606</ARTG>
                <ARTG>224540</ARTG>
                <ARTG>224199</ARTG>
                <ARTG>236733</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC164</BillingCode>
            <Name>Delta TT Acetabular Cup</Name>
            <Description>Delta TT Acetabular Cup Ti6AI4V</Description>
            <Size>44 - 76mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>210796</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC199</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LC165</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Delta Multihole TT Cup</Name>
            <Description>Delta Multihole TT Acetabular Cup (Ti6AI4V)</Description>
            <Size>Diameter (mm) 44 to 76</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>292687</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC200</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LC165</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Delta ONE TT cup</Name>
            <Description>Delta One TT Acetabular Cup Ti6AI4V</Description>
            <Size>Diameter (mm) 44 - 66mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>216036</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI099</BillingCode>
            <Name>C2 Acetabular Shell</Name>
            <Description>titanium Cup with sintered titanium coating</Description>
            <Size>48 - 68mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>227893</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU140</BillingCode>
            <Name>Mpact Acetabular Shells</Name>
            <Description>Cementless titanium acetabular shell, variable holes</Description>
            <Size>42 to 66</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>209485</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU141</BillingCode>
            <Name>Mpact Revision Acetabular Shells</Name>
            <Description>Cementless titanium acetabular shell, variable holes</Description>
            <Size>42 to 76</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>229108</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF144</BillingCode>
            <Name>Logical G Shell</Name>
            <Description>titanium Cup with sintered titanium coating</Description>
            <Size>44 - 70mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>276894</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK428</BillingCode>
            <Name>Trident Tritanium Acetabular Shells</Name>
            <Description>Acetabular Shell, tritanium</Description>
            <Size>44mm - 72mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>218018</ARTG>
                <ARTG>221598</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA012</BillingCode>
            <Name>G7 OsseoTi Acetabular Shell</Name>
            <Description>Acetabular shell, porous Ti alloy</Description>
            <Size>42-80mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>278984</ARTG>
                <ARTG>287801</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI325</BillingCode>
            <Name>Trabecular Metal Modular Acetabular System</Name>
            <Description>Titanium, porous tantalum </Description>
            <Size>38-80mm diameter; Cluster, Multiholed, No Holes</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>208903</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI617</BillingCode>
            <Name>Continuum Acetabular Shell</Name>
            <Description>Trabecular Metal Acetabular Shell</Description>
            <Size>40CC, 42DD, 44EE, 46FF, 48GG, 50HH, 5II, 54JJ, 56KK, 58LL, 60MM, 62NN, 64OO, 66PP, 68QU, 70RR, 72SS, 74TT, 76UU, 78VV, 80W</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1426</GroupID>
            <SubGroupID>4014</SubGroupID>
            <ARTGs>
                <ARTG>115915</ARTG>
            </ARTGs>
            <MinimumBenefit>2812</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST548</BillingCode>
            <Name>Trident acetabular component system </Name>
            <Description>Titanium, arc deposited,  with HA</Description>
            <Size>40-82mm OD</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4015</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>145590</ARTG>
                <ARTG>145591</ARTG>
                <ARTG>145592</ARTG>
                <ARTG>152396</ARTG>
                <ARTG>152442</ARTG>
            </ARTGs>
            <MinimumBenefit>2192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK092</BillingCode>
            <Name>Stryker Hydroxyapatite coated cup with ceramic liner</Name>
            <Description>Shell with Biolox forte ceramic liner</Description>
            <Size>52-54mm OD</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4015</SubGroupID>
            <Suffix>Shell &amp; Insert</Suffix>
            <ARTGs>
                <ARTG>205394</ARTG>
            </ARTGs>
            <MinimumBenefit>2760</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW015</BillingCode>
            <Name>ABG 11Cup with Hydroxyapatite</Name>
            <Description>Titanium, grit blast and HA for ceramic insert</Description>
            <Size>Sizes 44mm to 66mm OD in 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4015</SubGroupID>
            <ARTGs>
                <ARTG>205384</ARTG>
            </ARTGs>
            <MinimumBenefit>2192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO032</BillingCode>
            <Name>Link acetabular cup system</Name>
            <Description>Titanium, grit blast, HA</Description>
            <Size>40 - 68mm  Small, medium, large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4015</SubGroupID>
            <ARTGs>
                <ARTG>212117</ARTG>
                <ARTG>212232</ARTG>
            </ARTGs>
            <MinimumBenefit>2192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF010</BillingCode>
            <Name>Atlas Acetabular Cup System</Name>
            <Description>Titanium, grit blast &amp; HA</Description>
            <Size>Atlas Cup 40-74mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4015</SubGroupID>
            <ARTGs>
                <ARTG>141168</ARTG>
            </ARTGs>
            <MinimumBenefit>2192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN286</BillingCode>
            <Name>Reflection</Name>
            <Description>Acetabular Cup HA Coated Titanium Alloy, beaded</Description>
            <Size>40-80mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4016</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>212782</ARTG>
                <ARTG>223523</ARTG>
            </ARTGs>
            <MinimumBenefit>2398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV033</BillingCode>
            <Name>Procotyl L  Acetabular Cup</Name>
            <Description>Beaded, Titanium HA coated cup</Description>
            <Size>42 - 68mm&#xD;
A-G</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4016</SubGroupID>
            <ARTGs>
                <ARTG>285236</ARTG>
            </ARTGs>
            <MinimumBenefit>2398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY520</BillingCode>
            <Name>Pinnacle Acetabular Shell</Name>
            <Description>Titanium. Beaded with HA (Duofix) acetabular cup</Description>
            <Size>48 - 66 mm  </Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4016</SubGroupID>
            <ARTGs>
                <ARTG>221677</ARTG>
                <ARTG>221678</ARTG>
            </ARTGs>
            <MinimumBenefit>2398</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI035</BillingCode>
            <Name>Trilogy Acetabular Cup</Name>
            <Description>Titanium mesh (fibre metal) with HA for UHMPE insert</Description>
            <Size>38 - 80</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4017</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>213174</ARTG>
            </ARTGs>
            <MinimumBenefit>2286</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR242</BillingCode>
            <Name>Dual Mobility Cup, shell uncemented</Name>
            <Description>Acetabular shell titanium Plasma spray + HA, flanges and/or hook.</Description>
            <Size>42 to 68mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <Suffix>Flange</Suffix>
            <ARTGs>
                <ARTG>210208</ARTG>
                <ARTG>210209</ARTG>
                <ARTG>210210</ARTG>
            </ARTGs>
            <MinimumBenefit>2835</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM131</BillingCode>
            <Name>POLAR CUP ACETABULAR Cementless Shell</Name>
            <Description>Stainless steel with titanium plasma spray coating and HA and pegs &amp; flanges, that has polished inner surface for dual mobility with constrained UHMWPE liner/head</Description>
            <Size>43-67MM</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <Suffix>Flange</Suffix>
            <ARTGs>
                <ARTG>148672</ARTG>
            </ARTGs>
            <MinimumBenefit>2835</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB243</BillingCode>
            <Name>Plasmacup</Name>
            <Description>Titanium, plasma, HA</Description>
            <Size>44mm-68mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>134535</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR165</BillingCode>
            <Name>Trinity Acetabular Cup</Name>
            <Description>Tri-liner hemispherical shell. Titanium (Ti6A14V) material with Titanium and HA coated plasma spray</Description>
            <Size>44 - 68 mm in 2mm increments</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>106747</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR302</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO298</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Acetabular Shell</Name>
            <Description>Titanium, plasma spray, HA with variable number of holes</Description>
            <Size>42-72mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>305163</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA003</BillingCode>
            <Name>BSC Acetabular Shell</Name>
            <Description>Titanium, plasma spray, HA with 3 holes</Description>
            <Size>46-66mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>285479</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG001</BillingCode>
            <Name>Fin II Acetabular Shell</Name>
            <Description>titanium, Plasma sprayed, HA, with variable screw options</Description>
            <Size>44 to 72mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>279500</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC166</BillingCode>
            <Name>Delta PF Acetabular Cup</Name>
            <Description>Delta PF Acetabular Cup Ti6AI4V + Poro + HA</Description>
            <Size>44 - 76mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>210795</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC167</BillingCode>
            <Name>Met Acetabular Cup</Name>
            <Description>Met Acetabular Cup CoCrMo + Poro + HA</Description>
            <Size>42 - 64mm OD x 38 - 58mm ID</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>222644</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI061</BillingCode>
            <Name>Saturne Press Fit Dual Mobility Acetabular Cup</Name>
            <Description>A cementless, stippled and peripherally expanded, acetabular cup.  Flattened pole and an elevated rim to help prevent dislocation.</Description>
            <Size>Sizes: 44 - 64 in 2mm increments</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>216969</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN347</BillingCode>
            <Name>BI-MENTUM Dual Mobility System</Name>
            <Description>Press-Fit cementless metal acetabular dual mobility cup, designed to be used with a polyethylene liner.</Description>
            <Size>43mm to 69mm diameter in 2mm increments</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>363113</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN351</BillingCode>
            <Name>BI-MENTUM Dual Mobility System</Name>
            <Description>Plus and Revision cementless metal acetabular dual mobility cups designed to be used with a polyethylene liner.</Description>
            <Size>41mm - 69mm diameter in 2mm increments</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>363132</ARTG>
                <ARTG>363151</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU008</BillingCode>
            <Name>Versafitcup Acetabular Shell</Name>
            <Description>Titanium, plasma spray, with HA, variable holes</Description>
            <Size>40 to 64</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>215939</ARTG>
                <ARTG>209003</ARTG>
                <ARTG>215938</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU022</BillingCode>
            <Name>Versafitcup Dual Mobility Acetabular Shell</Name>
            <Description>Stainless steel, with titanium plasma coating and HA, and polished inner surface for dual articulation</Description>
            <Size>from diameter 46mm to 64mm in 2mm increments</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>208323</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH436</BillingCode>
            <Name>Samo Acetabular Cup</Name>
            <Description>Acetabular cup</Description>
            <Size>40 - 70</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL007</BillingCode>
            <Name>Permedica JUMP System Acetabular Cup HaX-Pore - Acetabular Shell</Name>
            <Description>This acetabular component is for un-cemented applications and is coated with a titanium plasma spray and hydroxyapatite coating.  Anchorage of the device to the bone is by press-fit insertion which can be augmented with cancellous bone screws and the screw holes can be sealed with special plugs.  The acetabular shell is a hemispherical shape with polar deflection and is used in combination with an articular liner, a femoral ball head and a femoral stem.</Description>
            <Size>44mm - 70mm in 2mm increments</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>234000</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF038</BillingCode>
            <Name>Logical ™ Acetabular Shell</Name>
            <Description>Titanium, plasma spray, HA with variable number of holes</Description>
            <Size>42-72mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>266797</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK500</BillingCode>
            <Name>Restoration ADM Cup (Anatomic Dual Mobility) Cup</Name>
            <Description>Chobalt-Chome; HA Coated; Anatomic Dual Mobility Cup</Description>
            <Size>48-64mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>205438</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM024</BillingCode>
            <Name>EP Fit Acetabular Shell</Name>
            <Description>Titanium, plasma spray,  and HA, with variable number of holes for UHMWPE,ceramic &amp; metal inserts</Description>
            <Size>40 - 72mm Dia</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>223819</ARTG>
                <ARTG>223820</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG022</BillingCode>
            <Name>JRI CSF Plus Cup</Name>
            <Description>Titanium, plasma, HA for modified poly insert</Description>
            <Size>44mm - 70mm O/D</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>132477</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG027</BillingCode>
            <Name>JRI CSF Plus Cup</Name>
            <Description>Titanium, plasma, HA for ceramic insert</Description>
            <Size>44mm - 70mm O/D</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>132477</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO233</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Novae Dual Mobility Cup</Name>
            <Description>A cementless metal acetabular dual mobility cup designed to be used with a polyethylene liner.</Description>
            <Size>41mm to 73mm diameter in 2mm increments</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>296620</ARTG>
                <ARTG>296616</ARTG>
                <ARTG>296615</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI987</BillingCode>
            <Name>G7 Acetabular Shell</Name>
            <Description>Acetabular Shell, porous plasma, HA</Description>
            <Size>42-68mm in 2mm increments</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1427</GroupID>
            <SubGroupID>4018</SubGroupID>
            <ARTGs>
                <ARTG>231250</ARTG>
            </ARTGs>
            <MinimumBenefit>2137</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB237</BillingCode>
            <Name>Plasmacup PE insert</Name>
            <Description>UMHPE unmodified liner</Description>
            <Size>44mm-68mm diameters, 22.2mm-32mm articulations</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>134535</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR228</BillingCode>
            <Name>Dual Mobility Cup, Liner</Name>
            <Description>Acetabular Liner UHMWPE</Description>
            <Size>Head 22.2mm or 28mm, Diameter 42 mm to 68mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>210218</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP968</BillingCode>
            <Name>SROM Acetabular UHMWPE Liner</Name>
            <Description>UHMWPE </Description>
            <Size>22-32mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>98086</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO033</BillingCode>
            <Name>Link acetabular Insert</Name>
            <Description>UHMWPE Insert, Cross-linked</Description>
            <Size>28mm - 36mm  Small, medium, large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>212120</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO152</BillingCode>
            <Name>BetaCup Cementless Acetabular Cup System</Name>
            <Description>UHMWPE Insert</Description>
            <Size>26mm&gt;</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>140650</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA419</BillingCode>
            <Name>SeleXys Acetabular UHMWPE Liner</Name>
            <Description>UHMWPE</Description>
            <Size>44mm-72mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>274137</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU010</BillingCode>
            <Name>Medacta UHMWPE Liner</Name>
            <Description>UHMWPE</Description>
            <Size>Internal diameter 22,28,32 mm, hooded &amp; neutral, hooded &amp; neutral</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>132458</ARTG>
                <ARTG>211169</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH435</BillingCode>
            <Name>Samo acetabular cup poly insert</Name>
            <Description>X linked poly insert</Description>
            <Size>22 - 36</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF011</BillingCode>
            <Name>Atlas Acetabular Cup System</Name>
            <Description>liner polyethylene liner, Titanium &amp; HA</Description>
            <Size>Atlas Poly Insert Std. Dia 28 and 32mm</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>141168</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST561</BillingCode>
            <Name>Strker Omnifit/SecurFit Acetabular Insert</Name>
            <Description>Series I and II inserts, UHMPE</Description>
            <Size>22 - 36mm ID for cups 40 - 80mm OD</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4020</SubGroupID>
            <ARTGs>
                <ARTG>225228</ARTG>
            </ARTGs>
            <MinimumBenefit>688</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN291</BillingCode>
            <Name>Reflection/ Reflection3 (R3)</Name>
            <Description>Acetabular Liner XLPE modified UHMPE</Description>
            <Size>22 - 44mm inner diameter, 42 - 80mm outer diameter</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>218151</ARTG>
                <ARTG>230903</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA067</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI045</PriorBillingCode>
                <PriorBillingCode>ZI046</PriorBillingCode>
                <PriorBillingCode>ZI047</PriorBillingCode>
                <PriorBillingCode>ZI048</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Longevity XLPE Acetabular liner</Name>
            <Description>XLPE Acetabular liner</Description>
            <Size>35-80mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>226197</ARTG>
                <ARTG>230853</ARTG>
                <ARTG>231596</ARTG>
                <ARTG>240575</ARTG>
                <ARTG>284918</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI357</BillingCode>
            <Name>Alpha Durasul Insert</Name>
            <Description>UHMPE modified </Description>
            <Size>22mm x 42 to 28mm x 68</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>226717</ARTG>
                <ARTG>230651</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB377</BillingCode>
            <Name>Vitelene PE Cup Insert</Name>
            <Description>Highly cross-linked polyethylene liner stabilised with vitamin E</Description>
            <Size>22.2mm - 40mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>297205</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI972</BillingCode>
            <Name>E-Poly HXLPE Liner</Name>
            <Description>Highly cross linked PE liner, stabilised with Vit E</Description>
            <Size>28mm to 44mm in 4mm increments</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>98098</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV025</BillingCode>
            <Name>Dynasty Acetabular System /poly liner</Name>
            <Description>A-Class Crosslinked Liner&#xD;
STD, Lipped</Description>
            <Size>28-36mm&#xD;
B-K</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>272312</ARTG>
                <ARTG>272313</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV026</BillingCode>
            <Name>Procotyl L System /poly liner</Name>
            <Description>Rim-Lock&#xD;
A-Class Crosslinked Liners&#xD;
Standard, Lipped</Description>
            <Size>28-36mm&#xD;
B-G</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>265521</ARTG>
                <ARTG>265522</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR163</BillingCode>
            <Name>Trinity polyethylene liner</Name>
            <Description>Highly cross linked Polyethylene liner in neutral +4mm offset +4mm oblique and 4mm elevated wall variants for use with the Trinity acetabular multi-bearing shell</Description>
            <Size>28mm, 32mm, 36mm, 40mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>106747</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR216</BillingCode>
            <Name>Trinity ECiMA Liner</Name>
            <Description>Cross linked polyethylene with vitamin E</Description>
            <Size>Size 1-5, 28mm, 32mm, 36mm, 40mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>210774</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR267</BillingCode>
            <Name>Dual Mobility Cup (MobiliT), Liner</Name>
            <Description>Acetabular Liner ECiMa</Description>
            <Size>Head 22.2mm or 28mm, Diameter 42 mm to 68mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>383768</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR305</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO301</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Acetabular System HCLA (highly Cross-Linked and Annealed) Acetabular Liner</Name>
            <Description>Highly Cross-Linked and Annealed polyethylene Insert</Description>
            <Size>44-72mm Cup OD  22-40mm Head ID  Neutral and Lipped</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>305162</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD044</BillingCode>
            <Name>FMP Acetabular System - Acetabular Cup Insert UHMWPE</Name>
            <Description>Acetabular cup inserts, UHMWPE compression moulded and cross-linked.  28-44mm Internal Diameters available in 0-degree (neutral), 10-degree hooded and 20-degree hooded options and +5mm offset options</Description>
            <Size>ID of 28mm - 44mm to suit Acetabular shells of OD 40mm-80mm&#xD;
0,10,20-degree hooded and non-hooded.&#xD;
+5mm Offset</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>209548</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY210</BillingCode>
            <Name>Pinnacle Acetabular Cross Linked UHMWPE Insert</Name>
            <Description>UHMWPE, highly cross linked insert</Description>
            <Size>22-48mm ID</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>98086</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA006</BillingCode>
            <Name>Xonit X-PE Acetabular Liner</Name>
            <Description>Highly Cross-Linked Acetabular Insert</Description>
            <Size>Standard/Dysplasia:&#xD;
39-52mm/28mm&#xD;
39-52mm/32mm&#xD;
44-52mm/36mm&#xD;
48-52mm/40mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>285483</ARTG>
                <ARTG>285959</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG008</BillingCode>
            <Name>FIN XLPE Liner</Name>
            <Description>A cup liner made from Cross-linked UHMWPE (Ultra High Molecular Weight Polyethylene) for use in hip prostheses systems.</Description>
            <Size>Inner 28mm-5°, DIA 44/46&#xD;
Inner 32mm-5°, DIA 48/50&#xD;
Inner 32mm-5°, DIA 52/54&#xD;
Inner 32mm-5°, DIA 56/58 &#xD;
Inner 36mm-5°, DIA 52/54&#xD;
Inner 36mm-5°, DIA 56/58&#xD;
Inner 36mm-5°, DIA 60/72 &#xD;
Inner 40mm-5°, DIA 60/72 &#xD;
Inner 28mm-0°, DIA 44/46 &#xD;
Inner 32mm-0°, DIA 48/50&#xD;
Inner 32mm-0°, DIA 52/54 &#xD;
Inner 32mm-0°, DIA 56/58&#xD;
Inner 36mm-0°, DIA 52/54&#xD;
Inner 36mm-0°, DIA 56/58&#xD;
Inner 36mm-0°, DIA 60/72&#xD;
Inner 40mm-0°, DIA 60/72</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>308933</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Adler PE Acetabular Liners</Name>
            <Description>XLPE Liners - for Fixa Cups</Description>
            <Size>Neutral, 15 degree, in 22,28,32,36mm ID,   </Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>208840</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC170</BillingCode>
            <Name>Delta Non Constrained Liner</Name>
            <Description>Delta Non Constrained Liner UHMWPE X Lima Ti6AI4V Neutral and Protruded</Description>
            <Size>Diameter (mm) 28 to 40  Size Small to Extra Large  Shape Neutral  Shape Protruded</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>218819</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC171</BillingCode>
            <Name>SPH Constrained Poly Liner</Name>
            <Description>SPH Constrained Poly Liner UHMWPE protruded 20*</Description>
            <Size>Protruded Liners&#xD;
ID 28mm X Size XXA, A, B, C, D, E&#xD;
ID 32mm x Size B, C, D, E&#xD;
&#xD;
Neutral Liners&#xD;
ID 28mm X Size XXA, A, B, C, D, E&#xD;
ID 32mm x Size B, C, D, E</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>222629</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH697</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO149</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Implacross PE liner</Name>
            <Description>PE Liner for LUMiC acetabula reconstruction system</Description>
            <Size>0,15 and 15 with 4mm offset. 39 - 52 external diameter</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>277989</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI097</BillingCode>
            <Name>C2 XL2 Polyethylene Liner</Name>
            <Description>XL2 Polyethylene Liner</Description>
            <Size>32-48mm, 32-50mm, 32-52mm, 32-54mm, 32-56mm, 32-58mm, 32-60mm, 32-62mm, 32-64mm, 32-66mm, 36-68mm, 36-52mm, 36-54mm, 36-56mm, 36-58mm, 36-60mm, 36-62mm, 36-64mm, 36-66mm, 36-68mm.</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>229459</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA503</BillingCode>
            <Name>Selexys Acetabular Cup Liner</Name>
            <Description>Insert / Liner, modified polyethylene.  Highly crossed link polyethylene, stabilised with Vit E.</Description>
            <Size>Articulation 28, 32, 36mm; Cup size AA to LL (42 to 70mm)</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>274134</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN348</BillingCode>
            <Name>BI-MENTUM Dual Mobility System</Name>
            <Description>Polyethylene liner </Description>
            <Size>22.2mm heads: 41 - 69mm diameter in 2mm increments,   28mm heads: 47 - 69mm diameter in 2mm increments</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>363212</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU019</BillingCode>
            <Name>Medacta Highly Crosslinked UHMWPE Liner</Name>
            <Description>Highly Crosslinked UHMWPE</Description>
            <Size>Internal diameter 22, 28,32,36, 40 mm neutral &amp; hooded, 4mm offset, face changing 10 degrees</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>209250</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL008</BillingCode>
            <Name>Vital-XE Acetabular Liner</Name>
            <Description>Crosslinked UHWMPE with Vitamin E</Description>
            <Size>28mm, 32mm, 36mm, 40mm,   Angles 0, 10, 20 degrees.</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>382990</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF027</BillingCode>
            <Name>Cross Linked Acetabular Liner</Name>
            <Description>Highly Cross linked Acetabular Liner</Description>
            <Size>Liner Neutral: Group 1: 28mm ID, Group 2: 28mm IS, 32mm ID, Group 3: 32mm ID, 36mm ID; Group 4: 32mm, 36mm, Group 5: 32mm, 36mm, Liner "Lipped": Group 1: 28mm, Group2: 28mm, 32mm, Group 3: 36mm, Group 4: 32mm, 36mm, Group 5: 36mm, Liner "+5 Lateralised" G</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>277875</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF039</BillingCode>
            <Name>Logical™ Acetabular Liner</Name>
            <Description>HCLA (highly Cross-Linked and Annealed) Acetabular Insert</Description>
            <Size>28mm, 32mm, 36mm, 40mm diameter; Neutral, 10 and 20 degree; Size range 44mm to 72mm, including laterialised liners</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>277875</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK318</BillingCode>
            <Name>X3 Trident Acetabular Inserts</Name>
            <Description>Modified UHMPE</Description>
            <Size>Inner diameters: 22mm, 26mm, 28mm 32mm, 36mm, 38 - 64mm.  For outer diameter shells 40mm - 80mm.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>219398</ARTG>
                <ARTG>220404</ARTG>
                <ARTG>230931</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM029</BillingCode>
            <Name>EP Fit &amp; MPF Highly cross linked UHMWPE Insert</Name>
            <Description>Modified UHMWPE</Description>
            <Size>40-68mm Dia, all head sizes</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>222566</ARTG>
                <ARTG>222567</ARTG>
                <ARTG>342564</ARTG>
                <ARTG>342565</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST546</BillingCode>
            <Name>Stryker Acetabular Crossfire Insert</Name>
            <Description>Modified UHMPE</Description>
            <Size>22 -36mm  ID</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>290924</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST549</BillingCode>
            <Name>Trident acetabular component system</Name>
            <Description>Trident polyethlene liner, enhanced polyethlene</Description>
            <Size>22, 26, 28, 32mm dia</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>219397</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST931</BillingCode>
            <Name>Stryker Acetabular Insert</Name>
            <Description>Enhanced Polyethylene insert</Description>
            <Size>22 - 36mm ID</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>205393</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG025</BillingCode>
            <Name>JRI CSF Plus Cup Insert </Name>
            <Description>UHMWPE modified </Description>
            <Size>10 degree liners 28mm, 32mm, 36mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>132477</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI620</BillingCode>
            <Name>Continuum Acetabular System</Name>
            <Description>HXPE Liner (Highly Cross Linked) - Neutral, Elevated, Offset and Oblique</Description>
            <Size>28mm Neutral - EE to QU; 32mm Neutral GG to VV; 36mm Neutral II to W; 40mm Neutral KK to VV; 22mm Elevated - CC to FF; 28mm Elevated EE to QU; 32mm Elevated GG to VV; 36mm Elevated II to VV; 28mm 7 mm Offset CC28 to QU28; 32mm 7mm Offset EE32 to QU32; 36m</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>231010</ARTG>
                <ARTG>231319</ARTG>
                <ARTG>231320</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI969</BillingCode>
            <Name>Vivacit-E  Highly Crossed Linked Polyethylene Liner</Name>
            <Description>Highly Crossed Linked Polyethylene Liner</Description>
            <Size>22-40mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4021</SubGroupID>
            <ARTGs>
                <ARTG>273104</ARTG>
                <ARTG>273105</ARTG>
            </ARTGs>
            <MinimumBenefit>931</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF009</BillingCode>
            <Name>Atlas Acetabular Cup System</Name>
            <Description>liner - ceramic and poly 'Titanium &amp; HA</Description>
            <Size>Atlas Alumina Insert Dia 28mmort</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <Suffix>Sandwich</Suffix>
            <ARTGs>
                <ARTG>141168</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI073</BillingCode>
            <Name>Modular Ceramic System</Name>
            <Description>Acetabular Ceramic/ Polyethylene Liner, UHMWPE</Description>
            <Size>28mm to 44mm in 4mm increments</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>98098</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR303</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO299</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Acetabular Ceramic Insert</Name>
            <Description>Ceramic, Biolox Delta</Description>
            <Size>44-72mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>305161</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY034</BillingCode>
            <Name>Duraloc Option Acetabular Shell Ceramic Insert</Name>
            <Description>Ceramic, Biolox Forte</Description>
            <Size>46-66 mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>97696</ARTG>
                <ARTG>98086</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Adler Ceramic Acetabular Liners</Name>
            <Description>Ceramic Liners - for Fixa Cups</Description>
            <Size>Delta, 28,32,36 &amp; 40 mm ID</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>206130</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH688</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO139</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Implantcast delta ceramic liner</Name>
            <Description>Biolox delta cup liner</Description>
            <Size>32/39, 32/44,36/44, 32/48,36/48,32/52, 36/52, 40/48, 40/52</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>233781</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI076</BillingCode>
            <Name>Horizon II Delta Ceramic Insert</Name>
            <Description>Ceramic Insert, Biolox Delta</Description>
            <Size>9 sizes for 28, 32 and 36mm heads</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>223258</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO151</BillingCode>
            <Name>Link Acetabular Cup System</Name>
            <Description>Ceramic Insert</Description>
            <Size>32mm -40mm  Small, medium, large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>212119</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH437</BillingCode>
            <Name>Samo acetabular cup ceramic insert</Name>
            <Description>Ceramic insert</Description>
            <Size>28 - 40</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST565</BillingCode>
            <Name>Alumina acetabular inserts</Name>
            <Description>Ceramic insert, alumina</Description>
            <Size>28, 32 &amp; 36mm dia</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>217830</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG011</BillingCode>
            <Name>JRI CSF Plus Cup ceramic Insert</Name>
            <Description>CSF Plus Cup Liner, Delta Liner </Description>
            <Size>28mm, 32mm, 36mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4022</SubGroupID>
            <ARTGs>
                <ARTG>132477</ARTG>
            </ARTGs>
            <MinimumBenefit>1900</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH682</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO171</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACCIS Insert (15 degrees)</Name>
            <Description>ACCIS liner (15 degrees) for use with MUTARS RS and LUMIC Cup</Description>
            <Size>38/39, 42/44, 46/48, 50/52mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4023</SubGroupID>
            <Suffix>Revision/Tumour</Suffix>
            <ARTGs>
                <ARTG>281539</ARTG>
            </ARTGs>
            <MinimumBenefit>2140</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR164</BillingCode>
            <Name>Trinity Metal Liner</Name>
            <Description>Metal liner for use with the Trinity acetabular shell</Description>
            <Size>35mm,40mm,42.5mm, 45mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4023</SubGroupID>
            <ARTGs>
                <ARTG>312411</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GM119</BillingCode>
            <Name>Global Metal Acetabular Inserts</Name>
            <Description>CoCr, metal on metal, varying diameter</Description>
            <Size>Multiple sizes</Size>
            <SupplierCode>GM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4023</SubGroupID>
            <ARTGs>
                <ARTG>120787</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW485</BillingCode>
            <Name>MDM CoCr Liner</Name>
            <Description>Modular Dual Mobility (MDM) CoCr Liner</Description>
            <Size>The MDM CoCr Liner comes in a range of inner diameters of 36mm - 58mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4023</SubGroupID>
            <ARTGs>
                <ARTG>217674</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC012</BillingCode>
            <Name>Lima Cup </Name>
            <Description>Metal Liner</Description>
            <Size>28mm, 32mm and 36mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4023</SubGroupID>
            <ARTGs>
                <ARTG>216035</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO234</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Novae Double Mobility Cup Insert</Name>
            <Description>A cementless metal acetabular dual mobility cup designed to be used with a polyethylene liner.</Description>
            <Size>22mm x 43 - 69mm diameter in 2mm increments  28mm x 47 - 69mm diameter in 2mm increments</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4023</SubGroupID>
            <ARTGs>
                <ARTG>282775</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA077</BillingCode>
            <Name>G7 Dual Mobility CoCr Liner</Name>
            <Description>CoCr Liner</Description>
            <Size>32-60mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4023</SubGroupID>
            <ARTGs>
                <ARTG>285123</ARTG>
            </ARTGs>
            <MinimumBenefit>1762</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP014</BillingCode>
            <Name>Pinnacle Constrained Inserts</Name>
            <Description>UHMWPE, constrained liner with titanium alloy locking ring</Description>
            <Size>Inner diameter 28-44mm, 36-76mm outer diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <Suffix>Cup &amp; Ring</Suffix>
            <ARTGs>
                <ARTG>222179</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST932</BillingCode>
            <Name>Stryker Trident Constrained Acetabular Insert</Name>
            <Description>Two pre assembled components: Outer insert component and a captured UHR (Universal Head) component.  Composition - Cobalt chrome alloy and UHMWPE (ultra high molecular weight polyethylene) with a Titanium 6A1-4V ELI alloy retaining ring</Description>
            <Size>Sizing 22 - 32mm in 0 degrees &amp; 10 degrees</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <Suffix>Cup &amp; Ring</Suffix>
            <ARTGs>
                <ARTG>235283</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI737</BillingCode>
            <Name>LONGEVITY CONSTRAINED LINER</Name>
            <Description>Longevity HXPE constrained Liner with Titanium Alloy Locking Ring</Description>
            <Size>Inner Diameter: 28mm, 32mm and 36mm head size.  Outer Diameter 50mm to 80mm shell size in 2mm increments.</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <Suffix>Cup &amp; Ring</Suffix>
            <ARTGs>
                <ARTG>230336</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH041</BillingCode>
            <Name>Avantage Dual Mobility Acetabular Cup Inlay</Name>
            <Description>UHMWPE Dual Mobility Liner</Description>
            <Size>OD: 44 – 66mm and ID: 22.25mm and 28mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>230317</ARTG>
                <ARTG>230318</ARTG>
                <ARTG>294052</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI092</BillingCode>
            <Name>Mallory Head Hip System</Name>
            <Description>Acetabular Liner,  Constrained, Ringloc, UHMWPE</Description>
            <Size>28-38mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI878</BillingCode>
            <Name>Freedom Constrained Liner</Name>
            <Description>Constrained Acetabular Liner - UHMWPE, Ti</Description>
            <Size>23mm to 62mm in 1mm increments</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>98098</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GM124</BillingCode>
            <Name>Global Acetabular System- Highly cross-linked and Annealed constrained liner</Name>
            <Description>highly cross linked and annealed constrained liner</Description>
            <Size>28mm, 32mm  36mm Diameter Neutral, 10 degree and 20 degree size range 44mm to 72mm</Size>
            <SupplierCode>GM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>120787</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH623</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC Polaric head</Name>
            <Description>IC Polaric head</Description>
            <Size>38, 40, 42, 44, 46, 48, 50, 52, 54, 56, 58</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>281540</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI045</BillingCode>
            <Name>Saturne acetabular liner</Name>
            <Description>Polyethylene liner for double mobility cup</Description>
            <Size>42/22- 66/22 (13 sizes)  48/28- 66/28 (10 sizes)</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>217778</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU024</BillingCode>
            <Name>Versafitcup UHMWPE  Constrained Liner</Name>
            <Description>UHMWPE Constrained Liner for Versafitcup Dual Mobility Acetabular Shell</Description>
            <Size>For head diameter 22mm sizes 42 - 64mm. For head diameter 28mm sizes 48 - 64mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>208308</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU098</BillingCode>
            <Name>Versafitcup HX UHMWPE Constrained Liner</Name>
            <Description>HighCross UHMWPE Constrained Liner for Versafitcup Dual Mobility Acetabular Shell</Description>
            <Size>From Ø 42 to Ø 64mm for head Ø 22mm. From Ø 48 to Ø 64mm for head Ø 28mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>208705</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF037</BillingCode>
            <Name>Logical™ Constrained Acetabular Liner</Name>
            <Description>highly cross linked and annealed constrained liner</Description>
            <Size>28mm, 32mm  36mm Diameter Neutral, 10 degree and 20 degree size range 44mm to 72mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>297186</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK501</BillingCode>
            <Name>Restoration Anatomic Dual Mobility Polyethylene Insert</Name>
            <Description>The polyethylene insert for the Restoration ADM component articulates with the highly polished inner surface of the Restoration ADM cup and is articul;ated with a standard cobalt-chrome or ceramic 28mm diameter femoral head</Description>
            <Size>Outer Diameter 36mm - 64mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>205711</ARTG>
                <ARTG>211464</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM135</BillingCode>
            <Name>POLAR Dual Mobility Constrained Highly Cross Linked Liner</Name>
            <Description>Modified UHMWPE</Description>
            <Size>FOR '22.2-28MM Head sizes and 43-72MM diameter shells</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>231322</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN689</BillingCode>
            <Name>Reflection</Name>
            <Description>Constrained Acetabular Liner unmodified UHMWPE</Description>
            <Size>22 - 32mm, 42 - 76mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>218152</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN856</BillingCode>
            <Name>R3 Acetabular System</Name>
            <Description>XLPE Constrained Acetabular liner</Description>
            <Size>40-78mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>260953</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR067</BillingCode>
            <Name>Anatomic X3 Liners</Name>
            <Description>Anatomic X3 Liner with constraint</Description>
            <Size>36mm, 40mm, 44mm, 48mm and 52mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>219398</ARTG>
                <ARTG>220404</ARTG>
                <ARTG>230931</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST539</BillingCode>
            <Name>Constrained acetabular insert </Name>
            <Description>UHMPE &amp; cobalt chrome bipolar constrained insert</Description>
            <Size>22, 26, 28, 32mm dia</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>217730</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI561</BillingCode>
            <Name>Trabecular Metal Acetabular Revision System</Name>
            <Description>Cemented Constrained Liner</Description>
            <Size>50x28mm; 52x28mm; 54x32mm; 56x32mm; 58x36mm; 60x36mm; 66/68/70x36mm; 72/74x36mm; 76/78/80x36mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>231529</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI568</BillingCode>
            <Name>Trilogy Acetabular System</Name>
            <Description>Longevity Constrained Liner</Description>
            <Size>50/52/54mmODx28mmID; 56mmODx32mmID; 58mmODx32mmID; 60mmODx36mmID; 62mmODx36mmID; 64mmODx36mmID; 66mmODx36ID; 68mmODx36mmID; 70mmODx36mmID; 72mmODx36mmID; 74mmODx36mmID; 76mmODx36mmID; 78mmODx36mmID; 80mmODx36mmID</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4024</SubGroupID>
            <ARTGs>
                <ARTG>218867</ARTG>
            </ARTGs>
            <MinimumBenefit>1540</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN855</BillingCode>
            <Name>R3 Acetabular system</Name>
            <Description>Delta Ceramic Liner</Description>
            <Size>40-78mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <Suffix>Ring</Suffix>
            <ARTGs>
                <ARTG>218185</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB235</BillingCode>
            <Name>Biolox Delta Ceramic Liner</Name>
            <Description>Biolox Delta Liner</Description>
            <Size>28, 32, 36 &amp; 40mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>134535</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV029</BillingCode>
            <Name>Procotyl L Delta Ceramic Liner</Name>
            <Description>Rim-Lock Biolox&#xD;
Delta Ceramic Liners</Description>
            <Size>28-40mm&#xD;
A-G</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>273669</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR158</BillingCode>
            <Name>Biolox Delta Acetabular Liner</Name>
            <Description>Biolox Delta ceramic acetabular liner</Description>
            <Size>28mm, 32mm, 36mm, 40mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>157687</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY512</BillingCode>
            <Name>Pinnacle Acetabular Cup System</Name>
            <Description>Pinnacle ceramic liner</Description>
            <Size>44 - 66mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>223381</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA005</BillingCode>
            <Name>Biolox Delta Acetabular Liner</Name>
            <Description>Biolox Delta ceramic acetabular liner</Description>
            <Size>28mm, 32mm, 36mm, 40mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>285506</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG004</BillingCode>
            <Name>Contile Fin II Acetabular Biolox Delta Ceramic Liners</Name>
            <Description>Contile Fin II Acetabular Biolox Delta Ceramic Liner inserts 28mm,32mm, 36mm &amp; 46mm</Description>
            <Size>Inserts 28mm 44mm to 46mm, Inserts 32mm 48mm to 66mm, Inserts 36mm 52mm to 66mm, Inserts 40mm 56mm to 66mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>281318</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC168</BillingCode>
            <Name>Delta Ceramic Liner Biolox Delta</Name>
            <Description>Delta Ceramic Liner Biolox Delta</Description>
            <Size>28 - 40mm ID x Small to Large</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>210724</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA486</BillingCode>
            <Name>SeleXys Acetabular Ceramys Ceramic Liner</Name>
            <Description>Ceramys ceramic (zirconia &amp; alumina combination)</Description>
            <Size>28/AA, 28/BB, 28/CC, 28/DD, 32/CC, 32DD, 32/EE, 32/FF,36/EE, 36/FF, 36/GG, 386HH,36/II, 36/JJ, 36/KK, /36/LL</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>274136</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU013</BillingCode>
            <Name>Delta Ceramic Liners</Name>
            <Description>Ceramic, Delta</Description>
            <Size>28mm (A to G), 32mm (C to G), 36mm (E to G), 40mm (F to G)</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>140177</ARTG>
                <ARTG>205457</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG010</BillingCode>
            <Name>Acetabular Liner Ceramic</Name>
            <Description>Ceramic Acetabular Liner</Description>
            <Size>28/35G, 32/39G, 32/44G, 36/44G,  32/48G, 36/48G, 32/52G, 36/52G</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>326320</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL003</BillingCode>
            <Name>MAC Surgical Delta Ceramic Liner</Name>
            <Description>Biolox delta ceramic liner</Description>
            <Size>Available in 10 different sizes (4 diameters for the articulating surface)</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>230838</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF031</BillingCode>
            <Name>Biolox Delta Acetabular Liner</Name>
            <Description>Biolox Delta ceramic acetabular liner</Description>
            <Size>28mm, 32mm, 36mm, 40mm, 44mm, 48mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>276016</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM143</BillingCode>
            <Name>EP fit &amp; MPF Delta Ceramic Insert</Name>
            <Description>Ceramic Delta Acetabular Liners</Description>
            <Size>44mm-72mm *28mm - 44mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>222565</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI621</BillingCode>
            <Name>Continuum Acetabular System</Name>
            <Description>Biolox Delta Taper Ceramic Liner</Description>
            <Size>28mm: EE28 to HH28; 32mm: GG32 to JJ32; 36mm: II36 to TT36; 40mm: KK40 to VV40</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1428</GroupID>
            <SubGroupID>4025</SubGroupID>
            <ARTGs>
                <ARTG>209626</ARTG>
            </ARTGs>
            <MinimumBenefit>1937</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA513</BillingCode>
            <Name>RM Acetabular Cup, Polyethylene</Name>
            <Description>Titanium bonded UHMWPE Cup, with and without lugs</Description>
            <Size>46 to 64mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1429</GroupID>
            <SubGroupID>4026</SubGroupID>
            <ARTGs>
                <ARTG>209312</ARTG>
                <ARTG>212648</ARTG>
                <ARTG>212649</ARTG>
            </ARTGs>
            <MinimumBenefit>2517</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA502</BillingCode>
            <Name>RM Pressfit Acetabular Cup</Name>
            <Description>Acetabular component - Bonded Shell / Liner - polyethylene modified. Ti coated monoblock, bearing surface is Vit E stabilised highly cross linked polyethylene</Description>
            <Size>28, 32, 36mm (Articulation); 42 to 70mm (Cup size)</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1429</GroupID>
            <SubGroupID>4027</SubGroupID>
            <ARTGs>
                <ARTG>274133</ARTG>
            </ARTGs>
            <MinimumBenefit>2854</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Agilis Tipor</Name>
            <Description>AGILIS Ti-POR is an uncemented monoblock hemispherical acetabulum cup designed to articulate with ceramic heads of large diameter.</Description>
            <Size>42 – 66 mm diameter</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1429</GroupID>
            <SubGroupID>4030</SubGroupID>
            <ARTGs>
                <ARTG>292345</ARTG>
            </ARTGs>
            <MinimumBenefit>4381</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI903</BillingCode>
            <Name>Maxera Cup</Name>
            <Description>Maxera Cup</Description>
            <Size>42mm-66mm OD</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1429</GroupID>
            <SubGroupID>4030</SubGroupID>
            <ARTGs>
                <ARTG>99907</ARTG>
            </ARTGs>
            <MinimumBenefit>4381</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ003</BillingCode>
            <Name>Adept MoM Acetabular Component - Extra Fixation Cup</Name>
            <Description>Porocast beaded Shell , Co Cr, HA coated, dysplasia flange </Description>
            <Size>46-66mm Outer diameter going up in 4mm increments</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1431</GroupID>
            <SubGroupID>4032</SubGroupID>
            <Suffix>Flange</Suffix>
            <ARTGs>
                <ARTG>192533</ARTG>
                <ARTG>192534</ARTG>
            </ARTGs>
            <MinimumBenefit>5874</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ002</BillingCode>
            <Name>Adept MoM Acetabular Component</Name>
            <Description>Porocast beaded Shell , Co Cr, HA coated size 44-66mm</Description>
            <Size>44-66mm Outer diameter going up in 2mm increments</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1431</GroupID>
            <SubGroupID>4032</SubGroupID>
            <ARTGs>
                <ARTG>192533</ARTG>
                <ARTG>192534</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN742</BillingCode>
            <Name>Birmingham Hip Resurfacing Prostheses - Acetabular Cup</Name>
            <Description>Cobal Chrome, beaded, HA</Description>
            <Size>44 - 66 mm cups</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1431</GroupID>
            <SubGroupID>4032</SubGroupID>
            <ARTGs>
                <ARTG>274334</ARTG>
            </ARTGs>
            <MinimumBenefit>4322</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW586</BillingCode>
            <Name>METS Coned Hemi-Pelvis Shell</Name>
            <Description>METS Coned Hemi-Pelvis Shell</Description>
            <Size>Diameters: 9,10,12,16</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4034</SubGroupID>
            <Suffix>Tumour</Suffix>
            <ARTGs>
                <ARTG>277434</ARTG>
            </ARTGs>
            <MinimumBenefit>8351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH694</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO146</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS LUMiC Cup</Name>
            <Description>Modular partial pelvic replacement and acetabular reconstruction device in case of large bone defects</Description>
            <Size>50, 54 and 60mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4034</SubGroupID>
            <Suffix>Tumour</Suffix>
            <ARTGs>
                <ARTG>227162</ARTG>
                <ARTG>284582</ARTG>
            </ARTGs>
            <MinimumBenefit>8351</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC022</BillingCode>
            <Name>Delta Revision TT Acetabular Cup</Name>
            <Description>Delta Revision TT Acetabular Cup Ti</Description>
            <Size>50 - 66mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4034</SubGroupID>
            <ARTGs>
                <ARTG>210779</ARTG>
            </ARTGs>
            <MinimumBenefit>2658</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI046</BillingCode>
            <Name>Saturne reconstruction cup</Name>
            <Description>Dual coated, mobile, cementless reconstruction cup</Description>
            <Size>Sizes: 50 - 66mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4034</SubGroupID>
            <ARTGs>
                <ARTG>216970</ARTG>
            </ARTGs>
            <MinimumBenefit>2658</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO013</BillingCode>
            <Name>Link Acetabular Reconstruction Cup System</Name>
            <Description>Acetabular reconstruction shell</Description>
            <Size>45 - 66 mm  Small, Medium, Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4034</SubGroupID>
            <ARTGs>
                <ARTG>212102</ARTG>
                <ARTG>212118</ARTG>
                <ARTG>212130</ARTG>
            </ARTGs>
            <MinimumBenefit>2658</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI249</BillingCode>
            <Name>Trabecular Metal Reconstruction Shell</Name>
            <Description>Porous tantalum, reconstruction shell</Description>
            <Size>OD: 48 – 80mm and ID: 22.25 mm and 28mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4034</SubGroupID>
            <ARTGs>
                <ARTG>216639</ARTG>
            </ARTGs>
            <MinimumBenefit>2658</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY064</BillingCode>
            <Name>Protrusio Acetabular Reconstruction Cage</Name>
            <Description>Titanium, grit blast, proximal distal flange, left &amp; right sided</Description>
            <Size>49-69ID</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>138292</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC021</BillingCode>
            <Name>Acetabular Plate</Name>
            <Description>Acetabular Reconstruction Plate Ti</Description>
            <Size>50 - 66mm x Standard or Long</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>210762</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH624</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC Reinforcement cage</Name>
            <Description>Acetabular Reinforcement cage</Description>
            <Size>Left and Right. 44mm, 50mm, 56mm, 62mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>169691</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH625</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC titanium ring</Name>
            <Description>Acetabular recontrusction ring</Description>
            <Size>42mm, 44mm, 46mm, 48mm, 50mm, 52mm, 54mm, 56mm, 58mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>169691</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO029</BillingCode>
            <Name>LINK Partial Pelvis Replacement</Name>
            <Description>Acetabular reconstruction cage with inferior flange</Description>
            <Size>48-67mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>237076</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA024</BillingCode>
            <Name>CCE Acetabular Reinforcing Ring</Name>
            <Description>Titanium, grit blast, acetabular reconstruction cage with proximal rim</Description>
            <Size>Dia 42 - 58mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>211196</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN272</BillingCode>
            <Name>BI-MENTUM Dual Mobility</Name>
            <Description>Acetabular Reinforcement Plate</Description>
            <Size>Left and Right. Internal plate diameter from 50 to 60 mm.</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>330120</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU139</BillingCode>
            <Name>Reinforcement Cages</Name>
            <Description>Acetabular Reinforcement Cage</Description>
            <Size>Internal diameter from 40 to 62 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>237104</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH431</BillingCode>
            <Name>Samo Revision Hip System acetabular</Name>
            <Description>Acetabular reinforcement ring with hook</Description>
            <Size>44 - 64 mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH432</BillingCode>
            <Name>Samo Revision Hip System acetabular</Name>
            <Description>Acetabular reinforcement ring</Description>
            <Size>44 - 64 mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN265</BillingCode>
            <Name>Contour</Name>
            <Description>Acetabular  Reinforcement cage</Description>
            <Size>44 - 74mm OD</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>141017</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST557</BillingCode>
            <Name>Restoration  gap cup II acetabular cage</Name>
            <Description>Acetabular reconstruction cage with extended plates </Description>
            <Size>48-72mm OD in 2mm increments </Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>242314</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI391</BillingCode>
            <Name>Acetabular Reinforcement</Name>
            <Description>Roof Ring with Hook - Ti alloy</Description>
            <Size>36/23 to 64/23mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>99907</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI392</BillingCode>
            <Name>Acetabular Reinforcement</Name>
            <Description>Protrusio Cage - Ti alloy</Description>
            <Size>44 to 50mm (left and right)</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>99907</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI540</BillingCode>
            <Name>Trabecular metal acetabular revision system modular cup-cage</Name>
            <Description>Modular cup-cage titanium alloy</Description>
            <Size>56-80 Long &amp; short flanged left &amp; right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>163</SubCategoryID>
            <GroupID>1432</GroupID>
            <SubGroupID>4035</SubGroupID>
            <ARTGs>
                <ARTG>117219</ARTG>
            </ARTGs>
            <MinimumBenefit>1197</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW473</BillingCode>
            <Name>Restoration Acetabular Wedge Augment System</Name>
            <Description>The Restoration Acetabular Wedge Augment System is designed for hip surgeries requiring additional acetabular component support in cases where host bone is insuficient. &#xD;
&#xD;
The Wedge Augments provide the intraoperative flexibility to optimize screw placement.</Description>
            <Size>Outer Diameter 46mm, Inner Diameter 48, Thickness 15mm Screw Holes 3&#xD;
Outer Diameter 46mm, Inner Diameter 48, Thickness 20mm Screw Holes 4&#xD;
Outer Diameter 46mm, Inner Diameter 48, Thickness 25mm Screw Holes 4&#xD;
Outer Diameter 50mm, Inner Diameter 52, Thickness 15mm Screw Holes 3&#xD;
Outer Diameter 50mm, Inner Diameter 52, Thickness 20mm Screw Holes 4&#xD;
Outer Diameter 50mm, Inner Diameter 52, Thickness 25mm Screw Holes 4&#xD;
Outer Diameter 54mm, Inner Diameter 56, Thickness 15mm Screw Holes 4&#xD;
Outer Diameter 54mm, Inner Diameter 56, Thickness 20mm Screw Holes 6&#xD;
Outer Diameter 54mm, Inner Diameter 56, Thickness 25mm Screw Holes 6&#xD;
Outer Diameter 58mm, Inner Diameter 60, Thickness 15mm Screw Holes 6&#xD;
Outer Diameter 58mm, Inner Diameter 60, Thickness 20mm Screw Holes 6&#xD;
Outer Diameter 58mm, Inner Diameter 60, Thickness 25mm Screw Holes 6&#xD;
Outer Diameter 62mm, Inner Diameter 64, Thickness 15mm Screw Holes 6&#xD;
Outer Diameter 62mm, Inner Diameter 64, Thickness 20mm Screw Holes 8&#xD;
Outer Diameter 62mm, Inner Diameter 64, Thickness 25mm Screw Holes 8&#xD;
Outer Diameter 66mm, Inner Diameter 68, Thickness 15mm Screw Holes 6&#xD;
Outer Diameter 66mm, Inner Diameter 68, Thickness 20mm Screw Holes 8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1433</GroupID>
            <Suffix>Bone Reconstruction</Suffix>
            <ARTGs>
                <ARTG>192159</ARTG>
            </ARTGs>
            <MinimumBenefit>2769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN150</BillingCode>
            <Name>Pinnacle Acetabular System</Name>
            <Description>Gripton Ti-Foam Augments</Description>
            <Size>Wedges 52-72, buttress 56-68 or shim 5 to 15 degrees</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1433</GroupID>
            <Suffix>Bone Reconstruction</Suffix>
            <ARTGs>
                <ARTG>248252</ARTG>
            </ARTGs>
            <MinimumBenefit>2769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU165</BillingCode>
            <Name>Mpact Acetabular System</Name>
            <Description>3D Metal Augments</Description>
            <Size>50-80 mm.  Thickness 10 ÷ 30 mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1433</GroupID>
            <Suffix>Bone Reconstruction</Suffix>
            <ARTGs>
                <ARTG>307500</ARTG>
            </ARTGs>
            <MinimumBenefit>2769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL163</BillingCode>
            <Name>REDAPT Acetabular Augment</Name>
            <Description>Titanium Alloy Acetabular Augment</Description>
            <Size>50 to 74mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1433</GroupID>
            <Suffix>Bone Reconstruction</Suffix>
            <ARTGs>
                <ARTG>292977</ARTG>
            </ARTGs>
            <MinimumBenefit>2769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI276</BillingCode>
            <Name>Trabecular Metal Acetabular Augment</Name>
            <Description>Tantalum acetabular augment</Description>
            <Size>40 - 70mm x 10, 15, 20 &amp;30mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1433</GroupID>
            <Suffix>Bone Reconstruction</Suffix>
            <ARTGs>
                <ARTG>115915</ARTG>
            </ARTGs>
            <MinimumBenefit>2769</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC025</BillingCode>
            <Name>Delta Hemispheric Acetabular Cup</Name>
            <Description>Delta Hemispheric Acetabular Cup Ti6AI4V</Description>
            <Size>50 - 62mm &amp; Eccentricity 12-18mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1433</GroupID>
            <ARTGs>
                <ARTG>210763</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI271</BillingCode>
            <Name>Trabecular Metal acetabular Medial wall augment</Name>
            <Description>Tantalum disc</Description>
            <Size>26mm, 32mm and 38mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1433</GroupID>
            <ARTGs>
                <ARTG>115915</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ844</BillingCode>
            <Name>Reclaim Revision Hip System - Bolt</Name>
            <Description>Locking Bolt</Description>
            <Size>75-105mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>242912</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH617</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars RS revision system - bolt</Name>
            <Description>RS bolt</Description>
            <Size>40,50,65,75,90,100,115,125mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>250156</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH691</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO142</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS RS screw for coupling device</Name>
            <Description>RS coupling device screw</Description>
            <Size>60-140mm length M8</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>250353</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH692</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO144</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - M10 Screw</Name>
            <Description>M10 Screw - Tumour System and Arthrodesis Interlocking System</Description>
            <Size>25mm - 245mm Length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>250194</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH696</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO148</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS LUMiC Screw, M6</Name>
            <Description>M6 Screw used to bolt the LUMiC Cup and LUMiC Stem together</Description>
            <Size>28mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>250195</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO188</BillingCode>
            <Name>Link MP Reconstruction Expansion Bolt</Name>
            <Description>MP Reconstruction Expansion Bolt</Description>
            <Size>41mm, 61mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>257495</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>QG005</BillingCode>
            <Name>MRP Titan Locking Bolt</Name>
            <Description>Bolt used to lock together the proximal femoral component to the femoral stem of a modular revision hip system</Description>
            <Size>Short &amp; Long</Size>
            <SupplierCode>QG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>311586</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG006</BillingCode>
            <Name>Securus Modular Revision Hip System</Name>
            <Description>Modular Locking Bolt</Description>
            <Size>One Size</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>132478</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI860</BillingCode>
            <Name>Segmental Trabecular Proximal Femoral Component - Bolt</Name>
            <Description>4mm Bolt&#xD;
7mm Bolt&#xD;
Set Screw</Description>
            <Size>4mm and 7mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1434</GroupID>
            <ARTGs>
                <ARTG>95938</ARTG>
            </ARTGs>
            <MinimumBenefit>336</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB238</BillingCode>
            <Name>Acetabular Fixation Screws</Name>
            <Description>Isotan</Description>
            <Size>16mm-68mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>98978</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI109</BillingCode>
            <Name>Mallory Head Hip System</Name>
            <Description>Screw, Acetabular</Description>
            <Size>(6.5 - 5.5)mm dia x (15 - 70)mm length</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>98098</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV036</BillingCode>
            <Name>Bone Screw</Name>
            <Description>Cancellous Bone Screw Titanium</Description>
            <Size>6.5mm x 1.5 – 6 cm in 0.5cm increments</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>247558</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR070</BillingCode>
            <Name>Titanium Counter Sunk Screw</Name>
            <Description>Titanium Counter Sunk Screw</Description>
            <Size>Lengths 15-70mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>106747</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR266</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TO089</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dynacup Titanium Screws</Name>
            <Description>Cancellous bone screw, Titanium</Description>
            <Size>7 Lengths from 20mm to 55mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>230108</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR304</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO300</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Acetabular Cancellous Screw</Name>
            <Description>Titanium 6.5mm cancellous bone screw</Description>
            <Size>15mm to 50mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>300221</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP944</BillingCode>
            <Name>DePuy Hip Bone Screws</Name>
            <Description>Titanium, cancellous screws</Description>
            <Size>Size 3.5-6.5 diameter 5-120mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>150913</ARTG>
                <ARTG>171784</ARTG>
                <ARTG>98086</ARTG>
                <ARTG>99196</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX006</BillingCode>
            <Name>Novation Crown Cup Screws</Name>
            <Description>Titanium cortical bone screws</Description>
            <Size>Full radius tip: 6.5mm x 15mm, 6.5mm x 20mm, 6.5mm x 25mm, 6.5mm x 30mm, 6.5mm x 35mm, 6.5mm x 40mm, 6.5mm x 45mm, 6.5mm x 50mm, 6.5mm x 55mm, 6.5mm x 60mm, 6.5mm x 70mm; Peripheral Rim screw: 4.5mm x 25mm, 4.5mm x 30mm, 4.5mm x 35mm, 4.5mm x 40mm, 4.5mm x 45mm, 4.5mm x 50mm, 4.5mm x 55mm, 4.5mm x 60mm, 4.5mm x 65mm, 4.5mm x 70mm; Pointed tip: MBA 6.5mm x 15mm, MBA 6.5mm x 20mm, MBA 6.5mm x 25mm, MBA 6.5mm x 30mm, MBA 6.5mm x 35mm, MBA 6.5mm x 40mm, MBA 6.5mm x 45mm, MBA 6.5mm x 50mm, MBA 6.5mm x 55mm, MBA 6.5mm x 60mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>250113</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Adler Bone Screw</Name>
            <Description>Bone Screw for Acetabular Cup</Description>
            <Size>6.5 and 8.5mm Diameter.  15-65mm Length.</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>237073</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Flat Plate Compression Screw</Name>
            <Description>Ti6Al4V Screw </Description>
            <Size>Short, Medium, Long</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>237073</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW011</BillingCode>
            <Name>ABG Hip System</Name>
            <Description>Bone screw - Titanium, used with ABG11 Cups</Description>
            <Size>12,15,20,25,30,35,40,45 and 50mm lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>242299</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW047</BillingCode>
            <Name>Exeter Hip System</Name>
            <Description>X-Change Bone Screws -  Stainless Steel</Description>
            <Size>3.5mm X 10, 15, 20, 25, 30, 35mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>128022</ARTG>
                <ARTG>16232</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW603</BillingCode>
            <Name>METS Trochanter Screw</Name>
            <Description>Titanium</Description>
            <Size>Short, Medium, Long</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>246513</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC024</BillingCode>
            <Name>Lima Bone Screw</Name>
            <Description>Titanium  Bone Screw</Description>
            <Size>Dia. 4.5mm to 6.5mm&#xD;
Length 15mm - 90mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>168711</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH618</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars RS revision system - bone screws</Name>
            <Description>RS bone screw</Description>
            <Size>25mm, 30mm, 40mm, 42mm, 45mm, 50mm, 55mm, 60mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>237075</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI047</BillingCode>
            <Name>Femoral Shaft Locking Screw</Name>
            <Description>Titanium femoral locking screw</Description>
            <Size>6.2 diameter, 13 lengths 20-80 in 5mm increments</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>135326</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI048</BillingCode>
            <Name>Amplitude Orthopaedic Bone Screw</Name>
            <Description>Titanium cancellous bone screw</Description>
            <Size>Diam 6.5mm, lengths 15 - 55 mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>242000</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA514</BillingCode>
            <Name>Acetabular Screws</Name>
            <Description>Titanium cancellous bone screws</Description>
            <Size>varying lengths and sizes</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>241996</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU014</BillingCode>
            <Name>Medacta Acetabular Screws</Name>
            <Description>Titanium, cancellous screws</Description>
            <Size>6.5 L 15-70mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>219907</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU127</BillingCode>
            <Name>Medacta Cortical Bone Screws</Name>
            <Description>Titanium cortical bone screws</Description>
            <Size>25 - 70 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>219907</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH438</BillingCode>
            <Name>Samo Acetabular Cup bone screw</Name>
            <Description>Bone screw</Description>
            <Size>20 - 40 mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>165470</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF012</BillingCode>
            <Name>Atlas Acetabular Cup System</Name>
            <Description>Screw</Description>
            <Size>Atlas Screw Dia 6.5mm 15-50mm L</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>141168</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL006</BillingCode>
            <Name>Orthopaedic bone screw, non-biodegradable</Name>
            <Description>Acetabular shell cancellous bone screw</Description>
            <Size>8 x sized from 20mm - 60mm</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>237105</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF034</BillingCode>
            <Name>Bone Screw</Name>
            <Description>Titanium, cancellous screw</Description>
            <Size>15mm - 90mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM041</BillingCode>
            <Name>Universal Cancellous Bone Screws</Name>
            <Description>Cancellous bone screw titanium</Description>
            <Size>15-60mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>181252</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM137</BillingCode>
            <Name>Polar Cup Acetabular Screws</Name>
            <Description>Stainless Steel Cortical Screws</Description>
            <Size>4.5mm by 40-60mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>181252</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST545</BillingCode>
            <Name>Osteonics hip prostheses </Name>
            <Description>Cancellous bone screw, Titanium</Description>
            <Size>6.5mm &amp; 5.5mm dia</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>242299</ARTG>
                <ARTG>242312</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG001</BillingCode>
            <Name>JRI CSF Hip System</Name>
            <Description>CSF Bone Screws, Titanium Alloy</Description>
            <Size>15mm - 50mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>132409</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO261</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Novae Double Cup Cortical Bone Screw</Name>
            <Description>Cortical Bone Screw</Description>
            <Size>5mm diameter, 30 to 65mm length in 5mm increments</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>246511</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI036</BillingCode>
            <Name>Acetabular Cup</Name>
            <Description>Trilogy Bone Screw - Titanium</Description>
            <Size>15 - 60</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1435</GroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI024</BillingCode>
            <Name>Zimmer 'VerSys CRC Hip Systems</Name>
            <Description>Modular Calcar Block</Description>
            <Size>13/15 x 10-30mm &amp; 17/19 x 10-30mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1436</GroupID>
            <ARTGs>
                <ARTG>246833</ARTG>
            </ARTGs>
            <MinimumBenefit>480</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR041</BillingCode>
            <Name>Canal Occluder</Name>
            <Description>Cement plug, UHMWPE, multi-layered</Description>
            <Size>08/10mm, 12/14mm, 16/18mm,20/22mm and universal.</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>106747</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR281</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO166</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Absolut Bone Plugs</Name>
            <Description>Medullary bone plugs</Description>
            <Size>Small, Medium, Large, Extra Large</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>257494</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP233</BillingCode>
            <Name>Hardinge Cement Restrictor</Name>
            <Description>Hardinge cement Restrictor (ea)</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>137671</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP448</BillingCode>
            <Name>BIO Stop G</Name>
            <Description>Biostop Restrictor (Gelatin, Glkycerol, PHBM, Water)</Description>
            <Size>size 8-20</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>126998</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP575</BillingCode>
            <Name>C-Stem End Cap</Name>
            <Description>End Cap Biostop Restrictor (Gelatin, Glycerol, PHBM, water)</Description>
            <Size>Size 8- 20 </Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>138222</ARTG>
                <ARTG>97695</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW001</BillingCode>
            <Name>Hardinge Cement Restrictor</Name>
            <Description>PMMA</Description>
            <Size>6,9 and 12 Leaf</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>289666</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ754</BillingCode>
            <Name>DePuy Femoral Cement Restrictor</Name>
            <Description>UHMWPE cement restrictor</Description>
            <Size>Size 0 to 10</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>138869</ARTG>
                <ARTG>97695</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH643</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO102</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC Intramedullary Plug</Name>
            <Description>Intramedullary Plug</Description>
            <Size>9mm, 14mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>208322</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO106</BillingCode>
            <Name>LINK Intramedullary Plug</Name>
            <Description>P/E Intramedullary Plug</Description>
            <Size>12 to 20 mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>157547</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA018</BillingCode>
            <Name>Intramedullary Plug</Name>
            <Description>Cement Restricter</Description>
            <Size>Small to Extra Large</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>241997</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU111</BillingCode>
            <Name>MectaPlug PE</Name>
            <Description>Cement Restrictor</Description>
            <Size>12 - 30 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>229714</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU183</BillingCode>
            <Name>MectaPlug PE II</Name>
            <Description>Cement restrictor</Description>
            <Size>5 sizes  from Ø8 to Ø30</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>229714</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF036</BillingCode>
            <Name>Cement Pug</Name>
            <Description>UHMWPE Cement Plug</Description>
            <Size>14 - 35mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>246579</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK505</BillingCode>
            <Name>BioPrep Bone Preparation System</Name>
            <Description>Femoral Preparation Kit with cement restrictor</Description>
            <Size>18.5 - 25mm O.D.</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>139937</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN263</BillingCode>
            <Name>Buck</Name>
            <Description>Cement Restrictor</Description>
            <Size>18.5 - 35mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>140410</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST582</BillingCode>
            <Name>Osteonics hip prostheses </Name>
            <Description>Cement restrictor Polyethylene</Description>
            <Size>Universal and sizes 1-8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>289666</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI226</BillingCode>
            <Name>Zimmer Bone Plug</Name>
            <Description>Allen Medullary Plug</Description>
            <Size>8 - 23mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>115913</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI356</BillingCode>
            <Name>Medullary Plug, MS 30</Name>
            <Description>Centring Plug, cement restrictor, hip - PE</Description>
            <Size>1 to 7</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1437</GroupID>
            <ARTGs>
                <ARTG>99907</ARTG>
            </ARTGs>
            <MinimumBenefit>100</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB245</BillingCode>
            <Name>Distal centraliser</Name>
            <Description>PMMA</Description>
            <Size>7mm - 18mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>123313</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI131</BillingCode>
            <Name>Mallory Head Hip System</Name>
            <Description>Femoral Centraliser, UHMWPE</Description>
            <Size>9-17mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV039</BillingCode>
            <Name>Cement Centraliser</Name>
            <Description>Profemur XM Cement Centraliser</Description>
            <Size>N/A</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>247578</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR280</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO165</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Centraliser</Name>
            <Description>Femoral Centraliser</Description>
            <Size>Various</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>247614</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ584</BillingCode>
            <Name>Femoral Prep Kit</Name>
            <Description>Femoral Preparation Kit</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>132111</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ963</BillingCode>
            <Name>DePuy Hip Systems</Name>
            <Description>Distal femoral centralisers</Description>
            <Size>8 to 20mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>137671</ARTG>
                <ARTG>97695</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC150</BillingCode>
            <Name>Proximal Centraliser PMMA</Name>
            <Description>Proximal Centraliser PMMA</Description>
            <Size>Left &amp; Right Size 0-3</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>186627</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI092</BillingCode>
            <Name>E2 PMMA Centraliser</Name>
            <Description>PMMA distal Centraliser</Description>
            <Size>20mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>260435</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU002</BillingCode>
            <Name>Medacta Femoral Stem Distal centraliser</Name>
            <Description>PMMA</Description>
            <Size>Distal centraliser, various sizes</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>233996</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU187</BillingCode>
            <Name>Medacta Femoral Stem Proximal Centraliser</Name>
            <Description>PMMA Proximal centraliser</Description>
            <Size>Proximal Centraliser, various sizes</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>233996</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF030</BillingCode>
            <Name>PMMA Centraliser</Name>
            <Description>PMMA centraliser used for cemented total hip arthroplasty</Description>
            <Size>Size 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 17mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>246578</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK315</BillingCode>
            <Name>Exeter Hip System</Name>
            <Description>Exeter Distal Centraliser -PMMA</Description>
            <Size>One Size Only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>289666</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN269</BillingCode>
            <Name>CPCS</Name>
            <Description>Polished Cemented Stem Distal Centraliser</Description>
            <Size>8 - 18</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>230144</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN359</BillingCode>
            <Name>Invis</Name>
            <Description>Distal Centraliser PMMA</Description>
            <Size>size 1-5, 7 - 21mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>230144</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST581</BillingCode>
            <Name>Osteonics hip prostheses</Name>
            <Description>Distal spacer  PMMA</Description>
            <Size>8-15mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>141275</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI013</BillingCode>
            <Name>Zimmer distal centralisers CPT, VerSys, Natural and MS30</Name>
            <Description> PMMA Centraliser  </Description>
            <Size>Size 1</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>95938</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI021</BillingCode>
            <Name>Zimmer Hip Systems Femoral Stem</Name>
            <Description>VerSys Distal Centraliser - PMMA</Description>
            <Size>10 - 18</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>95938</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI374</BillingCode>
            <Name>MS-30 Hip prosthesis </Name>
            <Description>Centralizer for Cemented Stems (Protek) - metal alloys</Description>
            <Size>8 to 18</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1438</GroupID>
            <ARTGs>
                <ARTG>99906</ARTG>
            </ARTGs>
            <MinimumBenefit>128</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI124</BillingCode>
            <Name>Modular Calcar Mallory Head Revision Hip System</Name>
            <Description>Trochanteric Claw, Titanium</Description>
            <Size>Medium, Large </Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1439</GroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI125</BillingCode>
            <Name>Modular Calcar Mallory Head Revision Hip System</Name>
            <Description>Trochanteric Connector</Description>
            <Size>Sizes 40-70mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1440</GroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY077</BillingCode>
            <Name>Apex Hole eliminator </Name>
            <Description>Hole eliminator screw Titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1441</GroupID>
            <ARTGs>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI102</BillingCode>
            <Name>C2 Hole Eliminator</Name>
            <Description>Titanium Screw Hole Plug</Description>
            <Size>6.3 x 3.2mm, 11.3 x 4.2mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1441</GroupID>
            <ARTGs>
                <ARTG>260435</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF141</BillingCode>
            <Name>C2 Hole Eliminator</Name>
            <Description>Titanium Screw Hole Plug</Description>
            <Size>6.3 x 3.2mm, 11.3 x 4.2mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1441</GroupID>
            <ARTGs>
                <ARTG>246580</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN295</BillingCode>
            <Name>Reflection</Name>
            <Description>Threaded hole cover (Reflection)</Description>
            <Size>One size only</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1441</GroupID>
            <ARTGs>
                <ARTG>238632</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST551</BillingCode>
            <Name>Osteonics Hip Prostheses</Name>
            <Description>Dome hole plug titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1441</GroupID>
            <ARTGs>
                <ARTG>300154</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG016</BillingCode>
            <Name>Securus Modular Revision Hip System</Name>
            <Description>Modular Body Cap</Description>
            <Size>One size</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1441</GroupID>
            <ARTGs>
                <ARTG>132478</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI622</BillingCode>
            <Name>Continuum Acetabular System</Name>
            <Description>Continuum Hole Plugs</Description>
            <Size>One Size - Dome Hole Plug&#xD;
One Size - Screw Hole Plug</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1441</GroupID>
            <ARTGs>
                <ARTG>95692</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH037</BillingCode>
            <Name>Biolox Delta Option Taper</Name>
            <Description>Taper Sleeve, Titanium</Description>
            <Size>-6mm, -3mm, Std, +3mm and +6mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1442</GroupID>
            <ARTGs>
                <ARTG>117715</ARTG>
            </ARTGs>
            <MinimumBenefit>350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY403</BillingCode>
            <Name>Cathcart Taper Insert</Name>
            <Description>CoCr head taper insert for use with Unipolar Head (DY402)</Description>
            <Size>-3 to +10mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1442</GroupID>
            <ARTGs>
                <ARTG>255314</ARTG>
            </ARTGs>
            <MinimumBenefit>350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Adler Revision Sleeve</Name>
            <Description>Adler revision femoral head titanium sleeve</Description>
            <Size>Short, Medium, Long, X-Long</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1442</GroupID>
            <ARTGs>
                <ARTG>296609</ARTG>
            </ARTGs>
            <MinimumBenefit>350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN307</BillingCode>
            <Name>Unipolar</Name>
            <Description>Taper Sleeve Co Cr</Description>
            <Size>12/14 and 14/16 tapers, +0,-3,+4,+8,+12mm.</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1442</GroupID>
            <ARTGs>
                <ARTG>229993</ARTG>
                <ARTG>242995</ARTG>
            </ARTGs>
            <MinimumBenefit>350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST569</BillingCode>
            <Name>Head Taper Insert</Name>
            <Description>Neck extention, vitallium alloy</Description>
            <Size>-4 TO +12mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1442</GroupID>
            <ARTGs>
                <ARTG>255353</ARTG>
            </ARTGs>
            <MinimumBenefit>350</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR300</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO292</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BioBall - Revision Neck Adaptor</Name>
            <Description>Titanium, varying tapers &amp; lengths, for ceramic &amp; metal heads</Description>
            <Size>Types: 12/14, 14/16, V40, PCA, ABG, 11/13, SROM, 10/12, 8/10  Sizes:  S, M, L, XL, 2XL, 3XL, 4XL, 5XL  Options: Standard, Offset</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1443</GroupID>
            <ARTGs>
                <ARTG>276306</ARTG>
            </ARTGs>
            <MinimumBenefit>436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC190</BillingCode>
            <Name>BioBall - Revision Neck Adaptor</Name>
            <Description>Titanium, varying tapers &amp; lengths, for ceramic &amp; metal heads</Description>
            <Size>8/10 standard, 8/10 offset&#xD;
10/12 standard, 10/12 offset&#xD;
12/14 standard, 12/14 offset&#xD;
14/16 standard,14/16 offset&#xD;
V40 standard, V40 offset,&#xD;
PCA standard, PCA offset&#xD;
Type 1 standard &#xD;
11/13 standard, 11/13 offset&#xD;
S - 5XL standard&#xD;
M-5XL offset</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1443</GroupID>
            <ARTGs>
                <ARTG>227099</ARTG>
            </ARTGs>
            <MinimumBenefit>436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK482</BillingCode>
            <Name>Stryker Neck Taper Adaptor</Name>
            <Description>Adaptor Sleeve for Stryker stems</Description>
            <Size>Offset -2.5mm to +4mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1443</GroupID>
            <ARTGs>
                <ARTG>224747</ARTG>
                <ARTG>236777</ARTG>
            </ARTGs>
            <MinimumBenefit>436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI567</BillingCode>
            <Name>Zimmer Hip System</Name>
            <Description>VerSys Endo Adaptors</Description>
            <Size>+7.0mm; +10.5mm; +14.0mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1443</GroupID>
            <ARTGs>
                <ARTG>95938</ARTG>
            </ARTGs>
            <MinimumBenefit>436</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI902</BillingCode>
            <Name>ZMR Compression Nut</Name>
            <Description>Compression Nut</Description>
            <Size>One Size</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1444</GroupID>
            <ARTGs>
                <ARTG>259942</ARTG>
            </ARTGs>
            <MinimumBenefit>172</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW588</BillingCode>
            <Name>Steinmann Pins</Name>
            <Description>Titanium Steinmann Pins</Description>
            <Size>Ø5mm x 300mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1445</GroupID>
            <ARTGs>
                <ARTG>246513</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN292</BillingCode>
            <Name>Reflection</Name>
            <Description>Fixation peg Titanium Alloy</Description>
            <Size>15mm, 25mm, 35mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1445</GroupID>
            <ARTGs>
                <ARTG>238633</ARTG>
            </ARTGs>
            <MinimumBenefit>159</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB277</BillingCode>
            <Name>Excia Hip System</Name>
            <Description>Cement plug</Description>
            <Size>8mm-18mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>123313</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI130</BillingCode>
            <Name>Bio-Plug Cement Restrictor</Name>
            <Description>Canal Plug, UHMWPE</Description>
            <Size>7-20mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV030</BillingCode>
            <Name>WMT Perfecta Hip System</Name>
            <Description>PMMA cement Plug</Description>
            <Size>9 - 21mm in 1mm increments</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>143863</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR311</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO309</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Global Acetabular System Apical Plugs</Name>
            <Description>Titanium Apical Dome Hole plug</Description>
            <Size>One size only</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>300153</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP998</BillingCode>
            <Name>DePuy Acetabular Apical Plugs</Name>
            <Description>Titanium, apical hole plug for Duraloc, Pinnacle &amp; SROM Acetabular shells</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>132151</ARTG>
                <ARTG>153087</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU017</BillingCode>
            <Name>Medacta Acetabular Plug</Name>
            <Description>Titanium Plug</Description>
            <Size>no sizes</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>237072</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RL005</BillingCode>
            <Name>Acetabulum prosthesis apical hole plug</Name>
            <Description>This is a screw hole plug intended to close the screw holes of a two-piece acetabular prosthesis.  It is screwed into place after implantation of the acetabular component at the discretion of the surgeon.</Description>
            <Size>One size M10 screw hole plug</Size>
            <SupplierCode>RL</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>237111</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI451</BillingCode>
            <Name>Allofit screw hole plugs</Name>
            <Description>Sterile, 7 per set</Description>
            <Size>One size only</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1446</GroupID>
            <ARTGs>
                <ARTG>99907</ARTG>
            </ARTGs>
            <MinimumBenefit>135</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC149</BillingCode>
            <Name>Lima Plug and hood </Name>
            <Description>UHMWPE Cement Plug with distal femoral stem hood</Description>
            <Size>10mm - 20mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1447</GroupID>
            <ARTGs>
                <ARTG>186627</ARTG>
            </ARTGs>
            <MinimumBenefit>237</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC151</BillingCode>
            <Name>Cement Plug UHMWPE</Name>
            <Description>UHMWPE Cement Restrictor / Plug</Description>
            <Size>Size 1 - 3</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1447</GroupID>
            <ARTGs>
                <ARTG>186627</ARTG>
            </ARTGs>
            <MinimumBenefit>237</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI140</BillingCode>
            <Name>Mallory Head Hip System</Name>
            <Description>Acetabular Shell, Ringloc.  Replacement Ring, Titanium alloy</Description>
            <Size>Size 1</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1449</GroupID>
            <ARTGs>
                <ARTG>98098</ARTG>
            </ARTGs>
            <MinimumBenefit>143</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP250</BillingCode>
            <Name>Duraloc Cup Locking System</Name>
            <Description>Titanium locking Ring for Duraloc insert, seperately listed, only for revision</Description>
            <Size>Size 36-76mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1449</GroupID>
            <ARTGs>
                <ARTG>98086</ARTG>
            </ARTGs>
            <MinimumBenefit>143</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN701</BillingCode>
            <Name>Reflection</Name>
            <Description>Constrained acetabular liner - adaptor ring</Description>
            <Size>42 - 76mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1449</GroupID>
            <ARTGs>
                <ARTG>218153</ARTG>
            </ARTGs>
            <MinimumBenefit>143</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GG013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>CR221</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SMR Locking Screw</Name>
            <Description>Locking Screw for Proximal Body to Stem</Description>
            <Size>40 to 70mm</Size>
            <SupplierCode>GG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>246519</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW587</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Titanium Bone Screws</Description>
            <Size>Ø4.5mm 50mm &amp; 80mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>246513</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH629</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO043</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IC bone screw</Name>
            <Description>Cancellous bone screw</Description>
            <Size>6.5mm x 15/20/25/30/35/40/45/50/55/60/65/70/75/80/85mm length.</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>237075</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO031</BillingCode>
            <Name>LINK Endo-Model Partial Pelvis Replacement</Name>
            <Description>Fixation Screws, for Obturator Foramen, including screw lock</Description>
            <Size>20mm - 35mm; four (4) sizes</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>140660</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN350</BillingCode>
            <Name>BI-MENTUM Dual Mobility System</Name>
            <Description>Cortical Bone Screws</Description>
            <Size>5mm diameter, 20 to 70mm length in 5mm increments </Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>329786</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN284</BillingCode>
            <Name>Screws</Name>
            <Description>Cancellous, Peripheral, Spherical Head, REDAPT Locking</Description>
            <Size>15mm - 70mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>230143</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TG010</BillingCode>
            <Name>Securus Modular Revision Hip System</Name>
            <Description>Distal locking screws</Description>
            <Size>30-70mm</Size>
            <SupplierCode>TG</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>132409</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA090</BillingCode>
            <Name>Arcos Modular Femoral Revision System</Name>
            <Description>Distal Interlocking Stem Screws</Description>
            <Size>25-60mm length</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>145406</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI399</BillingCode>
            <Name>Cancellous Screws</Name>
            <Description>Screws- Cancell - Ti alloy</Description>
            <Size>6.5/15 to 6.5/70mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1450</GroupID>
            <ARTGs>
                <ARTG>100337</ARTG>
            </ARTGs>
            <MinimumBenefit>166</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR196</BillingCode>
            <Name>Biolox Option (Titanium Sleeve)</Name>
            <Description>Titanium Sleeve for use with the Biolox Option Ceramic Femoral Heads</Description>
            <Size>28mm, 32mm 36mm and 40mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>157505</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI117</BillingCode>
            <Name>Ceramic Head Revision Sleeve</Name>
            <Description>Titanium Sleeve</Description>
            <Size>10/12 and 12/14 Taper  Short, Medium, Long and Extra-Long</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>281067</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU116</BillingCode>
            <Name>Mectacer Biolox Option Sleeves</Name>
            <Description>Biolox Option Titanium Sleeve</Description>
            <Size>S, M, L, XL</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>206685</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PF013</BillingCode>
            <Name>Pharo</Name>
            <Description>Intermediate Sleeve</Description>
            <Size>-5 to +10 (six sizes)</Size>
            <SupplierCode>PF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>141168</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF024</BillingCode>
            <Name>Taper Sleeve</Name>
            <Description>Taper Sleeve for femoral head</Description>
            <Size>taper sleeve: 12/14 -3.5mm, 12/14 +0mm, 12/14 +3.5mm, 12/14 +7mm, 12/14 +10mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>298300</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM166</BillingCode>
            <Name>Revision Delta Ceramic Femoral Head Sleeve</Name>
            <Description>Biolox Option Sleeve</Description>
            <Size>≤32mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>236061</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM168</BillingCode>
            <Name>Revision Delta Ceramic Femoral Head Sleeve</Name>
            <Description>Biolox Option Sleeve</Description>
            <Size>&gt;32mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>236061</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST821</BillingCode>
            <Name>Titanium Adapter Sleeve</Name>
            <Description>For use with new ceramic heads</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1451</GroupID>
            <ARTGs>
                <ARTG>288040</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI953</BillingCode>
            <Name>Stage One Select Hip Mould</Name>
            <Description>Modular Spacer Mould, Stainless Steel, Silicon.</Description>
            <Size>Stem 9 - 17mm&#xD;
Head 43 - 64 Head</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1452</GroupID>
            <ARTGs>
                <ARTG>98097</ARTG>
            </ARTGs>
            <MinimumBenefit>1309</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC203</BillingCode>
            <Name>SpaceFlex Hip</Name>
            <Description>Modular Hip Spacer Mold</Description>
            <Size>10mm  13mm  15mm</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1452</GroupID>
            <ARTGs>
                <ARTG>329464</ARTG>
            </ARTGs>
            <MinimumBenefit>1309</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER295</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spacer-G</Name>
            <Description>Temporary implantable device for the treatment of infected total hip replacement, Composition - stainless steel core surrounded by PMMA impregnated with Gentamicin</Description>
            <Size>Short Stems,  Head size 46mm, 54mm, 60mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1452</GroupID>
            <ARTGs>
                <ARTG>155142</ARTG>
            </ARTGs>
            <MinimumBenefit>1309</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER296</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spacer-G</Name>
            <Description>Temporary implantable device for the treatment of infected total hip replacement, Composition - stainless steel core surrounded by PMMA impregnated with Gentamicin</Description>
            <Size>Long Stems, Head size 46mm, 54mm, 60mm</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1452</GroupID>
            <ARTGs>
                <ARTG>155142</ARTG>
            </ARTGs>
            <MinimumBenefit>1309</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ028</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pantheon Flat Plate with Spikes</Name>
            <Description>Ti6Ai4V Plate with spikes on inner surface, screw and cable compatibility for Trochanter</Description>
            <Size>L50, L70</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1454</GroupID>
            <ARTGs>
                <ARTG>340794</ARTG>
            </ARTGs>
            <MinimumBenefit>387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cortical Plate </Name>
            <Description>Titanium plate either rough with HA or porous Ti-Por used as a flange for femoral or tibial prosthesis</Description>
            <Size>30 to 70mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1454</GroupID>
            <ARTGs>
                <ARTG>340794</ARTG>
            </ARTGs>
            <MinimumBenefit>387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW602</BillingCode>
            <Name>METS Trochanter plate</Name>
            <Description>Titanium with plasma spray of titanium and HA</Description>
            <Size>One size</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1454</GroupID>
            <ARTGs>
                <ARTG>246512</ARTG>
            </ARTGs>
            <MinimumBenefit>387</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP001</BillingCode>
            <Name>Reef Femoral Wing </Name>
            <Description>Titanium grit blasted with HA trochanteric replacement/augment</Description>
            <Size>Sizes 1-3</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1455</GroupID>
            <ARTGs>
                <ARTG>143075</ARTG>
            </ARTGs>
            <MinimumBenefit>839</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP986</BillingCode>
            <Name>SROM Trochanteric Washer</Name>
            <Description>Titanium, fixation with separate screw (DY020) to calcar replacing SROM Femoral Stem</Description>
            <Size>40 x 31, 60 x 45, 70 x 54</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1456</GroupID>
            <ARTGs>
                <ARTG>139288</ARTG>
            </ARTGs>
            <MinimumBenefit>484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI861</BillingCode>
            <Name>Segmental Trabeculer Metal Proximal Femoral Component - Washer</Name>
            <Description>4mm Flat Washer&#xD;
&amp;mm Flat Washer&#xD;
4mm Curved Washer</Description>
            <Size>4mm and 7mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1456</GroupID>
            <ARTGs>
                <ARTG>95938</ARTG>
            </ARTGs>
            <MinimumBenefit>484</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW642</BillingCode>
            <Name>METS Trochanter Reattachment Wire</Name>
            <Description>CoCr</Description>
            <Size>0.6m</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1457</GroupID>
            <ARTGs>
                <ARTG>246517</ARTG>
            </ARTGs>
            <MinimumBenefit>67</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP224</BillingCode>
            <Name>Charnley &amp; Wroblewski Trochanteric Spring Wire</Name>
            <Description>Stainless steel wire for trochanteric attachment</Description>
            <Size>0.5-3.00mm, 18 to 20g</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1458</GroupID>
            <ARTGs>
                <ARTG>99178</ARTG>
            </ARTGs>
            <MinimumBenefit>165</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LC023</BillingCode>
            <Name>DELTA Coupling / Spacer / Liner</Name>
            <Description>DELTA Coupling / Spacer / Adaptor / Liner</Description>
            <Size>Size Small to Extra Large  Angle (In degrees) 0 to 20  Offset +5</Size>
            <SupplierCode>LC</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1806</GroupID>
            <ARTGs>
                <ARTG>210771</ARTG>
            </ARTGs>
            <MinimumBenefit>1309</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH695</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO147</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS LUMiC Stem</Name>
            <Description>Stems for use with a modular partial pelvic replacement and acetabula reconstruction device in case of large bone defects</Description>
            <Size>10mm x 65, 75, 85mm, 8mm x 65, 75, 85mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>18</CategoryID>
            <SubCategoryID>164</SubCategoryID>
            <GroupID>1820</GroupID>
            <ARTGs>
                <ARTG>236007</ARTG>
                <ARTG>236018</ARTG>
            </ARTGs>
            <MinimumBenefit>5833</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB360</BillingCode>
            <Name>AS Columbus Knee System Femur CR cemented</Name>
            <Description>Columbus cemented AS coated CR Fixed bearing femoral component for total knee arthroplasty</Description>
            <Size>1-7 Left and Right</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>279466</ARTG>
            </ARTGs>
            <MinimumBenefit>3009</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY374</BillingCode>
            <Name>LCS Complete Knee System femoral component </Name>
            <Description>Femoral component, cemented, Titanium with TiN surface treatment </Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>3009</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU027</BillingCode>
            <Name>Evolis Knee System Femoral Component </Name>
            <Description>Femoral Component, cemented, CoCr, with TiNi (TiNibN) surface coating</Description>
            <Size>1 - 6, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>132459</ARTG>
            </ARTGs>
            <MinimumBenefit>3009</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ021</BillingCode>
            <Name>MRK (Medial Rotation Knee) Total Knee System Revision Femoral Component</Name>
            <Description>Stemmed Femoral Component, Cemented, CoCr</Description>
            <Size>0-5 Left and Right</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Fixed Stem</Suffix>
            <ARTGs>
                <ARTG>117768</ARTG>
                <ARTG>192370</ARTG>
            </ARTGs>
            <MinimumBenefit>3877</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV008</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Stemmed condular medial pivot component, cemented, grit blasted, minimally stabilised, femoral component, CoCr, usually used with a anterior lipped insert</Description>
            <Size>1, 2, 3, 4, 5  All in Left &amp; Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>236060</ARTG>
            </ARTGs>
            <MinimumBenefit>5276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV057</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Stemmed Femoral CS</Description>
            <Size>3-8  Left, Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>392216</ARTG>
            </ARTGs>
            <MinimumBenefit>5276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY368</BillingCode>
            <Name>LCS Complete Knee System femoral component </Name>
            <Description>Femoral component, cemented, CoCr</Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>216984</ARTG>
            </ARTGs>
            <MinimumBenefit>5276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH609</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - ACS LS Revision Femoral component, Cemented</Name>
            <Description>Cemented femoral component, revision, for use with stems</Description>
            <Size>Left/Right Sizes 2/3/4/5/6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>265605</ARTG>
            </ARTGs>
            <MinimumBenefit>5276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU081</BillingCode>
            <Name>GMK Revision cemented standard femur</Name>
            <Description>Cemented minimally stabilised femoral component</Description>
            <Size>Sizes 1 to 6, Left and Right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>211444</ARTG>
            </ARTGs>
            <MinimumBenefit>5276</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI898</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Femoral Component, CR, Cemented, anatomic, CoCr.</Description>
            <Size>55, 57.5, 60, 62.5, 65, 67.5, 70, 75, 80 Left and Right</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>218494</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP004</BillingCode>
            <Name>LCS Complete Knee System femoral component </Name>
            <Description>Femoral cemented, CoCr</Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK324</BillingCode>
            <Name>Triathlon Knee System Femoral Component</Name>
            <Description>Minimally stabilised, cemented, CoCr</Description>
            <Size>Sizes 1 to 8</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>212698</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN991</BillingCode>
            <Name>Genesis II Knee System Femoral Component</Name>
            <Description>Femoral Component, cemented, CoCr</Description>
            <Size>1-8&#xD;
Left &amp; Right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>207041</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE039</BillingCode>
            <Name>Active Knee Femoral Component </Name>
            <Description>Femoral Component, Cemented, CoCr </Description>
            <Size>Sizes 00 - 5 Left &amp; Right</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>164032</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB205</BillingCode>
            <Name>Columbus Total Knee System (TKS) Femoral Component</Name>
            <Description>Femoral component, cemented, CR, CoCr</Description>
            <Size>F1 - F8, Left and Right</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>279465</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB348</BillingCode>
            <Name>e.motion Total Knee System FP/UC Femoral Component cemented</Name>
            <Description>e.motion mobile bearing FP/UC Femoral Component cemented</Description>
            <Size>1-8, Left and right</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV003</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Cemented, grit blasted, minimally stabilised, femoral component</Description>
            <Size>1-8&#xD;
Left, Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>225086</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV021</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Cemented, grit blasted, minimally stabilised, femoral component</Description>
            <Size>1, 2, 3, 4, 5, 6, 7 &amp; 8</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>278299</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR249</BillingCode>
            <Name>Unity Knee - Cruciate Retaining Femur Cemented</Name>
            <Description>Femoral Component Cemented - Cruciate Retaining</Description>
            <Size>Size 1 – 9, Left and Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>223554</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR288</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO196</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee - Cemented Femoral Component</Name>
            <Description>CR Cemented Femoral Component, Non-Porous, Size 1 to 6</Description>
            <Size>Size 1-6, 1+, 2+, 3+, 4+, 5+, 6+ in Left &amp; Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>273814</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR316</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Femoral Component </Name>
            <Description>Femoral Component, CoCr, cemented</Description>
            <Size>0 - 5</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>278987</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD017</BillingCode>
            <Name>3D Knee System Femoral Component </Name>
            <Description>Femoral Component, cemented, CoCr </Description>
            <Size>Size 2 to 12</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>161909</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY471</BillingCode>
            <Name>PFC Sigma Knee System femoral component</Name>
            <Description>Femoral component, cemented, CoCr</Description>
            <Size>Size 1-6 including narrow sizes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
                <ARTG>97699</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX031</BillingCode>
            <Name>Optetrak Total Knee System Femoral Component</Name>
            <Description>Femoral Component, cemented, CoCr</Description>
            <Size>Size 0 -  6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>277742</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA008</BillingCode>
            <Name>Optetrak Logic Total Knee System, Femoral Component, CR, Cemented</Name>
            <Description>Femoral Component, cemented, CoCr</Description>
            <Size>Size 0 - 6, Left and Right</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>285439</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FL007</BillingCode>
            <Name>iTotal Cruciate-Retaining (CR) Total Knee Replacement System – iTotal Femoral Component</Name>
            <Description>Minimally stabilised femoral component, cemented, CoCrMo</Description>
            <Size>Left Knee, Right Knee, patient-specific</Size>
            <SupplierCode>FL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>377130</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Knee System - Genus Cemented Femoral Component</Name>
            <Description>Femoral Component for Total Knee Arthroplasty</Description>
            <Size>1-7 right, 1-7 left, Minus</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>232056</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW671</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SR063</PriorBillingCode>
                <PriorBillingCode>SK332</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Scorpio Knee System - Femoral Component</Name>
            <Description>Minimally stabilised, cemented, alloy.</Description>
            <Size>Sizes 3 - 13</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>211461</ARTG>
                <ARTG>211480</ARTG>
                <ARTG>211484</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ953</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Cruciate Retaining Cemented Femur</Description>
            <Size>1-10 including narrow</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>220502</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH600</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - Femoral component cemented</Name>
            <Description>Cemented resurfacing femoral component for use in knee athroplasty</Description>
            <Size>Left/Right 1-7</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>265601</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI062</BillingCode>
            <Name>Score Knee System Femoral Component</Name>
            <Description>Femoral component, Cemented, CoCr, with extended patellar groove </Description>
            <Size>7 sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>210577</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA108</BillingCode>
            <Name>balanSys Femoral Component</Name>
            <Description>Femoral component, cemented, CoCr</Description>
            <Size>XS TO F Left and Right</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>206062</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA490</BillingCode>
            <Name>balanSys Knee System / Femoral Component, CR, cemented, TiNbN coated</Name>
            <Description>Balansys Femoral Component/ CR cemented, TiNbN coated</Description>
            <Size>XS to F, left and right</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>206173</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ005</BillingCode>
            <Name>Saiph Knee System Femoral Component Cemented</Name>
            <Description>CoCr Polished Cemented Femoral Component</Description>
            <Size>1 - 8 Left &amp; Right</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>117768</ARTG>
                <ARTG>192370</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ020</BillingCode>
            <Name>MRK (Medial Rotation Knee) Total Knee System Femoral Component </Name>
            <Description>Pegged Femoral Component, Cemented, CoCr</Description>
            <Size>0-5 Left and Right</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>117768</ARTG>
                <ARTG>192370</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU026</BillingCode>
            <Name>Evolis Knee System Femoral Component </Name>
            <Description>Femoral component, cemented, CoCr </Description>
            <Size>1- 6, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>204213</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU063</BillingCode>
            <Name>GMK Primary Cemented Standard Femoral Component</Name>
            <Description>Cemented standard femoral component</Description>
            <Size>0 to 7, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>211426</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU112</BillingCode>
            <Name>GMK Cemented Standard Femur - TiNbN coated</Name>
            <Description>Cemented standard femoral component, with TiNbN surface coating</Description>
            <Size>sizes 0 to 7, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>254612</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU145</BillingCode>
            <Name>GMK Sphere Femoral Component</Name>
            <Description>Cemented femoral component</Description>
            <Size>1 to 7 Left&#xD;
1 to 7 Right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>211411</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH553</BillingCode>
            <Name>Trekking Knee System, Femoral Component - CR</Name>
            <Description>Femoral Component - CR</Description>
            <Size>Shape: Left and Right&#xD;
Width (mm): 59 - 79&#xD;
Width (mm): Depth 53-73&#xD;
Size: T1L - T5L&#xD;
Size: T1R - T5R</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>287516</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF139</BillingCode>
            <Name>Active Knee Femoral Component </Name>
            <Description>Femoral Component, Cemented, CoCr </Description>
            <Size>Sizes 00 - 5 Left &amp; Right</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>276959</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN992</BillingCode>
            <Name>Legion Knee System Femoral Component</Name>
            <Description>Legion Femoral, cemented, CoCr</Description>
            <Size>2-8&#xD;
Left &amp; Right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>212548</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI559</BillingCode>
            <Name>Natural Knee II Flex Femur</Name>
            <Description>Femoral Component, cemented, CoCr, High Flex </Description>
            <Size>Sizes 1 to 5 GSM Left and Right and Sizes 0 to 4 GSF Left and Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>220139</ARTG>
                <ARTG>220140</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI961</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Persona CR Femoral Component, Cemented</Description>
            <Size>Sizes 1-12</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3906</SubGroupID>
            <ARTGs>
                <ARTG>261278</ARTG>
            </ARTGs>
            <MinimumBenefit>2793</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB196</BillingCode>
            <Name>E.motion Total Knee System</Name>
            <Description>Posterior Stabilised Knee Component cemented</Description>
            <Size>F2 - F8 Right Left</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>5363</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR295</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO286</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex PS Cemented Revision Femoral Component</Name>
            <Description>The femoral component of a total knee revision system that incorporates a proportionally sized box.</Description>
            <Size>Sizes 1-6, plus Sizes 1+ to 5+ Left and Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>311060</ARTG>
            </ARTGs>
            <MinimumBenefit>5363</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI063</BillingCode>
            <Name>Score Knee System Femoral Component</Name>
            <Description>Femoral Component, CoCr, cemented, Posterior Stabilised</Description>
            <Size>4 sizes in left and right</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>210579</ARTG>
            </ARTGs>
            <MinimumBenefit>5363</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA506</BillingCode>
            <Name>Balansys Revision Knee</Name>
            <Description>Femoral component, contrained</Description>
            <Size>A to E, right to left</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>209536</ARTG>
            </ARTGs>
            <MinimumBenefit>5363</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU089</BillingCode>
            <Name>GMK Revision cemented posterior-stabilised femur</Name>
            <Description>Cemented posterior stabilised femoral component</Description>
            <Size>Sizes 1 to 6, Left and Right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>211486</ARTG>
            </ARTGs>
            <MinimumBenefit>5363</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH419</BillingCode>
            <Name>Trekking Knee System: TCK Revision Femoral Component PS</Name>
            <Description>Femoral Component Revision - PS</Description>
            <Size>Size: T1R - T5R&#xD;
Size: T1L - T5L&#xD;
Shape: Left and Right&#xD;
Width (mm): 59 - 79&#xD;
Width (mm): Depth 53-73</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>287507</ARTG>
            </ARTGs>
            <MinimumBenefit>5363</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN989</BillingCode>
            <Name>Genesis II Knee System Femoral Component</Name>
            <Description>Femoral component, cemented posterior stabilised, CoCr</Description>
            <Size>1-8&#xD;
Left &amp; Right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>207012</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB206</BillingCode>
            <Name>Columbus Total Knee System (TKS) Femoral Component</Name>
            <Description>Femoral component, cemented, CoCr, posterior stabilised</Description>
            <Size>F1 - F8, Left and Right</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>279467</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI897</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Femoral Component, Posterior Stabilised, Cemented, anatomic, CoCr.</Description>
            <Size>55, 57.5, 60, 62.5, 65, 67.5, 70, 75, 80 Left and Right</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR259</BillingCode>
            <Name>Unity Knee – Posterior Stabilised Femur Cemented</Name>
            <Description>Femoral Component Cemented - Posterior Stabilised</Description>
            <Size>Size 1 – 9, Left and Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>223555</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR296</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO287</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex PS Cemented Femoral Component</Name>
            <Description>The femoral component of a total knee system that incorporates a proportionally sized box.</Description>
            <Size>Sizes 1-6, plus Sizes 1+ to 6+ Left and Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>278616</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP149</BillingCode>
            <Name>PFC Sigma Knee System femoral component</Name>
            <Description> Femoral component, cemented, CoCr, posterior stabilised</Description>
            <Size>Size 1-6 including narrow sizes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
                <ARTG>97699</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY404</BillingCode>
            <Name>PFC Sigma Knee System RPF/PS150 femoral component</Name>
            <Description>Femoral component, cemented, CoCr, high flex, posterior stabilised </Description>
            <Size>Size 1-6 including narrow sizes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>191588</ARTG>
                <ARTG>97698</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA011</BillingCode>
            <Name>Optetrak Logic Total Knee System, Femoral Component, PS, Cemented</Name>
            <Description>Femoral Component, PS, Cemented</Description>
            <Size>Size 0 - 6, Left and Right</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>285440</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW670</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ST984</PriorBillingCode>
                <PriorBillingCode>SR003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Scorpio Knee System - Femoral Component</Name>
            <Description>Posterior stabilised, cemented, alloy.</Description>
            <Size>Sizes 3 - 13</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>211477</ARTG>
                <ARTG>211480</ARTG>
                <ARTG>211857</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ954</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Posterior Stabilised Cemented Femur</Description>
            <Size>1-10 including narrow</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>220504</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH610</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - PS Femoral component, cemented</Name>
            <Description>ACS posterior stabilised femoral component, cemented</Description>
            <Size>Size 2,2.5,3,4,5,6 left/right</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>265603</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI111</BillingCode>
            <Name>Anatomic Cemented Femur</Name>
            <Description>Cemented Posterior Stabilised Femoral Component</Description>
            <Size>0 to 8</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>222529</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA487</BillingCode>
            <Name>balanSys Femoral Component</Name>
            <Description>Femoral component, cemented, CoCr, posterior stabilised </Description>
            <Size>XS to F, Left and Right</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>206047</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA493</BillingCode>
            <Name>Balansys Knee System / Femoral Component, PS, cemented, TiNbN coated</Name>
            <Description>Balansys Femoral Component/PS cemented, TiNbN coated, CoCrMo, TiNbN</Description>
            <Size>XS to F, Left and Right</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>206174</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU028</BillingCode>
            <Name>Evolis Knee System Femoral Component </Name>
            <Description>Femoral Component, cemented, CoCr, posterior stabilised </Description>
            <Size>1 - 6, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>205428</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU029</BillingCode>
            <Name>Evolis Knee System Femoral Component </Name>
            <Description>Femoral Component, cemented, CoCr, posterior stabilised with TiNi (TiNibN) surface coating</Description>
            <Size>1 - 6, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>205777</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU064</BillingCode>
            <Name>GMK posterior stabilised cemented femur</Name>
            <Description>Cemented posterior stabilised femoral component</Description>
            <Size>0 to 7, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>223521</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU113</BillingCode>
            <Name>GMK Posterior Stabilised Cemented Femur -TiNbN coated</Name>
            <Description>Cemented posterior stabilised femoral component, with TiNbN surface coating</Description>
            <Size>sizes 0 to 7, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>254613</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH552</BillingCode>
            <Name>Trekking Knee System, Femoral Component - PS</Name>
            <Description>Femoral Component - PS</Description>
            <Size>Size: T1R - T5R&#xD;
Size: T1L - T5L&#xD;
Width (mm): 59 - 79&#xD;
Width (mm) Depth 53-73&#xD;
Shape: Left and Right</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>287517</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL172</BillingCode>
            <Name>Journey II BCS Femoral CoCr</Name>
            <Description>Femoral component, CoCr, cemented</Description>
            <Size>1 - 9; Left/Right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>375295</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN990</BillingCode>
            <Name>Legion Knee System Femoral Component</Name>
            <Description>Femoral Component, cemented posterier stabilised, CoCr</Description>
            <Size>2-8&#xD;
Left &amp; Right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>212549</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR009</BillingCode>
            <Name>Triathlon Knee System Femoral Component </Name>
            <Description>Posterior stabilised, cemented, CoCr, with ability to add lugs or augments </Description>
            <Size>Sizes 1 to 8</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>213155</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI589</BillingCode>
            <Name>NexGen LPS Flex GSF Femoral Components - Option</Name>
            <Description>Cobalt Chrome, High Flex, cemented, posterior stabilised</Description>
            <Size>Sizes GSF C to G, Left to Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>222083</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI736</BillingCode>
            <Name>NexGen LPS-Flex Tivanium Femoral Component</Name>
            <Description>LPS-Flex Tivanium Femoral Component, Size C Left&#xD;
LPS-Flex Tivanium Femoral Component, Size C Right&#xD;
LPS-Flex Tivanium Femoral Component, Size D Left&#xD;
LPS-Flex Tivanium Femoral Component, Size D Right&#xD;
LPS-Flex Tivanium Femoral Component, Size E Left&#xD;
LPS</Description>
            <Size>00-5968-013-51 LPS-Flex Tivanium Femoral Component, Size C Left&#xD;
00-5968-013-52 LPS-Flex Tivanium Femoral Component, Size C Right&#xD;
00-5968-014-51 LPS-Flex Tivanium Femoral Component, Size D Left&#xD;
00-5968-014-52 LPS-Flex Tivanium Femoral Component, Size D </Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>231632</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI933</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Persona PS Femoral Component, Cemented</Description>
            <Size>1-12, including narrow</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3907</SubGroupID>
            <ARTGs>
                <ARTG>261279</ARTG>
            </ARTGs>
            <MinimumBenefit>2855</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP254</BillingCode>
            <Name>SROM Noiles Knee System femoral component </Name>
            <Description>Rotating Hinge, cemented, CoCr femoral component.</Description>
            <Size>Sizes xxsmall-large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Hinged</Suffix>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH702</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO159</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS GenuX MK Femoral Component Cemented</Name>
            <Description>MUTARS GenuX MK Femoral Component Cemented</Description>
            <Size>Left/Right&#xD;
2,3,4,5,6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Hinged</Suffix>
            <ARTGs>
                <ARTG>238795</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI305</BillingCode>
            <Name>Nexgen Rotating Hinged Knee Femoral Component</Name>
            <Description>Femoral Component, with a fixed rotating hinge on UHMWPE bearings, cemented, CoCr </Description>
            <Size>B-F</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Hinged</Suffix>
            <ARTGs>
                <ARTG>220388</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB390</BillingCode>
            <Name>AS Columbus Revision Femoral Component Cemented</Name>
            <Description>Revision Femoral Component AS (Advanced Surface)</Description>
            <Size>1 - 7</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>312584</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI933</BillingCode>
            <Name>Vanguard SSK Knee System</Name>
            <Description>Femoral Component, CoCr, Ti</Description>
            <Size>55 to 80mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV009</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Cemented, grit blasted, totally constrained, femoral component, CoCr</Description>
            <Size>1, 2, 3, 4, 5</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>220420</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV055</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision CCK Femoral Component</Description>
            <Size>Sizes 3-8  Left, Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>317408</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP150</BillingCode>
            <Name>PFC Sigma Knee System TC3 femoral component</Name>
            <Description>Femoral component, cemented, CoCr, totally constrained</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>131657</ARTG>
                <ARTG>97698</ARTG>
                <ARTG>98088</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY148</BillingCode>
            <Name>LCS Complete Knee System femoral component </Name>
            <Description>Femoral component, cemented, CoCr, totally constrained</Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>131657</ARTG>
                <ARTG>138036</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX066</BillingCode>
            <Name>Optetrak Total Knee System CCK (Constrained Condylar Knee) Femoral Component</Name>
            <Description>Femoral Component, cemented, CoCr, totally stabilised</Description>
            <Size>Size 1 - 6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>277741</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH608</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - ACS SC Revision Femoral component, Cemented</Name>
            <Description>Cemented femoral component, Cemented</Description>
            <Size>Left/Right Sizes 2/2.5/3/4/5/6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>265609</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN222</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Cemented Revision Femur</Description>
            <Size>Sizes 1 to 10</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>298538</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK440</BillingCode>
            <Name>Triathlon TS Knee System Femoral Component </Name>
            <Description>Totally constrained, cemented, CoCr</Description>
            <Size>Left &amp; Right Size 1-8</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>217421</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN851</BillingCode>
            <Name>Legion Knee System Femoral Component</Name>
            <Description>Femoral Component, CoCr, Cemented, totally constrained</Description>
            <Size>Sizes 1-10, Left and Right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>208088</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR060</BillingCode>
            <Name>Scorpio Knee System Femoral Component</Name>
            <Description>Totally constrained, CoCr with TiNi surface treatment (LFIT - Low Friction Ion Treatment)</Description>
            <Size>3 Left, 3 Right, 5 Left, 5 Right, 7 Left, 7 Right, 9 Left, 9 Right, 11 Left, 11 Right, 13 Left, 13 Right</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>211485</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA091</BillingCode>
            <Name>Persona Revision Femur Cemented</Name>
            <Description>Femoral component, CoCr, for cemented use</Description>
            <Size>1, 1+, 3, 3+, 5, 5+, 7, 7+, 9, 9+, 11, 11+, 13 in right and left configurations</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>374550</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI119</BillingCode>
            <Name>NexGen LCCK (Legacy Constrained Condylar Knee)  Femoral Component</Name>
            <Description>Femoral component, totally constrained, CoCr</Description>
            <Size>A - H (L&amp;R)</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>214729</ARTG>
            </ARTGs>
            <MinimumBenefit>5450</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB350</BillingCode>
            <Name>EnduRo Rotating Hinge Knee Femoral Component</Name>
            <Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthroplasty as well as unstable knees.</Description>
            <Size>1-3 Right&#xD;
1-3 Left</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB387</BillingCode>
            <Name>AS EnduRo Femoral Component Cemented</Name>
            <Description>EnduRo Rotating Hinge Knee Femoral Component AS (Advanced Surface)</Description>
            <Size>1 - 3 R&#xD;
1 - 3 L</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>312500</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO169</BillingCode>
            <Name>RBK Total Knee System Femoral Component</Name>
            <Description>Femoral Component, cemented, CoCr, totally constrained</Description>
            <Size>Size 0 to 5</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>143926</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW143</BillingCode>
            <Name>MRH (Modular Rotating Hinge) (Modular Rotating Hinge) Femoral Component</Name>
            <Description>MRH Rotating Hinge Femoral component, CoCr (Vitallium), cemented, w/attachable stem, Fixed</Description>
            <Size>Left, Right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>223914</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH639</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO097</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Genux Hinged knee femoral component</Name>
            <Description>Cemented Hinge Knee</Description>
            <Size>Size 3,4,5 left and right</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>223514</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO157</BillingCode>
            <Name>Link Modular Knee Prosthesis&#xD;
System</Name>
            <Description>Femoral Components</Description>
            <Size>Extra Small - Extra Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>221853</ARTG>
                <ARTG>224956</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU099</BillingCode>
            <Name>GMK Hinge femur</Name>
            <Description>Rotating hinge femoral component</Description>
            <Size>1 to 6 Left and Right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>211408</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF134</BillingCode>
            <Name>SHiVA Modular Knee Hinge Prosthesis - Femoral Component</Name>
            <Description>Hinge Knee Femoral Component</Description>
            <Size>Sizes 2,3 and 4 Left and right</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>192962</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM158</BillingCode>
            <Name>Legion Hinge Femur CoCr</Name>
            <Description>The femoral component of the Legion Hinge system.</Description>
            <Size>Size 2 to 7</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>232073</ARTG>
            </ARTGs>
            <MinimumBenefit>5887</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO170</BillingCode>
            <Name>LINK Endo Model Rotational and Hinge Knee Prostheses</Name>
            <Description>Femoral Components</Description>
            <Size>Extra Small - Extra Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1348</GroupID>
            <SubGroupID>3908</SubGroupID>
            <ARTGs>
                <ARTG>157545</ARTG>
            </ARTGs>
            <MinimumBenefit>3053</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI111</BillingCode>
            <Name>NexGen Knee Femoral Component</Name>
            <Description>Femoral Component, cemented with PMMA, CoCr</Description>
            <Size>A - H (L&amp;R)</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1349</GroupID>
            <SubGroupID>3909</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>216340</ARTG>
            </ARTGs>
            <MinimumBenefit>2873</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI590</BillingCode>
            <Name>NexGen CR Flex Femoral Components - Precoat</Name>
            <Description>Cobalt Chrome, High Flex, Precoat cemented, Cruciate retaining</Description>
            <Size>Sizes A to G, Left to Right, GSF C to G Left to Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1349</GroupID>
            <SubGroupID>3909</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>214841</ARTG>
            </ARTGs>
            <MinimumBenefit>2873</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI588</BillingCode>
            <Name>NexGen LPS Flex Femoral Component - PreCoat</Name>
            <Description>Cobalt Chrome, High Flex, cemented, PMMA coating, posterior stabilised</Description>
            <Size>Sizes A to G, Left to Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1349</GroupID>
            <SubGroupID>3910</SubGroupID>
            <ARTGs>
                <ARTG>223086</ARTG>
            </ARTGs>
            <MinimumBenefit>3053</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL048</BillingCode>
            <Name>Legion Oxinium</Name>
            <Description>Legion Femoral component, Oxinium, cemented</Description>
            <Size>Left / Right 1-9</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1350</GroupID>
            <SubGroupID>3911</SubGroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>224561</ARTG>
            </ARTGs>
            <MinimumBenefit>3662</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL047</BillingCode>
            <Name>Genesis II Oxinium</Name>
            <Description>Genesis II Femoral component, Oxinium, cemented</Description>
            <Size>Left / Right 1-9</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1350</GroupID>
            <SubGroupID>3911</SubGroupID>
            <Suffix>Ceramic Surface, SCP</Suffix>
            <ARTGs>
                <ARTG>207016</ARTG>
            </ARTGs>
            <MinimumBenefit>3662</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL167</BillingCode>
            <Name>Journey II BCS Femoral Oxinium</Name>
            <Description>Femoral component, Oxinium, cemented</Description>
            <Size>1-10, Left/Right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1350</GroupID>
            <SubGroupID>3912</SubGroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>370843</ARTG>
            </ARTGs>
            <MinimumBenefit>3751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN988</BillingCode>
            <Name>Legion Oxinium</Name>
            <Description>Femoral Component, cemented, posterior stabilised, Oxinium</Description>
            <Size>Left / Right 1-9</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1350</GroupID>
            <SubGroupID>3912</SubGroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>224562</ARTG>
            </ARTGs>
            <MinimumBenefit>3751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN987</BillingCode>
            <Name>Genesis II Oxinium</Name>
            <Description>Genesis II Femoral Component, cemented, posterior stabilised, Oxinium</Description>
            <Size>Left / Right 1-9</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1350</GroupID>
            <SubGroupID>3912</SubGroupID>
            <Suffix>Ceramic Surface, SCP</Suffix>
            <ARTGs>
                <ARTG>207011</ARTG>
            </ARTGs>
            <MinimumBenefit>3751</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN736</BillingCode>
            <Name>Legion Knee System Femoral Component</Name>
            <Description>Femoral Component, Oxinium, Cemented, totally constrained</Description>
            <Size>Size 1 - 9</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1350</GroupID>
            <SubGroupID>3913</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>210518</ARTG>
            </ARTGs>
            <MinimumBenefit>6541</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY373</BillingCode>
            <Name>LCS Complete Knee System femoral component</Name>
            <Description>Femoral component, uncemented, Porocoat, beaded Titanium with TiN surface treatment </Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <Suffix>Ceramic Surface, SCP</Suffix>
            <ARTGs>
                <ARTG>97699</ARTG>
            </ARTGs>
            <MinimumBenefit>3357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP003</BillingCode>
            <Name>LCS Complete Knee System femoral component </Name>
            <Description>Femoral component, uncemented, CoCr, beaded (Porocoat)</Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>216982</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI109</BillingCode>
            <Name>NexGen Knee Femoral Component </Name>
            <Description>Femoral Component, uncemented, CoCr plus titanium fibre metal mesh ingrowth</Description>
            <Size>A - H (L&amp;R)</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>216884</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI591</BillingCode>
            <Name>NexGen CR Flex Femoral Components - Uncemented</Name>
            <Description>Cobalt Chrome, High Flex, Uncemented, Cruciate retaining</Description>
            <Size>Sizes A to G, Left to Right, GSF C to G Left to Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>211981</ARTG>
                <ARTG>214320</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI886</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Femoral Component, CR, uncemented, anatomic, CoCr, Ti</Description>
            <Size>55, 57.5, 60, 62.5, 65, 67.5, 70, 75, 80 Left and Right</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV022</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Uncemented, beaded, non HA, CoCr, usually used with a anterior lipped insert</Description>
            <Size>1, 2, 3, 4, 5, 6</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>236923</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV042</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Uncemented, beaded, CoCr</Description>
            <Size>1-8&#xD;
Left, Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>290173</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR272</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Femoral Component</Name>
            <Description>Femoral Component, uncemented,  CoCr, Porous coated</Description>
            <Size>1-5 Left and Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>278986</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR287</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO195</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee, Femoral Component Porous Coated</Name>
            <Description>Femoral Component Porous Coated Size 1 to 6 left &amp; Right.</Description>
            <Size>Sizes 1-6, 1+, 2+, 3+, 4+, 5+, 6+ in Left &amp; Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>286880</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD018</BillingCode>
            <Name>3D Knee System Femoral Component </Name>
            <Description>Femoral Component, uncemented,  beaded, CoCr</Description>
            <Size>Size 2 to 12</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>161909</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP148</BillingCode>
            <Name>PFC Sigma Knee System femoral component</Name>
            <Description>Femoral component, uncemented, CoCr, Beaded</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA009</BillingCode>
            <Name>Optetrak Logic Total Knee System, Femoral Component, CR, Porous</Name>
            <Description>Femoral Component, CR, Porous Coated</Description>
            <Size>Size 0 - 6, Left and Right</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>285901</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ606</BillingCode>
            <Name>PFC Sigma Knee System femoral component</Name>
            <Description>Femoral component, uncemented, CoCr, beaded (Porocoat)</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>97699</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH601</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - Femoral component porous coated</Name>
            <Description>Porous coated resurfacing femoral component</Description>
            <Size>Left/Right 1-6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>265596</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA457</BillingCode>
            <Name>Balansys Femoral Component</Name>
            <Description>Femur, CoCr with Ti vacuum plasma spray coating</Description>
            <Size>XS TO F Left and Right</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>206063</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN273</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Cruciate Retaining Cementless Component</Description>
            <Size>Sizes 1-10 including narrow</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>290326</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU038</BillingCode>
            <Name>Evolis Knee System Femoral Component </Name>
            <Description>Femoral component, uncemented, CoCr, titanium plasma spray</Description>
            <Size>1 - 6, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>204254</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN326</BillingCode>
            <Name>'Genesis II Knee System Femoral Component</Name>
            <Description>Femoral Component, CoCr, uncemented, beaded</Description>
            <Size>Left/Right Size 1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>242832</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST033</BillingCode>
            <Name>Scorpio Knee System Femoral Component</Name>
            <Description>Minimally stabilised, uncemented, beaded, (microstructure), CoCr</Description>
            <Size>3,5,7,9,11,13</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>211476</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA003</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Persona CR Femoral Component, Uncemented</Description>
            <Size>Sizes 3-12</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>222703</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI558</BillingCode>
            <Name>Natural Knee II Flex Femur CSTi</Name>
            <Description>Femoral Component, uncemented, CoCr, with cancellous structure titanium ingrowth CSTi High Flex </Description>
            <Size>Sizes 1 to 5 GSM Left &amp; Right and Sizes 0 to 4 GSF Left and Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3914</SubGroupID>
            <ARTGs>
                <ARTG>222231</ARTG>
                <ARTG>222232</ARTG>
            </ARTGs>
            <MinimumBenefit>3226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI115</BillingCode>
            <Name>NexGen Knee Femoral Component</Name>
            <Description>Femoral Component, uncemented, CoCr plus titanium fibre metal mesh ingrowth, posterior stabilised </Description>
            <Size>A - H (L&amp;R)</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3915</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>221601</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI951</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Femoral Component, Posterior Stabilised, anatomic, Plasma Porous Coated, CoCr &amp; Ti alloy</Description>
            <Size>55-80</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3915</SubGroupID>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH603</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - Posterior stabilised femoral component porous coated</Name>
            <Description>Posterior stabilised, porous coated, femoral component for use in knee arthroplasty</Description>
            <Size>Left/Right 1-6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3915</SubGroupID>
            <ARTGs>
                <ARTG>265604</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU039</BillingCode>
            <Name>Evolis Knee System Femoral Component </Name>
            <Description>Femoral component, uncemented, CoCr, titanium plasma spray, posterior stabilised </Description>
            <Size>1 - 6, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3915</SubGroupID>
            <ARTGs>
                <ARTG>204595</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN873</BillingCode>
            <Name>Genesis II Knee System Femoral Component</Name>
            <Description>Femoral component, CoCr, cementless, beaded, posterior stabilised</Description>
            <Size>Left / Right 1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3915</SubGroupID>
            <ARTGs>
                <ARTG>242833</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR007</BillingCode>
            <Name>Scorpio Knee System Femoral Component</Name>
            <Description>Posterior stabilised, CoCr, uncemented, beaded, (microstructured), with TiNi surface treatment (LFIT - Low friction ion treatment)</Description>
            <Size>3,5,7,9,11,13</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3915</SubGroupID>
            <ARTGs>
                <ARTG>211479</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI592</BillingCode>
            <Name>NexGen LPS Flex Femoral Components - Uncemented</Name>
            <Description>Cobalt Chrome, High Flex, Uncemented, Posterior stabilised</Description>
            <Size>Sizes A to G, Left to Right, GSF C to G Left to Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1351</GroupID>
            <SubGroupID>3915</SubGroupID>
            <ARTGs>
                <ARTG>217687</ARTG>
                <ARTG>226499</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI062</BillingCode>
            <Name>NexGen Knee Femoral Component</Name>
            <Description>Femoral Component, uncemented, high flex, CoCr plus titanium fibre metal mesh ingrowth and HA/TCP</Description>
            <Size>Sizes A-G Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>214842</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE041</BillingCode>
            <Name>Active Knee Femoral Component</Name>
            <Description>Femoral Component, uncemented, distally beaded with HA</Description>
            <Size>Sizes 00 -- 5 Left &amp; Right</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>282290</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB232</BillingCode>
            <Name>Emotion Total Knee System (TKS) Femoral Component </Name>
            <Description>Femoral Component, uncemented, CoCr Titanium plasma spray (Plasmapore), HA coated</Description>
            <Size>F1 - F8, Left and Right</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI962</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Femoral Component, Cruciate Retaining, Anatomic, HA, Plasma Porous Coated, CoCr &amp; Ti alloy</Description>
            <Size>55 - 80</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>131310</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Knee System - Genus Cementless Femoral Component + HA</Name>
            <Description>Cementless Femoral Component with HA coating</Description>
            <Size>1-7 right, 1-7 left, Minus</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>232071</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH602</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - Femoral component Ti/TCP coated</Name>
            <Description>Tricalcium phosphate coated resurfacing femoral component for use in knee arthroplasty</Description>
            <Size>Left/Right 1-6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>265602</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI064</BillingCode>
            <Name>Score Knee System Femoral Component</Name>
            <Description>Femoral Component, CoCr, uncemented, stippled surface, titanium plasma spray with HA, pegged </Description>
            <Size>7 Sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>210576</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ006</BillingCode>
            <Name>MRK (Medial Rotation Knee) Total Knee System Femoral Component </Name>
            <Description>Femoral Component, uncemented, CoCr with stippled surface titanium plasma spray HA coated  </Description>
            <Size>0-5 Left and Right</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>117768</ARTG>
                <ARTG>192370</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ007</BillingCode>
            <Name>Saiph Knee System Femoral Component Cementless</Name>
            <Description>CoCr Polished Cementless Femoral Component, Porous Titanium and HA</Description>
            <Size>1 - 8 Left &amp; Right</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>117768</ARTG>
                <ARTG>192370</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU066</BillingCode>
            <Name>GMK Uncemented Standard Femur</Name>
            <Description>Uncemented standard femoral component with titanium porous covered by an hydroxyapatite coating</Description>
            <Size>1 to 7, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>225044</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH550</BillingCode>
            <Name>Trekking Knee System - Femoral Component - CR</Name>
            <Description>Femoral Component Uncemented - CR</Description>
            <Size>Size: T1R - T5R&#xD;
Size: T1L - T5L&#xD;
Shape: Left and Right&#xD;
Width (mm) - Depth 53-73&#xD;
Width (mm) - 59-79</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>287515</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK325</BillingCode>
            <Name>Triathlon Knee System Femoral Component </Name>
            <Description>Minimally stabilised, CoCr, uncemented, beaded with PA (Hydroxyapatite)</Description>
            <Size>Sizes 1 to 8</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>146118</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK334</BillingCode>
            <Name>Scorpio NRG Knee System Femoral Component</Name>
            <Description>Minimally stabilised, uncemented, with Hydroxyapatite, CoCr</Description>
            <Size>Sizes 3,4,5,6,7,9,11,13</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>153875</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN910</BillingCode>
            <Name>Genesis II</Name>
            <Description>CR HA Porous</Description>
            <Size>1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>242854</ARTG>
                <ARTG>248574</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST030</BillingCode>
            <Name>Scorpio Knee System Femoral Component</Name>
            <Description>Minimally stabilised, uncemented, beaded (microstructure) with PA, (Hydroxyapatite), CoCr, </Description>
            <Size>3,5,7,9,11,13</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3917</SubGroupID>
            <ARTGs>
                <ARTG>146116</ARTG>
            </ARTGs>
            <MinimumBenefit>3575</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI121</BillingCode>
            <Name>Anatomic Cementless Femur</Name>
            <Description>Posterior-Stabilised Cementless Femur Plasma-Sprayed Titanium and HAP</Description>
            <Size>Sizes 0 to 8 left and right</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3918</SubGroupID>
            <ARTGs>
                <ARTG>222528</ARTG>
            </ARTGs>
            <MinimumBenefit>3663</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU078</BillingCode>
            <Name>GMK Uncemented Posterior stabilised femur</Name>
            <Description>Uncemented posterior stabilised femoral component with titanium porus coating covered by an hydroxyapatite coating</Description>
            <Size>0 to 7, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3918</SubGroupID>
            <ARTGs>
                <ARTG>211441</ARTG>
            </ARTGs>
            <MinimumBenefit>3663</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH551</BillingCode>
            <Name>Trekking Knee System - Femoral Component PS</Name>
            <Description>Femoral Component PS</Description>
            <Size>Shape: Left and Right&#xD;
Width (mm): Depth 53-73&#xD;
Width (mm): 59-79&#xD;
Size: T1L - T5L&#xD;
Size: T1R - T5R</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3918</SubGroupID>
            <ARTGs>
                <ARTG>287514</ARTG>
            </ARTGs>
            <MinimumBenefit>3663</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN911</BillingCode>
            <Name>Genesis II</Name>
            <Description>PS HA Porous</Description>
            <Size>1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3918</SubGroupID>
            <ARTGs>
                <ARTG>247734</ARTG>
            </ARTGs>
            <MinimumBenefit>3663</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR004</BillingCode>
            <Name>Scorpio NRG Knee System Femoral Component</Name>
            <Description>Posterior stabilised, uncemented with Hydroxyapatite, CoCr, </Description>
            <Size>Sizes 3,4,5,6,7,9,11,13</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3918</SubGroupID>
            <ARTGs>
                <ARTG>153875</ARTG>
            </ARTGs>
            <MinimumBenefit>3663</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR006</BillingCode>
            <Name>Scorpio Knee System Femoral Component</Name>
            <Description>Posterior stabilised, uncemented, beaded (microstructure) with PA (Hydroxyapatite), CoCr</Description>
            <Size>3,5,7,9,11,13</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3918</SubGroupID>
            <ARTGs>
                <ARTG>146117</ARTG>
            </ARTGs>
            <MinimumBenefit>3663</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR024</BillingCode>
            <Name>Triathlon Knee System Femoral Component</Name>
            <Description>Posterior stabilised, uncemented, beaded with PA (Hydroxyapatite), CoCr  </Description>
            <Size>Size 1 - 8</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>149</SubCategoryID>
            <GroupID>1352</GroupID>
            <SubGroupID>3918</SubGroupID>
            <ARTGs>
                <ARTG>146119</ARTG>
            </ARTGs>
            <MinimumBenefit>3663</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI494</BillingCode>
            <Name>ZUK (Zimmer Uni-Compartmental High Flex Knee) Femoral Component </Name>
            <Description>Femoral Component, cemented, CoCr, high flex </Description>
            <Size>Sizes A to G</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <SubGroupID>3919</SubGroupID>
            <ARTGs>
                <ARTG>220167</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR059</BillingCode>
            <Name>Uniglide Uni Knee System Uni Femoral Component</Name>
            <Description>Uni Femoral Component, CoCr, cemented, with TiNi surface  coating</Description>
            <Size>1-4</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>106748</ARTG>
                <ARTG>115743</ARTG>
            </ARTGs>
            <MinimumBenefit>2136</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI031</BillingCode>
            <Name>Oxford Meniscal Knee System Uni Femoral Component </Name>
            <Description>Uni Femoral Component, CoCr, Cemented (Phase III)</Description>
            <Size>Small, Medium, Large, Extra Large.</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>126863</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Uni Cemented Femoral Component</Name>
            <Description>Genus Uni - unicompartmental Knee Femoral Component - Cemented</Description>
            <Size>RM/LL and LM/RL Sizes 1-6</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>287896</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ781</BillingCode>
            <Name>Sigma HP Unicompartmental Knee - Unicondylar femoral component</Name>
            <Description>Unicompartmental femoral component, cemented, CoCr</Description>
            <Size>Size 1-6, LM/RL &amp; RM/LL</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>223246</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO059</BillingCode>
            <Name>LINK Endo-Model SLED Uni femoral componet</Name>
            <Description>Uni Femoral Component, cemented, CoCr</Description>
            <Size>Short, medium-short, medium &amp; large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>271932</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA451</BillingCode>
            <Name>BalanSys UNI femoral component </Name>
            <Description>Uni Femoral component, cemented CoCr</Description>
            <Size>A, B,C,D,E</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>212827</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU060</BillingCode>
            <Name>Unicompartmental femoral component</Name>
            <Description>cemented unicompartmental femoral component</Description>
            <Size>1 to 4</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>223021</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK585</BillingCode>
            <Name>Restoris MCK Knee - Femeral Component</Name>
            <Description>Femeral Component</Description>
            <Size>LM/RL sizes 1 to 8  RM/LL sizes 1 to 8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>242176</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR083</BillingCode>
            <Name>Triathlon PKR - Cemented Femoral Component</Name>
            <Description>Triathlon PKR - Uni Femoral Component, CoCR, Cemented</Description>
            <Size>12 -Femurs in total: 1 through to 6, Left Media/Right lateral + 1 through to 6, Right Media/Left Lateral</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>224840</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA075</BillingCode>
            <Name>Persona Partial Knee System</Name>
            <Description>Femoral component</Description>
            <Size>Sizes 1-8</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1353</GroupID>
            <ARTGs>
                <ARTG>336793</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM156</BillingCode>
            <Name>Journey Uni Femur-Oxinium</Name>
            <Description>Uni Femur - Oxinium - It is UniCondylar Femur</Description>
            <Size>Size 1 to Size 7 Please refer to the pocket guide</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1354</GroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>206258</ARTG>
            </ARTGs>
            <MinimumBenefit>2464</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI966</BillingCode>
            <Name>Oxford Meniscal Knee System</Name>
            <Description>Femoral Component, Porous HA Coated CoCr, Ti, HA</Description>
            <Size>Small - Extra Large</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1355</GroupID>
            <SubGroupID>3920</SubGroupID>
            <ARTGs>
                <ARTG>126863</ARTG>
            </ARTGs>
            <MinimumBenefit>2180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Uni Cementless Co-Por Femoral Component</Name>
            <Description>Genus Uni Cementless Femoral Component manufactured using CoPor - (CoCr powder manaufacturing) to provide a monolithic structure with three dimensional porous matrix at the bone interface which is then HA coated.</Description>
            <Size>Sizes 1-6 RM/LL and LM/RL</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>150</SubCategoryID>
            <GroupID>1355</GroupID>
            <SubGroupID>3920</SubGroupID>
            <ARTGs>
                <ARTG>287897</ARTG>
            </ARTGs>
            <MinimumBenefit>2180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW663</BillingCode>
            <Name>Triathlon All Polyethylene Tibial Component - CS</Name>
            <Description>All poly monoblock tibial baseplate.</Description>
            <Size>1-8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1356</GroupID>
            <ARTGs>
                <ARTG>220722</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ589</BillingCode>
            <Name>PFC Sigma Knee System tibial baseplate</Name>
            <Description>All poly UHMWPE, Cemented, pegged</Description>
            <Size>Sizes  1 - 6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1356</GroupID>
            <ARTGs>
                <ARTG>97700</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ590</BillingCode>
            <Name>PFC Sigma Knee System Tibial Baseplate</Name>
            <Description>All poly UHMWPE, cemented, non pegged </Description>
            <Size>Sizes  1 - 6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1356</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN869</BillingCode>
            <Name>Genesis II Knee System Tibial Baseplate</Name>
            <Description>Tibial Baseplate, all poly, cemented</Description>
            <Size>Left / Right 1 - 8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1356</GroupID>
            <ARTGs>
                <ARTG>242033</ARTG>
                <ARTG>242853</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI127</BillingCode>
            <Name>NexGen Knee Tibial Baseplate</Name>
            <Description>Baseplate All Poly, cemented, UHMWPE</Description>
            <Size>1 - 10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1356</GroupID>
            <ARTGs>
                <ARTG>222316</ARTG>
                <ARTG>226648</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI122</BillingCode>
            <Name>NexGen Tibial Baseplate  </Name>
            <Description>Pegged Tibial Baseplate, cemented, for fixed insert, titanium, PMMA coated  </Description>
            <Size>1  - 10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <SubGroupID>3921</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>217360</ARTG>
            </ARTGs>
            <MinimumBenefit>1805</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI866</BillingCode>
            <Name>NexGen primary Tibial Component</Name>
            <Description>Precoat-Titanium</Description>
            <Size>1-10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <SubGroupID>3921</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>220079</ARTG>
            </ARTGs>
            <MinimumBenefit>1805</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO158</BillingCode>
            <Name>Link Modular Knee ProsthesisSystem</Name>
            <Description>Tibial Components</Description>
            <Size>Extra Small - Extra Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Hinged</Suffix>
            <ARTGs>
                <ARTG>221853</ARTG>
                <ARTG>225001</ARTG>
                <ARTG>225784</ARTG>
                <ARTG>226252</ARTG>
            </ARTGs>
            <MinimumBenefit>3619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB204</BillingCode>
            <Name>Columbus Total Knee System (TKS) Tibial Baseplate </Name>
            <Description>Tibial baseplate, cemented, CoCr for fixed insert</Description>
            <Size>T1 to T5</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB391</BillingCode>
            <Name>AS Columbus Revision Tibial Component Cemented</Name>
            <Description>Revision Tibial Component AS (Advanced Surface)</Description>
            <Size>T0+ - T5</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>312586</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI169</BillingCode>
            <Name>Biomet Universal Tibial Baseplate </Name>
            <Description>Tibial baseplate, Cemented, Titanium, which allows for attachmnet of a variety of different stems and for fixed inserts</Description>
            <Size>59-91mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI811</BillingCode>
            <Name>Offset Tibial Tray System </Name>
            <Description>Tibial baseplate, Cemented, Titanium, which allows for attachment of the offset adaptor </Description>
            <Size>59-91mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV006</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Revision tibial component, titanium, cemented with offset stem</Description>
            <Size>1, 1+, 2, 2+, 3, 3+, 4, 4+, 5, 5+ in Left &amp; Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>278300</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV015</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Revision tibial component,  titanium, cemented</Description>
            <Size>0+, 1, 1+, 2, 2+, 3, 3+, 4, 4+, 5, 5+, 6</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>238912</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR289</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO256</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Revision Knee System</Name>
            <Description>A modular tibial baseplate</Description>
            <Size>sizes 1-6</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>311061</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY467</BillingCode>
            <Name>PFC Sigma Knee System tibial baseplate</Name>
            <Description>Tibial baseplate, cemented, keeled, Titanium, standard and offset keels with capacity for augment and stem attachment </Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX036</BillingCode>
            <Name>Optetrak Total Knee System, Tibial Baseplate</Name>
            <Description>Tibial Baseplate, titanium, fixed insert (finned, trapezoid, offset with locking screw), cemented</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>279574</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA020</BillingCode>
            <Name>Optetrak Logic Tibial Tray</Name>
            <Description>Tibial Baseplate, titanium, fixed insert, cemented, fit and trapezoid. The tibial tray accepts augments and stem extensions with offset couplers (if needed).</Description>
            <Size>0F/0T - 6F/6T</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>285441</ARTG>
                <ARTG>285505</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ510</BillingCode>
            <Name>PFC Sigma Knee System tibial baseplate</Name>
            <Description>Tibial baseplate, cemented, keeled, forged CoCr, polished tibial insert surface </Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>97700</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH612</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System-ACS Revision tibial component, cemented</Name>
            <Description>Revision base plate, cemented, for use with augments and straight or offset stems</Description>
            <Size>Left and Right, Sizes 2,3,3.5,4,5,6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>265611</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA509</BillingCode>
            <Name>Balansys Revision Knee, Tibial Plateau</Name>
            <Description>Revision Tibial Baseplate, modular</Description>
            <Size>64 to 85</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>209537</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN207</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Revision fixed bearing tibial tray.</Description>
            <Size>1 to 10</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>289595</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU030</BillingCode>
            <Name>Evolis Knee System Tibial baseplate  </Name>
            <Description>Tibial baseplate, cemented, titanium for fixed insert </Description>
            <Size>1 - 6</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>204203</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU138</BillingCode>
            <Name>GMK Revision Cemented fixed Tibia Tray</Name>
            <Description>Asymmetric polished cemented fixed tibial component</Description>
            <Size>1 to 6, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>210966</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH417</BillingCode>
            <Name>Trekking Knee System - TCK Tibial Component Revision</Name>
            <Description>Revision Tibial Component</Description>
            <Size>Size: T1-T5&#xD;
Width (mm) Depth: 42 - 57&#xD;
Width (mm) 64 - 86</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>287508</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN824</BillingCode>
            <Name>Legion Knee System Tibial Baseplate</Name>
            <Description>Tibial baseplate, cemented, Titanium, for fixed insert,</Description>
            <Size>1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>208089</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR034</BillingCode>
            <Name>Triathlon TS Knee System Tibial Baseplate </Name>
            <Description>Tibial baseplate, stemmed revision, cemented, CoCr</Description>
            <Size>1 to 8</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>218001</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR080</BillingCode>
            <Name>Duracon Knee System Stemmed Revision Baseplate</Name>
            <Description>Stemmed revision baseplate, CoCr, (Vitallium). Cemented, Fixed</Description>
            <Size>XS1, XS2, S1, S2, M1, M2,  L1, L2, Xl1, Xl2</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>216479</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST034</BillingCode>
            <Name>Scorpio Knee System Tibial Baseplate </Name>
            <Description>Tibial baseplate, cemented, ability to attach stems, CoCr  </Description>
            <Size>3,5,7,9,11,13</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>211459</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA093</BillingCode>
            <Name>Persona Revision Tibia Fixed Non-Porous</Name>
            <Description>Fixed Tibial component made of Tivanium® for cemented use.</Description>
            <Size>A, B, C, D, E, F, G, H, J in Left and Right configurations</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>374551</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI126</BillingCode>
            <Name>NexGen Knee Tibial Baseplate </Name>
            <Description>Stemmed AP wedged tibial baseplate, cemented, for fixed insert, titanium, PMMA coated, with capacity for augment and stem attachment</Description>
            <Size>1 - 10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>217359</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI867</BillingCode>
            <Name>NexGen Stemmed Tibial Component - cemented</Name>
            <Description>Stemmed tibial baseplate, cemented,for fixed insert, titanium PMMA coated, with capacity for augment and stem attachment</Description>
            <Size>1-10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>227159</ARTG>
            </ARTGs>
            <MinimumBenefit>2899</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW141</BillingCode>
            <Name>MRH (Modular Rotating Hinge) Tibial Baseplate</Name>
            <Description>MRH Tibial baseplate, CoCr (Vitallium), fixed insert with central hole for hinged insertion, w/attachable stem</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>224539</ARTG>
            </ARTGs>
            <MinimumBenefit>3619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU100</BillingCode>
            <Name>GMK Hinge fixed tibial tray</Name>
            <Description>Tibial Component cemented CoCr</Description>
            <Size>1 to 6 Left and Right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>211409</ARTG>
            </ARTGs>
            <MinimumBenefit>3619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK327</BillingCode>
            <Name>Triathlon Knee System Tibial Baseplate</Name>
            <Description>Tibial baseplate, cemented, CoCr</Description>
            <Size>Sizes 0 to 8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>217832</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN857</BillingCode>
            <Name>Genesis II Knee System Tibial Baseplate</Name>
            <Description>Tibial Baseplate, cemented, Titanium, grit blasted</Description>
            <Size>1 - 9</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>207027</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI413</BillingCode>
            <Name>Natural Knee Tibial Baseplate</Name>
            <Description>Tibial Baseplate, Cemented - Titanium for fixed inserts</Description>
            <Size>Size 00 to 5</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>220170</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE040</BillingCode>
            <Name>Active Knee Tibial Baseplate</Name>
            <Description>Tibial baseplate, Cemented, CoCr</Description>
            <Size>Sizes 1-5</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>276957</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB396</BillingCode>
            <Name>Columbus Tibial Baseplate</Name>
            <Description>Tibial baseplate CRA/PSA, cemented, for fixed insert</Description>
            <Size>T0+ - T4+ and T0 - T5</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>298272</ARTG>
                <ARTG>298186</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB400</BillingCode>
            <Name>Columbus AS CR PS Tibial Plateau</Name>
            <Description>Tibial baseplate, cemented, for fixed insert</Description>
            <Size>T0 - T5</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>279473</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI182</BillingCode>
            <Name>Biomet Universal Tibial Baseplate </Name>
            <Description>Tibial baseplate, Cemented, one piece, Ti or CoCr</Description>
            <Size>59-91mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV002</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Tibial component, CoCr, cemented</Description>
            <Size>1-8&#xD;
Standard, Plus&#xD;
Left, Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>234319</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV018</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Tibial component, CoCr, cemented</Description>
            <Size>1-6&#xD;
Standard, Plus</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>237079</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV054</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision Tibial Base Implant</Description>
            <Size>Sizes 1 - 8  Left, Right  Standard, Plus</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>317407</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR251</BillingCode>
            <Name>Unity Knee – Tibial Tray</Name>
            <Description>Tibial Tray Cemented</Description>
            <Size>Sizes 1 – 9</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>223558</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR286</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO194</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee, Tibial Base Plate - Cemented</Name>
            <Description>Tibial Baseplate, Cemented, Non-Porous, Size 1 - 7 Left &amp; Right</Description>
            <Size>Size 1 Left &amp; Right, size 2 Left &amp; Right, size 3 Left &amp; Right, size 4 Left &amp; Right, size 5 Left &amp; Right, size 6 Left &amp; Right, size 7 Left &amp; Right.</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>278528</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD019</BillingCode>
            <Name>3D Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, cemented, CoCr</Description>
            <Size>Size 1 to 12</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>161909</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA013</BillingCode>
            <Name>Optetrak Logic Total Knee System, Tibial Baseplate</Name>
            <Description>Tibial Baseplate, titanium, fixed insert, cemented</Description>
            <Size>Size 0 - 6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>285441</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FL008</BillingCode>
            <Name>iTotal Cruciate-Retaining (CR) Total Knee Replacement System – iTotal G2+ Tibial Tray</Name>
            <Description>Tibial baseplate, cemented, CoCrMo</Description>
            <Size>Left Knee, Right Knee, patient-specific</Size>
            <SupplierCode>FL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>377131</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ662</BillingCode>
            <Name>PFC Sigma Knee System Tibial Baseplate</Name>
            <Description>Tibial baseplate, cemented, keeled, titanium, with capacity for stem attachment</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ663</BillingCode>
            <Name>PFC Sigma Knee System Tibial Baseplate</Name>
            <Description>Tibial baseplate, cemented, cruciform keeled, titanium</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ957</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Fixed Bearing Cemented Tibial Tray</Description>
            <Size>1-10</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>220503</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI112</BillingCode>
            <Name>Anatomic Cemented Tibial Baseplate</Name>
            <Description>Cemented fixed bearing tibial baseplate with the ability to attach stem extensions</Description>
            <Size>Size 0 to 8</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>222531</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA515</BillingCode>
            <Name>Balansys Tibial Baseplate</Name>
            <Description>Tibial Baseplate cemented, CoCr</Description>
            <Size>59mm to 85mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>211082</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA518</BillingCode>
            <Name>Balansys Tibial Baseplate</Name>
            <Description>Tibial Baseplate cemented, CoCr, TiNbN coated</Description>
            <Size>59mm to 85mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>211083</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ008</BillingCode>
            <Name>MRK (Medial Rotation Knee) Total Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, cemented, Titanium for fixed insert </Description>
            <Size>1-5</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>117769</ARTG>
                <ARTG>192371</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ009</BillingCode>
            <Name>Saiph Knee System Tibial Component Cemented</Name>
            <Description>CoCr Tibial Component, Cemented</Description>
            <Size>A - F, Standard and Long Stem</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>192371</ARTG>
                <ARTG>117769</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU114</BillingCode>
            <Name>GMK Cemented FIXED Tibial Tray -TiNbN coated</Name>
            <Description>Asymmetric polished cemented fixed tibial component, with TiNbN surface coating</Description>
            <Size>1 to 6, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>254614</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU137</BillingCode>
            <Name>GMK Cemented fixed Tibia Tray</Name>
            <Description>Asymmetric polished cemented fixed tibial component</Description>
            <Size>1 to 6, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>210966</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH425</BillingCode>
            <Name>Trekking Knee System, Tibial Component</Name>
            <Description>Tibial Component Cemented</Description>
            <Size>Size: T1 - T5&#xD;
Width (mm): Depth 42-57&#xD;
Width (mm): 64 - 86</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>287520</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF142</BillingCode>
            <Name>Active Knee Tibial Baseplate</Name>
            <Description>Tibial baseplate, Cemented, CoCr</Description>
            <Size>Sizes 1-5 </Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>276957</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN848</BillingCode>
            <Name>Journey Knee System Tibial Baseplate</Name>
            <Description>Tibial baseplate, cemented, Titanium, for fixed insert</Description>
            <Size>Sizes 1-8, Left and Right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>370844</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST066</BillingCode>
            <Name>Scorpio Knee System Tibial Baseplate </Name>
            <Description>Tibial baseplate, cemented, CoCr </Description>
            <Size>3, 5, 7, 9, 11, 13</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>217949</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI595</BillingCode>
            <Name>NexGen Knee Tibial Components Stemmed - Option</Name>
            <Description>Option - Titanium</Description>
            <Size>1 to 10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>217361</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI935</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Persona Tibial Tray, Stemmed</Description>
            <Size>9 sizes, left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1357</GroupID>
            <ARTGs>
                <ARTG>261273</ARTG>
            </ARTGs>
            <MinimumBenefit>1837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI862</BillingCode>
            <Name>NexGen Legacy Knee Tibial Baseplate</Name>
            <Description>Tibial baseplate, cemented, CoCr, with PMMA coating for legacy posterior stabilised mobile insert</Description>
            <Size>1 - 10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <SubGroupID>3922</SubGroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>227154</ARTG>
            </ARTGs>
            <MinimumBenefit>1983</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB201</BillingCode>
            <Name>e.MOTION Total Knee</Name>
            <Description>Tibial baseplate, cemented, CoCR with polished surface for mobile insert</Description>
            <Size>T1-T8, left and right</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>3402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR275</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO115</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, for mobile insert, CrCo, cemented</Description>
            <Size>Size 00 to 5</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>278989</ARTG>
            </ARTGs>
            <MinimumBenefit>3402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH611</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - ACS SC Revision Tibial component, Cemented</Name>
            <Description>Revision MB base plate for use with augments and straight or offset stems</Description>
            <Size>Sizes 2,3,4,5,6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>265619</ARTG>
            </ARTGs>
            <MinimumBenefit>3402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI068</BillingCode>
            <Name>Score Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, Cemented, CoCr, polished insert surface for mobile insert </Description>
            <Size>9 Sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>210578</ARTG>
            </ARTGs>
            <MinimumBenefit>3402</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ634</BillingCode>
            <Name>LCS Complete Knee System - MBT Revision Thick Tray</Name>
            <Description>Thick Tibial Tray</Description>
            <Size>1 to 6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Extra Thick</Suffix>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>6497</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ804</BillingCode>
            <Name>MBT Revision Thick Tibial Tray</Name>
            <Description>Tibial Tray</Description>
            <Size>Size range 2 to 5.  Tray Thickness of 25mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Extra Thick</Suffix>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>6497</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB354</BillingCode>
            <Name>EnduRo Rotating Hinge Knee Tibial Component</Name>
            <Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to&#xD;
treat complex revision knee arthoplasty as well as unstable knees</Description>
            <Size>1-3</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB388</BillingCode>
            <Name>AS EnduRo Tibial Component Cemented</Name>
            <Description>EnduRo Rotating Hinge Knee Tibial Component AS (Advanced Surface)</Description>
            <Size>1-3</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>312501</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY151</BillingCode>
            <Name>MBT Knee System Revision Tibial base Plate </Name>
            <Description>Tibial baseplate, cemented, CoCr, for rotating platform, also usable with specific hinged insert </Description>
            <Size>Sizes: 1-6 ; Tray Thickness: 4.8</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>230630</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH700</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO157</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS GenuX MK Tibial Component, cemented</Name>
            <Description>MUTARS GenuX MK Tibial Component, cemented</Description>
            <Size>2-6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>238837</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN270</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Revision mobile bearing tibial tray, also usable with specific hinged insert </Description>
            <Size>2-10</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>298539</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF136</BillingCode>
            <Name>SHiVA Modular Knee Prosthesis - Tibial Tray</Name>
            <Description>Tibial Tray</Description>
            <Size>Size 2,3 and 4</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>192962</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM160</BillingCode>
            <Name>Legion Hinge Tibial Baseplate</Name>
            <Description>A tibial baseplate used for the Legion Hinge system.</Description>
            <Size>Size 2 to 7 Left, Right</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>232074</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI308</BillingCode>
            <Name>Nexgen Rotating Hinge Tibial Baseplate </Name>
            <Description>Stemmed Tibial Baseplate with polished tibial insert surface, cemented, PMMA coated for Nexgen rotating hinged femoral component </Description>
            <Size>1-6</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <Suffix>Revision, Hinged</Suffix>
            <ARTGs>
                <ARTG>220389</ARTG>
                <ARTG>226691</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR270</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Tibial Baseplate </Name>
            <Description>Tibial baseplate, grit blast, CoCr, cemented, for mobile bearing insert </Description>
            <Size>0 - 5</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>279738</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP032</BillingCode>
            <Name>MBT Knee System tibial baseplate </Name>
            <Description>Tibial baseplate, cemented, CoCr, for rotating platform, (keeled and non keeled) </Description>
            <Size>Sizes 1 - 7</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>226233</ARTG>
                <ARTG>226234</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA015</BillingCode>
            <Name>Optetrak Logic Total Knee System, RBK Tibial Baseplate</Name>
            <Description>Tibial Baseplate, titanium with polished insert surface, cemented, for a mobile insert</Description>
            <Size>Size 1F/1T - 5F/5T</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>285906</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Knee System - Genus Cemented Tibial Tray</Name>
            <Description>Cemented Mobile Bearing Tibial Tray</Description>
            <Size>1-7</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>232058</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ958</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Mobile Bearing Cemented Tibial Tray</Description>
            <Size>1-10</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>226651</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH687</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO179</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Mobile Tibial Component Cemented</Name>
            <Description>Tibia Base Plate Cemented for use with a Mobile Bearing insert - TiN Coated</Description>
            <Size>2-7</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>265622</ARTG>
                <ARTG>265672</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO171</BillingCode>
            <Name>Link Endo Model Rotational and Hinge Knee Prostheses</Name>
            <Description>Tibial Components</Description>
            <Size>Extra small - extra large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>157545</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA312</BillingCode>
            <Name>balanSys Tibial Baseplate</Name>
            <Description>Tibial Baseplate for Mobile Bearing Insert, cemented, CoCr</Description>
            <Size>59mm to 85mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>211085</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU077</BillingCode>
            <Name>GMK Mobile Cemented Tibia Tray</Name>
            <Description>Asymmetric mobile cemented tibial component</Description>
            <Size>1 to 6, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>210965</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU115</BillingCode>
            <Name>GMK Mobile Cemented Tibial Tray  - TiNbN coated</Name>
            <Description>Asymmetric mobile cemented tibial component, with TiNbN surface coating.</Description>
            <Size>1 to 6, left to right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>254615</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH422</BillingCode>
            <Name>Trekking Knee System, Tibial Component MB Cemented</Name>
            <Description>Tibial Component MB Cemented</Description>
            <Size>Size: T1 - T5&#xD;
Width (mm): 64 - 86&#xD;
Width (mm): Depth 42 - 57</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1359</GroupID>
            <ARTGs>
                <ARTG>287519</ARTG>
            </ARTGs>
            <MinimumBenefit>2006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE099</BillingCode>
            <Name>Active Knee Tibial Baseplate</Name>
            <Description>Tibial Baseplate, HA, uncemented, beaded, stemmed , CoCr</Description>
            <Size>Sizes 1 to 5 (A-Narrow &amp; B-Wide)</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>276963</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR273</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO193</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee, Tibial Base Plate - Porous</Name>
            <Description>Tibial Baseplate, Cementless</Description>
            <Size>Size 1 Left &amp; Right, Size 2 Left &amp; Right, Size 3 Left &amp; Right, Size 4 Left &amp; Right, Size 5 Left &amp; Right, Size 6 Left &amp; Right</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>287595</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW669</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ST648</PriorBillingCode>
                <PriorBillingCode>ST031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Scorpio Knee System - Tibial Baseplate</Name>
            <Description>Tibial baseplate, uncemented, alloy, hydroxyapatite (HA) coating.</Description>
            <Size>Sizes 3 - 13</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>145648</ARTG>
                <ARTG>146120</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ010</BillingCode>
            <Name>MRK (Medial Rotation Knee) Total Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, uncemented, Titanium with stippled surface titanium plasma spray HA coated</Description>
            <Size>1-5</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>117769</ARTG>
                <ARTG>192371</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ011</BillingCode>
            <Name>Saiph Knee System Tibial Component Cementless</Name>
            <Description>CoCr Tibial Component, Porous Titanium and HA</Description>
            <Size>A - F, Standard an Long Stem</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>117769</ARTG>
                <ARTG>192371</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU067</BillingCode>
            <Name>GMK Uncemented Fixed Tibia Tray</Name>
            <Description>Asymmetric uncemented fixed tibial component</Description>
            <Size>1 to 6, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>225045</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH426</BillingCode>
            <Name>Trekking Knee System, tibial component</Name>
            <Description>Tibial component uncemented</Description>
            <Size>1 - 5</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>165471</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF140</BillingCode>
            <Name>Active Knee Tibial Baseplate </Name>
            <Description>Tibial Baseplate, HA, uncemented, beaded, stemmed , CoCr</Description>
            <Size>Sizes 1 to 5 (A-Narrow &amp; B-Wide)</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>276963</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK326</BillingCode>
            <Name>Triathlon Knee System Tibial Baseplate</Name>
            <Description>Tibial baseplate, uncemented, beaded with PA (Hydroxyapatite), without screw holes, CoCr</Description>
            <Size>Sizes 1 to 8</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>146115</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN861</BillingCode>
            <Name>Genesis II Knee System Tibial Baseplate</Name>
            <Description>Tibial baseplate, cementless, titanium, beaded, HA for fixed insert</Description>
            <Size>Left / Right 1 - 8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <SubGroupID>3923</SubGroupID>
            <ARTGs>
                <ARTG>242855</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV023</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Tibial component, beaded, titanium</Description>
            <Size>0-6&#xD;
Standard, Plus</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>278306</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH613</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System-ACS Revision tibial component, cementless porous coated</Name>
            <Description>Revision tibial component, cementless porous coated, for use with augments and straight or offset stems.</Description>
            <Size>Left and Right, Sizes 2,3,3.5,4,5,6</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>265612</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU040</BillingCode>
            <Name>Evolis Knee System Tibial baseplate  </Name>
            <Description>Tibial baseplate, uncemented, titanium with titanium plasma spray, for fixed insert </Description>
            <Size>1 -6</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>205559</ARTG>
            </ARTGs>
            <MinimumBenefit>3314</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD020</BillingCode>
            <Name>3D Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, uncemented,  beaded, CoCr and Titanium</Description>
            <Size>Size 1 to 12</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <ARTGs>
                <ARTG>161909</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW656</BillingCode>
            <Name>Triathlon Tritanium Baseplate</Name>
            <Description>Triathlon Tritanium BP</Description>
            <Size>0-8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <ARTGs>
                <ARTG>281719</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI412</BillingCode>
            <Name>Natural Knee Tibial Baseplate CSTi </Name>
            <Description>Tibial Baseplate, uncemented,  Cancellous structure Titanium ingrowth surface for fixed inserts </Description>
            <Size>Size 00 to 5</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <ARTGs>
                <ARTG>228018</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI569</BillingCode>
            <Name>Nexgen Trabecular Metal Tibial Tray</Name>
            <Description>Nexgen Trabecular Metal Tibial Tray</Description>
            <Size>sizes 2, 3, 4, 5, 6, 7 &amp; 8</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <ARTGs>
                <ARTG>231503</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI989</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Persona TM tibial base plate</Description>
            <Size>A-J, left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1360</GroupID>
            <ARTGs>
                <ARTG>222393</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI295</BillingCode>
            <Name>NexGen Porous Tantalum Tibial Baseplate and Insert</Name>
            <Description>One piece Trabecular Metal (Tantalum) Tibial Baseplate and Insert UHMWPE (minimal and posterior constrained)</Description>
            <Size>Sizes 3 - 8, Height 10mm - 17mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1361</GroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>226498</ARTG>
                <ARTG>228177</ARTG>
            </ARTGs>
            <MinimumBenefit>2742</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI069</BillingCode>
            <Name>Score Knee System Tibial Baseplate </Name>
            <Description>Tibial baseplate, CoCr, uncemented, stippled surface, titanium plasma spray with HA</Description>
            <Size>9 Sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>271352</ARTG>
            </ARTGs>
            <MinimumBenefit>3842</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB233</BillingCode>
            <Name>Emotion Total Knee System (TKS) Tibial Baseplate</Name>
            <Description>Tibial baseplate, uncemented, CoCr, Titanium plasma spray (Plasmapore) with polished insert surface, HA coated for mobile insert</Description>
            <Size>T1 - T8</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR271</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Tibial Baseplate </Name>
            <Description>Tibial baseplate, CoCr,  uncemented, beaded, with Titanium plasma spray and HA for mobile bearing insert </Description>
            <Size>1-5</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>278988</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP035</BillingCode>
            <Name>MBT Knee System tibial baseplate </Name>
            <Description>Tibial baseplate, uncemented, CoCr, HA (Duofix), beaded (Porocoat) for rotating platform, ( non keeled only) </Description>
            <Size>Size 1-7</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>143525</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO157</BillingCode>
            <Name>RBK Universal Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, short keel,  uncemented, CoCr, beaded, with titanium plasma spray and HA, for mobile insert </Description>
            <Size>1 -5</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>143926</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Knee System - Genus Cementless Tibial Tray + HA</Name>
            <Description>Mobile Bearing Cementless Tibial Tray with HA coating</Description>
            <Size>1-7</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>232061</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH604</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - TCP coated tibial component</Name>
            <Description>Tibial base plate, TCP coated for use with mobile bearing insert, TiN coated</Description>
            <Size>Sizes 2-7</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>265621</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU076</BillingCode>
            <Name>GMK Uncemented mobile Tibia Tray</Name>
            <Description>Asymmetric uncemented mobile tibia with titanium porous coating by an hydroxyapatite coating</Description>
            <Size>1 to 6, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>210967</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH421</BillingCode>
            <Name>Trekking Knee System, Mobile Bearing Tibial Component</Name>
            <Description>Mobile Bearing Tibial Component</Description>
            <Size>Size: T1 - T5&#xD;
Width (mm) Depth: 42-57&#xD;
Width (mm): 64 - 86</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <SubGroupID>3924</SubGroupID>
            <ARTGs>
                <ARTG>287518</ARTG>
            </ARTGs>
            <MinimumBenefit>2654</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP031</BillingCode>
            <Name>MBT Knee System tibial baseplate </Name>
            <Description>Tibial baseplate, uncemented, CoCr, beaded (Porocoat) for rotating platform, (keeled and non keeled) </Description>
            <Size>Sizes 1 - 7</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>2494</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY377</BillingCode>
            <Name>MBT knee system tibial baseplate </Name>
            <Description>Tibial baseplate, uncemented, Titanium, TiN, beaded (Porocoat) for rotating platform, (non keeled only) </Description>
            <Size>Sizes 1 - 7</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <ARTGs>
                <ARTG>97700</ARTG>
            </ARTGs>
            <MinimumBenefit>2494</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO004</BillingCode>
            <Name>RBK Total Knee System Tibial Baseplate </Name>
            <Description>Tibial baseplate, CoCr, beaded, uncemented, for mobile bearing insert </Description>
            <Size>1-5</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <ARTGs>
                <ARTG>143923</ARTG>
                <ARTG>75734</ARTG>
            </ARTGs>
            <MinimumBenefit>2494</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO156</BillingCode>
            <Name>RBK Universal Knee System Tibial Baseplate </Name>
            <Description>Tibial Baseplate, short keel,  uncemented, CoCr, beaded, for mobile insert </Description>
            <Size>1 - 5</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <ARTGs>
                <ARTG>143926</ARTG>
            </ARTGs>
            <MinimumBenefit>2494</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH686</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO178</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee Porous Coated Tibia Component Cementless</Name>
            <Description>Tibial base plate porous coated for use with mobile bearing insert - TiN Coated</Description>
            <Size>2-7</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <ARTGs>
                <ARTG>265617</ARTG>
                <ARTG>265623</ARTG>
            </ARTGs>
            <MinimumBenefit>2494</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN274</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Rotating Platform Cementless Components</Description>
            <Size>Size 1-10</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>151</SubCategoryID>
            <GroupID>1362</GroupID>
            <ARTGs>
                <ARTG>290324</ARTG>
            </ARTGs>
            <MinimumBenefit>2494</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR091</BillingCode>
            <Name>Uniglide Uni Knee System Uni Tibial Component</Name>
            <Description>All poly uni tibial component, cemented</Description>
            <Size>Sizes 3, 5 &amp; 7, thicknesses 7mm to 13mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1363</GroupID>
            <ARTGs>
                <ARTG>216337</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Uni All Poly tibial Component</Name>
            <Description>Genus Uni All Poly cemented Tibial Component</Description>
            <Size>Sizes 1-6, RM/LL and LM/RL Heights 9-14mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1363</GroupID>
            <ARTGs>
                <ARTG>287901</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ778</BillingCode>
            <Name>Sigma HP Unicompartmental Knee - All poly tibial component</Name>
            <Description>Unicompartmental all poly tibial component UHMWPE cemented</Description>
            <Size>Size 1-6, 8-12mm LM/RL &amp; RM/LL</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1363</GroupID>
            <ARTGs>
                <ARTG>223645</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU070</BillingCode>
            <Name>GMK Unicompartmental Full - PE Tibia Component</Name>
            <Description>cemented unicompartmental all polyethylene fixed component</Description>
            <Size>1 to 5, left and right, 8/9/10/11/12/14mm  thicknesses</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1363</GroupID>
            <ARTGs>
                <ARTG>211419</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN337</BillingCode>
            <Name>Genesis Uni Tibial Baseplate</Name>
            <Description>Uni Tibial baseplate, all poly, cemented</Description>
            <Size>size 1-6</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1363</GroupID>
            <ARTGs>
                <ARTG>208340</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI108</BillingCode>
            <Name>Unicompartmental All-Poly Tibia</Name>
            <Description>All Poly Uni Tibial Baseplate, UHMWPE</Description>
            <Size>1 to 6</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1363</GroupID>
            <ARTGs>
                <ARTG>230850</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Uni Tibial Tray Cemented</Name>
            <Description>Genus Uni Tibial Component Cemented is part of the Genus Uni Unicompartmental system.</Description>
            <Size>Sizes 1-6 RM/LL and LM/RL</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>287898</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ780</BillingCode>
            <Name>Sigma HP Unicompartmental Knee - Fixed bearing tibial tray</Name>
            <Description>Unicompartmental tibial base plate, cemented, CoCr for fixed bearing insert</Description>
            <Size>Size 1-6, LM/RL &amp; RM/LL</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>224039</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA452</BillingCode>
            <Name>BalanSys UNI tibial baseplate </Name>
            <Description>Uni tibial baseplate for fixed bearing insert, cemented, CoCr</Description>
            <Size>1,2,3,4,5</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>212824</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU065</BillingCode>
            <Name>GMK Unicompartmental fixed tibial baseplate</Name>
            <Description>cemented unicompartmental fixed tibial component with peg and fixation keel</Description>
            <Size>1 to 5, left and right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>223022</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK497</BillingCode>
            <Name>Triathlon PKR - Cemented Tibial component</Name>
            <Description>Uni tibial baseplate, cemented, CoCR</Description>
            <Size>Size 1 to 6</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>224797</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK586</BillingCode>
            <Name>Restoris MCK Knee - Tibial Baseplate</Name>
            <Description>Tibial Baseplate</Description>
            <Size>LM/RL and RM/LL, sizes 1 to 8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>242174</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL070</BillingCode>
            <Name>Journey Knee System Tibial Uni Baseplate</Name>
            <Description>Uni Tibial Baseplate, Titanium, cemented, for fixed insert</Description>
            <Size>1-6</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>207003</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA078</BillingCode>
            <Name>Persona Partial Knee System</Name>
            <Description>Tibial baseplate</Description>
            <Size>C-J</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>336795</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI107</BillingCode>
            <Name>Unicompartmental Tibial Plate</Name>
            <Description>Uni 'Tibial baseplate, cemented, Titanium </Description>
            <Size>1 to 6</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1364</GroupID>
            <ARTGs>
                <ARTG>220169</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO060</BillingCode>
            <Name>LINK Endo-Model SLED Uni Tibial Tray </Name>
            <Description>Uni tibial tray including UHMWPE insert, cemented, CoCr tray</Description>
            <Size>7mm-13mm in 45, 50, 55 diameter</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1365</GroupID>
            <ARTGs>
                <ARTG>140653</ARTG>
            </ARTGs>
            <MinimumBenefit>1744</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA083</BillingCode>
            <Name>Oxford Meniscal Knee System Uni Tibial Baseplate   </Name>
            <Description>tibial baseplate</Description>
            <Size>AA-F</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1366</GroupID>
            <ARTGs>
                <ARTG>205937</ARTG>
                <ARTG>206061</ARTG>
                <ARTG>206976</ARTG>
            </ARTGs>
            <MinimumBenefit>1527</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Uni Tibial Tray Cementless</Name>
            <Description>Genus Uni Tibial Tray for cementless fixation using Ti-Por powder printed monolithic construct with HA Coating.</Description>
            <Size>Sizes 1-6 RM/LL and LM/RL</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1367</GroupID>
            <SubGroupID>3925</SubGroupID>
            <ARTGs>
                <ARTG>287899</ARTG>
            </ARTGs>
            <MinimumBenefit>1570</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI860</BillingCode>
            <Name>Oxford Meniscal Knee System Uni Tibial Baseplate </Name>
            <Description>Uni Tibial Baseplate, uncemented Titanium plasma sprayed surface (Porous plasma spray PPS) with HA (Phase III)</Description>
            <Size>(38-53) x (26-34)mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>152</SubCategoryID>
            <GroupID>1368</GroupID>
            <SubGroupID>3926</SubGroupID>
            <ARTGs>
                <ARTG>126863</ARTG>
            </ARTGs>
            <MinimumBenefit>1744</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK328</BillingCode>
            <Name>Triathlon Knee System Tibial Insert</Name>
            <Description>Minimally stabilised, tibial insert, UHMWPE, (N2VAC)</Description>
            <Size>Sizes 0 to 8 (9/11/13/16/19/22/25mm thickness)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>218000</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI450</BillingCode>
            <Name>Natural Knee Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, Highly crossed linked (Durasul PE), congruent and ultra congruent</Description>
            <Size>00 to 5, 9 to 22mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>220172</ARTG>
                <ARTG>222216</ARTG>
                <ARTG>228017</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI584</BillingCode>
            <Name>NexGen Prolong Flex Articulating Surface</Name>
            <Description>Highly Crosslinked - Ultra High Molecular Weight Polyethylene - Fixed Bearing - CR</Description>
            <Size>Height 10-20mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <Suffix>SCP</Suffix>
            <ARTGs>
                <ARTG>215512</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE251</BillingCode>
            <Name>Active Knee Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE</Description>
            <Size>Sizes 1 - 5 Thickness 6 - 17.5mm</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>276961</ARTG>
                <ARTG>276964</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB198</BillingCode>
            <Name>Emotion Total Knee System (TKS) Tibial Insert </Name>
            <Description>Tibial Insert, UHMWPE, mobile</Description>
            <Size>T1 to T8 Size: 10 to 24mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>96482</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB207</BillingCode>
            <Name>Columbus Total Knee System (TKS) Tibial Insert  </Name>
            <Description>Tibial Insert, UHMWPE, fixed </Description>
            <Size>T1 - T5</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI197</BillingCode>
            <Name>Rotating Platform Knee System</Name>
            <Description>Tibial Bearing, UHMWPE</Description>
            <Size>60-75mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>109966</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI888</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Tibial Bearing, CR, curved or lipped, UHMWPE</Description>
            <Size>59, 63/67, 71/75, 79/83, 87/91 widths, 10, 12, 14, 16, 18, 20mm thicknesses</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI976</BillingCode>
            <Name>Vanguard E-Poly CR Tibial bearing</Name>
            <Description>Vitamin E infused Highly Cross linked Polyethylene /cruciate Retaining Tibial bearing.</Description>
            <Size>59 to 91 x (10 -18mm)</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV004</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Minimally stabilised, fixed, tibial insert, UHMWPE</Description>
            <Size>1-8&#xD;
Standard, Plus&#xD;
Left, Right&#xD;
10-24mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>234318</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV020</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Minimally stabilised, fixed, tibial insert, UHMWPE</Description>
            <Size>0-6&#xD;
Left, Right&#xD;
10-25mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>278296</ARTG>
                <ARTG>278297</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR250</BillingCode>
            <Name>Unity Knee - Cruciate Retaining Insert</Name>
            <Description>Tibial Insert Cruciate Retaining</Description>
            <Size>Size 1 – 9, Thickness 9-20MM</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>223556</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR269</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Tibial Insert </Name>
            <Description>Tibial Insert, UHMWPE, mobile bearing</Description>
            <Size>1-5, 10-20mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>279249</ARTG>
                <ARTG>279791</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR278</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO159</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Universal Tibial Insert </Name>
            <Description>Tibial Insert, UHMWPE, fixed, requiring fixation with separate bolt </Description>
            <Size>Size 1- 5, 10mm - 20mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>279249</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR284</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO191</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee, Tibial Insert</Name>
            <Description>Tibial Insert, Standard, Ultra &amp; Congruent, UHMWPE &amp; ECiMa, Size 1-6, 10mm to 20mm</Description>
            <Size>Size 1, 10mm to 20mm, size 2, 10mm to 20mm, size 3, 10mm to 20mm, size 4, 10mm to 20mm, size 5, 10mm to 20mm, size 6, 10mm to 20mm.</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>278615</ARTG>
                <ARTG>388575</ARTG>
                <ARTG>271614</ARTG>
                <ARTG>388574</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD021</BillingCode>
            <Name>3D Knee System Tibial Insert </Name>
            <Description>Tibial insert, UHMWPE, fixed with lateral pivot with locking screw</Description>
            <Size>Size 1 to 12, 9mm to 19mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>161909</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP026</BillingCode>
            <Name>LCS Complete Knee System rotating platform tibial Insert </Name>
            <Description>Tibial insert, for rotating platform, UHMWPE </Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP166</BillingCode>
            <Name>PFC Sigma Knee System  tibial insert </Name>
            <Description>Tibial Insert, rotating platform UHMWPE</Description>
            <Size>Sizes  1 - 6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>137608</ARTG>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP238</BillingCode>
            <Name>LCS Classic and Universal Knee System meniscal bearing tibial Insert </Name>
            <Description>Tibial inserts, meniscal bearing medial and lateral (by 2 per procedure)</Description>
            <Size>Sizes small to large+. 10-20mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>136903</ARTG>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY481</BillingCode>
            <Name>PFC Sigma Knee System  tibial insert </Name>
            <Description>Tibial insert, UHMWPE, standard and posterior lipped</Description>
            <Size>Sizes  1 - 6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>137608</ARTG>
                <ARTG>138289</ARTG>
                <ARTG>97698</ARTG>
                <ARTG>98088</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA010</BillingCode>
            <Name>Optetrak Logic Total Knee System, Tibial Insert, CR</Name>
            <Description>Tibial Insert, UHMWPE, Fixed (Cruciate retained), Neutral, Slope +, Slope ++</Description>
            <Size>Size 0 - 6, 9 - 15mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>285442</ARTG>
                <ARTG>284907</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FL011</BillingCode>
            <Name>iTotal Cruciate-Retaining (CR) Total Knee Replacement System – Tibial Insert iPoly G2+</Name>
            <Description>UHMWPE polyethylene (iPoly) minimally stabilised tibial insert.</Description>
            <Size>Shape - Medial and Lateral; Thickness (Medial) - 6mm-16mm, patient-specific; Size (Lateral) - A-K, patient-specific</Size>
            <SupplierCode>FL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>377134</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FL012</BillingCode>
            <Name>iTotal Cruciate-Retaining (CR) Total Knee Replacement System – Tibial Insert iPoly XE</Name>
            <Description>UHMWPE Vitmain E infused polyethylene (iPoly XE) minimally stabilised tibial insert.</Description>
            <Size>Shape - Medial and Lateral; Thickness (Medial) - 6mm-16mm, patient-specific; Size (Lateral) - A-K, patient-specific </Size>
            <SupplierCode>FL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>377135</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO160</BillingCode>
            <Name>RBK Universal Tibial Insert </Name>
            <Description>Tibial Insert, UHMWPE, mobile bearing, requiring fixation with separate bolt </Description>
            <Size>1-5, 10mm - 20mm</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>143926</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Knee System - Genus PE Tibial Insert</Name>
            <Description>Genus PE Insert</Description>
            <Size>1-7 in thickness; 10mm, 12mm, 14mm, 17mm, 20mm, 24mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>232064</ARTG>
                <ARTG>232063</ARTG>
                <ARTG>232062</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW091</BillingCode>
            <Name>Duracon Knee System Tibial Insert </Name>
            <Description>Minimally stabilised, AP Lipped tibial insert, UHMWPE, (Duration)</Description>
            <Size>Small, Medium, Large, Extra-Large in each thickness 9mm, 11mm, 13mm, 16mm, 19mm, 22mm, 25mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>213154</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW102</BillingCode>
            <Name>Duracon Knee System Tibial Insert </Name>
            <Description>Minimally stabilised, tibial insert to match PCA femur with Duracon baseplate, UHMWPE (Duration)</Description>
            <Size>Small, Medium, Large, Extra-Large in each thickness 9mm, 11mm, 13mm, 16mm, 19mm, 22mm, 25mm, 28mm, 31mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>141151</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW160</BillingCode>
            <Name>Kinemax Knee System Tibial Insert</Name>
            <Description>Minimally stabilised, tibial insert, Low Stress, UHMWPE (Duration)</Description>
            <Size>8, 10, 12, 15, 18, 21, 25mm per size</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>141151</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW232</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Rotating Hinge Tibial Insert</Name>
            <Description>HMRS Rotating Hinge Tibial insert, UHMWPE (Duration), Fixed </Description>
            <Size>6, 10, 14mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>247553</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW248</BillingCode>
            <Name>MRH (Modular Rotating Hinge) &amp; GMRS (Global Modular Replacement System) Tibial Inserts</Name>
            <Description>MRH &amp; GMRS Tibial insert, (Duration) UHMWPE, for MRH and GMRS Tibial baseplate, CoCr (Vitallium), Fixed with central hole for Hinge</Description>
            <Size>xsmall - xlarge</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>223659</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW662</BillingCode>
            <Name>Scorpio FLEX CR insert</Name>
            <Description>CR Knee poly insert for Scorpio CR minor revisions</Description>
            <Size>3-11 in thicknesses 8, 10, 12, 15, 18, 21 &amp; 24</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>293035</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ509</BillingCode>
            <Name>PFC Sigma Knee System  tibial insert </Name>
            <Description>Tibial insert, UHMWPE, moderately cross linked</Description>
            <Size>Sizes  1 - 6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>97700</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ658</BillingCode>
            <Name>LCS Complete Knee System APG Tibial Insert</Name>
            <Description>Tibial Insert, Mobile, UHMWPE, used with APG guide arm only</Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>136903</ARTG>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ955</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Cruciate Retaining Insert</Description>
            <Size>1-10</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>220506</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH644</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO103</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee Minimmaly Stabilised Tibial Insert</Name>
            <Description>ACS PE Insert</Description>
            <Size>10, 12.5, 15, 17.5, 20mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>265624</ARTG>
                <ARTG>265632</ARTG>
                <ARTG>265640</ARTG>
                <ARTG>265641</ARTG>
                <ARTG>265643</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI070</BillingCode>
            <Name>Score Knee System Tibial Insert  </Name>
            <Description>Tibial Insert, mobile bearing, UHMWPE</Description>
            <Size>7 sizes, 5 thicknesses</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>135327</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO172</BillingCode>
            <Name>Link Endo Model Rotational and Hinge Knee Prostheses</Name>
            <Description>Plastic insert</Description>
            <Size>Extra small - Extra large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>157545</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA311</BillingCode>
            <Name>balanSys Tibial Mobile Insert</Name>
            <Description>Tibial Insert, Mobile bearing, UHMWPE,</Description>
            <Size>XS/8mm to F/20.5mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>211084</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA516</BillingCode>
            <Name>BalanSys Tibial Insert</Name>
            <Description>Tibial Insert, ultra congruent and minimally stabilised, UHMWPE</Description>
            <Size>59/8mm to 85/20.5mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>211081</ARTG>
                <ARTG>211087</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA550</BillingCode>
            <Name>balanSys vitamys Inlay</Name>
            <Description>Tibial insert - cruciate retaining, ultra congruent and rotating platform, minimally stabilised, vitamys</Description>
            <Size>59/8mm to 85/20.5mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>312503</ARTG>
                <ARTG>312504</ARTG>
                <ARTG>312505</ARTG>
                <ARTG>312506</ARTG>
                <ARTG>312507</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ012</BillingCode>
            <Name>MRK (Medial Rotation Knee) Total Knee System Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, Fixed</Description>
            <Size>1/2/3, 8-18mm thickness</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>117769</ARTG>
                <ARTG>192415</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU034</BillingCode>
            <Name>Evolis Knee System Tibial Insert   </Name>
            <Description>Tibial Insert, UHMWPE, fixed  </Description>
            <Size>1 - 6, 9/11/13/16/19mm thickness</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>204596</ARTG>
                <ARTG>205623</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU068</BillingCode>
            <Name>GMK Standard mobile tibial insert</Name>
            <Description>posterior cruciate retaining mobile polyethylene insert</Description>
            <Size>size 1 to 7, 10/12/14/17/20mm thickness</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>210968</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU071</BillingCode>
            <Name>GMK Standard Fixed Tibial Insert</Name>
            <Description>Fixed polyethylene insert</Description>
            <Size>1 to 6, left to right, 10/11/12/13/14/17/20mm thickness</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>132459</ARTG>
                <ARTG>211413</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU074</BillingCode>
            <Name>GMK ultracongruent Fixed tibial Insert</Name>
            <Description>Ultracongruent fixed polyethylene insert</Description>
            <Size>1 to 6, left to right, 10/12/14/17/20mm thickness</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>210969</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU092</BillingCode>
            <Name>UC fixed insert for Evolis tibial revision</Name>
            <Description>Polyethylene ultra-congruent fixed insert for Evolis tibial revision (using a GMK tibia)</Description>
            <Size>Size 1 to 6, each one available in 5 thicknesses: 10, 12, 14, 17 20mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>211448</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU146</BillingCode>
            <Name>GMK Sphere Flex Insert</Name>
            <Description>Fixed polyethylene insert</Description>
            <Size>1 to 6, 10-11-12-13-14-17-20 mm&#xD;
Left &amp; Right</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>211413</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH548</BillingCode>
            <Name>Trekking Knee System - Tibial Insert - CR</Name>
            <Description>Tibial Insert - CR</Description>
            <Size>Size: T1 - T5&#xD;
Thickness: -0 - +13</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>287503</ARTG>
                <ARTG>287505</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF143</BillingCode>
            <Name>Active Knee Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE</Description>
            <Size>Sizes 1 - 5 Thickness 6 - 17.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>276960</ARTG>
                <ARTG>276961</ARTG>
                <ARTG>276964</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK091</BillingCode>
            <Name>Duracon Knee System CS Lipped Tibial Insert</Name>
            <Description>Minimally stabilised, CS Lipped tibial insert, deep dish, UHMWPE, (Duration)</Description>
            <Size>XS,S,M,L,XL Thickness 9,11,13,16,19,22,25mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>216478</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK333</BillingCode>
            <Name>Scorpio NRG Knee System Tibial Insert </Name>
            <Description>Minimally stabilised tibial insert, UHMPWE (N2VAC)</Description>
            <Size>Sizes 3,4,5,6,7,9,11,13, x (8/10/12/15/18/21/24mm thickness)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>211472</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK431</BillingCode>
            <Name>Triathlon Knee System CS Lipped Insert</Name>
            <Description>Minimally stabilised, CS Lipped tibial insert deep dish, UHMWPE (N2VAC) </Description>
            <Size>Sizes 1-8 _small - large) size increments, 9mm, 11mm, 13mm, 16mm, 19mm, 22mm, 25mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>128028</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL002</BillingCode>
            <Name>Genesis II Knee System Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, fixed, without peg</Description>
            <Size>1-8; 9-25mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>207043</ARTG>
                <ARTG>207045</ARTG>
                <ARTG>207346</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL003</BillingCode>
            <Name>Profix Knee System Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, Fixed</Description>
            <Size>Left / Right 1 - 8</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>224640</ARTG>
                <ARTG>224641</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM174</BillingCode>
            <Name>Smith &amp; Nephew CR XLPE Insert</Name>
            <Description>Highly Cross-linked UHMWPE Cruciate Retaining Tibial Insert</Description>
            <Size>1-8, 9-21mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>280113</ARTG>
                <ARTG>208014</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN320</BillingCode>
            <Name>Genesis II Knee System Tibial Insert</Name>
            <Description>Tibial Insert for mobile insert, UHMWPE</Description>
            <Size>Left &amp; Right, Size 1-8, 9-15mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>242032</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR031</BillingCode>
            <Name>Triathlon Knee System Tibial Insert </Name>
            <Description>Minimally stabilised, mobile bearing tibial insert, UHMWPE (N2VAC)</Description>
            <Size>1 to 8, 9mm to 19mm</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>141151</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR076</BillingCode>
            <Name>Triathlon X3 CR Tibial Insert</Name>
            <Description>Intended use as part of a total knee system in primary cemented and primary uncemented total knee arthroplasty.</Description>
            <Size>Sizes 0-8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>216480</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR077</BillingCode>
            <Name>Scorpio NRG X3 CR Tibial Insert</Name>
            <Description>Intended use as part of a total knee system in primary cemented and primary uncemented total knee arthroplasty.</Description>
            <Size>Sizes 3,5,7,9,11 in thicknesses: 8,10,12,15,18,21,24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>211473</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR079</BillingCode>
            <Name>Triathlon X3 CS Lipped Tibial Insert</Name>
            <Description>Intended use as part of a total knee system in primary cemented and primary uncemented total knee arthroplasty.</Description>
            <Size>Sizes 0-8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>218019</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST032</BillingCode>
            <Name>Scorpio Knee System Tibial Insert</Name>
            <Description>Minimally stabilised, mobile bearing tibial insert, UHMWPE (N2VAC)</Description>
            <Size>8-24mm for all tibia sizes</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>128031</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST608</BillingCode>
            <Name>Scorpio Knee System Tibial Insert</Name>
            <Description>Minimally stabilised tibial insert, UHMWPE (N2VAC)</Description>
            <Size>Size: 3-11  Thickness: 8-24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>211471</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST912</BillingCode>
            <Name>Duracon ISA Knee System Tibial Insert</Name>
            <Description>Minimally stabilised, mobile bearing tibial insert, UHMWPE (Duration)</Description>
            <Size>Small, medium, large, X-large - left, right</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>141151</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA058</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Medial Congruent tibial insert</Description>
            <Size>10-20mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>290973</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI134</BillingCode>
            <Name>NexGen Tibial Insert</Name>
            <Description>Tibial Insert, fixed, standard and anterior lipped, UHMWPE</Description>
            <Size>9 - 23 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>95761</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI135</BillingCode>
            <Name>NexGen Tibial Insert </Name>
            <Description>Ant. Constr. - UHMWPE</Description>
            <Size>9 - 23mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>220921</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI917</BillingCode>
            <Name>Natural Knee Flex Rotating Platform Articular Surface</Name>
            <Description>Tibial insert, UHMWPE, mobile insert</Description>
            <Size>0 to 5, 9 to 22mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>219733</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI962</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>CR and UC tibial insert</Description>
            <Size>10-18  mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1369</GroupID>
            <ARTGs>
                <ARTG>261282</ARTG>
                <ARTG>261284</ARTG>
                <ARTG>261275</ARTG>
                <ARTG>261276</ARTG>
            </ARTGs>
            <MinimumBenefit>992</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB199</BillingCode>
            <Name>Emotion Total Knee System (TKS) Tibial Insert </Name>
            <Description>Tibial Insert, UHMWPE, mobile, posterior stabilised with peg</Description>
            <Size>T1 to T8 Sizes: 10 to 24mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>96482</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB209</BillingCode>
            <Name>Columbus Total Knee System (TKS) Tibial Insert  </Name>
            <Description>Tibial Insert, UHMWPE, fixed, posterior stabilised with included screw for fixation to baseplate</Description>
            <Size>T1 - T5</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI885</BillingCode>
            <Name>ROCC Tibial Insert</Name>
            <Description>Tibial Insert, mobile bearing, rotating platform, UHMWPE</Description>
            <Size>1-6 (tray size), 10-20mm (bearing size)</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>104298</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI975</BillingCode>
            <Name>Vanguard E-Poly PS bearing</Name>
            <Description>Vitamin E infusion Highly Cross linked Polythylene Posterior Stabilised Tibial Bearing</Description>
            <Size>59 - 91 x (10 - 18mm)</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV019</BillingCode>
            <Name>Advance Medial Pivot Knee system</Name>
            <Description>Posterior stabilised, fixed tibial insert, UHMWPE</Description>
            <Size>1-6&#xD;
10-25mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>238893</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR261</BillingCode>
            <Name>Unity Knee – Posterior Stabilised Insert</Name>
            <Description>Tibial Insert Posterior Stabilised</Description>
            <Size>Size 1 – 9, Thickness 9-20MM</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>223557</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP270</BillingCode>
            <Name>SROM Noiles Knee System tibial insert</Name>
            <Description>Tibial insert, UHMWPE, posterior stabilised, rotating platform</Description>
            <Size>Xsm-lrg. 10-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY372</BillingCode>
            <Name>LCS Complete Knee System rotating platform tibial insert </Name>
            <Description>Tibial insert, rotating platform with post, UHMWPE </Description>
            <Size>Sizes small to large+. 10-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY405</BillingCode>
            <Name>PFC Sigma Knee System RPF tibial insert</Name>
            <Description>Tibial insert, UHMWPE, rotating platform for high flex with post </Description>
            <Size>Size 1 - 6.  10-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>97698</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY457</BillingCode>
            <Name>PFC Sigma Knee System  tibial insert </Name>
            <Description>Tibial insert, posterior stabilised, rotating platform UHMWPE</Description>
            <Size>Sizes  1 - 6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA012</BillingCode>
            <Name>Optetrak Logic Total Knee System, Tibial Insert, PS</Name>
            <Description>Tibial Insert, UHMWPE, Fixed (Posterior Stabilised)</Description>
            <Size>Size 0 - 6, 9-15mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>285502</ARTG>
                <ARTG>285503</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA014</BillingCode>
            <Name>Optetrak Logic Total Knee System, RBK Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, mobile, posterior stabilised</Description>
            <Size>Size 1 - 5, 9 - 15mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>285911</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO257</BillingCode>
            <Name>Apex Revision Knee Tibial Insert</Name>
            <Description>Apex Revision Knee Tibial Insert</Description>
            <Size>size 1 to 6mm x 10 to 28mm</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>196653</ARTG>
                <ARTG>282757</ARTG>
                <ARTG>282762</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW092</BillingCode>
            <Name>Duracon Knee System Tibial Insert </Name>
            <Description>Posterior stabilised tibial insert, with reinforcing pin, UHMWPE, (Duration) </Description>
            <Size>Small, Medium, Large, Extra-Large in each thickness 9mm, 11mm, 13mm, 16mm, 19mm, 22mm, 25mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>128028</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ508</BillingCode>
            <Name>PFC Sigma Knee System  tibial insert </Name>
            <Description>Tibial insert, UHMWPE, moderately cross linked, with peg </Description>
            <Size>Sizes  1 - 6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>97700</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ665</BillingCode>
            <Name>PFC Sigma Knee System Tibial Insert</Name>
            <Description>Tibial insert, posterior stabilised, UHMWPE, with post</Description>
            <Size>Sizes 1-6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ956</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Posterior Stabilised Insert</Description>
            <Size>1-10</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>213019</ARTG>
                <ARTG>220507</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH645</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO104</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee - Posterior Stabilised Tibial Insert</Name>
            <Description>ACS Posterior Stabilised Tibial PE Insert</Description>
            <Size>10, 12.5, 15, 17.5, 20mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>265625</ARTG>
                <ARTG>265626</ARTG>
                <ARTG>265639</ARTG>
                <ARTG>265642</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI071</BillingCode>
            <Name>Score Knee System Tibial Insert  </Name>
            <Description>Tibial Insert, mobile bearing, posterior stabilised with reinforcement post</Description>
            <Size>20 sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>210526</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI113</BillingCode>
            <Name>Anatomic Fixed Bearing Insert</Name>
            <Description>Posterior stabilised, fixed bearing polyethylene insert</Description>
            <Size>Size 0 to 8  Heights 10 to 20</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>222532</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA489</BillingCode>
            <Name>balanSys Tibial Insert</Name>
            <Description>Tibial insert, posterior stabilised UHMWPE</Description>
            <Size>59/8mm to 85/23mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>211054</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA510</BillingCode>
            <Name>Balansys Revision Knee, Tibial Insert</Name>
            <Description>Tibial insert, contrained, with stabilising screw for reinforcement</Description>
            <Size>64/10.5 to 85/23</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>210625</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA549</BillingCode>
            <Name>balanSys vitamys Inlay</Name>
            <Description>Tibial insert, posterior stabilised, vitamys</Description>
            <Size>59/8 to 85/20.5</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>312503</ARTG>
                <ARTG>312504</ARTG>
                <ARTG>312505</ARTG>
                <ARTG>312506</ARTG>
                <ARTG>312507</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ013</BillingCode>
            <Name>Saiph Knee System APS Tibial Insert</Name>
            <Description>Compression Moulded Anterior Posterior Stablilised Tibial Bearing</Description>
            <Size>A - F, Left &amp; Right 10 - 20mm</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>117769</ARTG>
                <ARTG>192415</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU032</BillingCode>
            <Name>Evolis Knee System Tibial Insert   </Name>
            <Description>Tibial Insert, UHMWPE, fixed, posterior stabilised </Description>
            <Size>1 - 6, 9/11/13/16/19mm thickness</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>205560</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU059</BillingCode>
            <Name>GMK Posterior Stabilised fixed tibial insert</Name>
            <Description>Posterior Stabilised fixed polyethylene insert</Description>
            <Size>size 1 to 6, 10/12/14/17/20mm thickness</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>140176</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU073</BillingCode>
            <Name>GMK Ultracongruent Mobile Tibial Insert</Name>
            <Description>Ultracongruent Mobile Polyethylene  Insert</Description>
            <Size>size 1 to 7, 10/12/14/17/20mm thickness</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>210980</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU090</BillingCode>
            <Name>PS fixed insert for Evolis tibial revision</Name>
            <Description>Polyethylene posterior-stabilised fixed insert for Evolis tibial revision (using a GMK tibia)</Description>
            <Size>Size 1 to 6, each one available in 5 thicknesses: 10, 12, 14, 17 20mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>211449</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU091</BillingCode>
            <Name>GMK Revision semi-constrained fixed tibial insert</Name>
            <Description>Semi-constrained Posterior Stabilised fixed Tibial Insert</Description>
            <Size>Size 1 to 6, each one available in 8 thicknesses: 10, 12, 14, 17, 20, 23, 26, 29mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>211428</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH420</BillingCode>
            <Name>Trekking Knee System, Tibial Insert</Name>
            <Description>Tibial Insert</Description>
            <Size>Size: T1 - T5&#xD;
Thickness: +0 - +7</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>287506</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH549</BillingCode>
            <Name>Trekking Knee System, Tibial Insert - PS</Name>
            <Description>Tibial Insert - PS</Description>
            <Size>Size: T1 - T5&#xD;
Thickness: +0 - +13</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>287504</ARTG>
                <ARTG>287509</ARTG>
                <ARTG>287510</ARTG>
                <ARTG>287511</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL005</BillingCode>
            <Name>Genesis II Knee System Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, Posterior Stabalised with peg, Fixed</Description>
            <Size>SZ 1-8; 9-25mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>207042</ARTG>
                <ARTG>207044</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL168</BillingCode>
            <Name>Journey II BCS XLPE Insert</Name>
            <Description>Highly cross-linked UHMWPE tibial insert</Description>
            <Size>1-8 Left/Right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>370845</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM175</BillingCode>
            <Name>Smith &amp; Nephew PS XLPE Inserts</Name>
            <Description>Highly Cross-linked UHMWPE Posterior Stabilized Tibial Insert</Description>
            <Size>1-8; 9-25mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>208015</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN780</BillingCode>
            <Name>Journey Knee System Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, Fixed posterior stabilised with peg</Description>
            <Size>8-30mm, 1-10</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>278110</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN876</BillingCode>
            <Name>Profix Knee System Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, posterior stabilised with peg, fixed</Description>
            <Size>1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>224649</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR002</BillingCode>
            <Name>Triathlon Knee System Tibial Insert </Name>
            <Description>Posterior stabilised insert, UHMWPE,(N2VAC) </Description>
            <Size>Sizes 0 to 8 (9/11/13/16/19/22/25mm thickness)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>219399</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR008</BillingCode>
            <Name>Scorpio Knee System Tibial Insert</Name>
            <Description>Posterior stabilised tibial insert, UHMWPE (N2VAC)</Description>
            <Size>8-18mm in 2mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>211470</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR012</BillingCode>
            <Name>Scorpio NRG Knee System Tibial Insert </Name>
            <Description>Posterior stabilised tibial insert, UHMWPE, (N2VAC)</Description>
            <Size>Sizes 3,4,5,6,7,9,11,13, x (8/10/12/15/18/21/24mm thickness)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>211460</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR013</BillingCode>
            <Name>Scorpio Knee System Tibial Insert</Name>
            <Description>Posterior stabilised mobile bearing insert,  UHMWPE (N2VAC)</Description>
            <Size>10,12,15,18, 21mm thickness; sizews 3,5,7,9,11,13</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>141151</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR020</BillingCode>
            <Name>S7000 Tibial Insert </Name>
            <Description>Posterior stabilised tibial insert, UHMWPE, (N2VAC), used for series 7000 revisions </Description>
            <Size>3, 5, 7, 9, 11, 13 in 8, 10, 12, 15, 18, 21,24mm</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>128028</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR032</BillingCode>
            <Name>Triathlon Knee System Tibial Insert</Name>
            <Description>Posterior stabilised mobile bearing insert, UHMWPE (N2VAC)</Description>
            <Size>1 to 8, 9mm to 22mm</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>141151</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR074</BillingCode>
            <Name>Triathlon X3 PS Tibial Insert</Name>
            <Description>Intended use as part of a total knee system in primary cemented and primary uncemented total knee arthroplasty. Intended to be used in situation where the posterior cruciate ligament is absent, or cannot be preserved.</Description>
            <Size>Sizes 0-8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>218200</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR078</BillingCode>
            <Name>Scorpio NRG X3 PS tibial Insert</Name>
            <Description>intended to be used in situations where the posterior cruciate ligament is absent, or cannot be preserved.</Description>
            <Size>3,5,7,9,11 in thickness: 8,10,12,15,18,21,24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>211474</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST925</BillingCode>
            <Name>Scorpio Knee System SuperFlex Tibial Insert </Name>
            <Description>Posterior stabilised tibial insert, SuperFlex, UHMWPE (N2VAC)</Description>
            <Size>3, 5, 7, 9 , 11, 13 in thickness 8, 10, 12, 15, 18, 21, 24mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>211482</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI057</BillingCode>
            <Name>NexGen Flex Tibial Insert </Name>
            <Description>Tibial Insert, fixed, posterior stabilised, high flex, UHMWPE</Description>
            <Size>Sizes 9 - 23mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>230874</ARTG>
                <ARTG>230875</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI058</BillingCode>
            <Name>NexGen LPS Tibial Insert </Name>
            <Description>Tibial Insert, posterior stabilised, UHMWPE, mobile </Description>
            <Size>Sizes 9 - 23mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>222233</ARTG>
                <ARTG>222625</ARTG>
                <ARTG>230874</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI586</BillingCode>
            <Name>NexGen Prolong Flex Articulating Surface</Name>
            <Description>Highly Crosslinked - Ultra high Molecular Weight Polyethylene - Fixed Bearing - LPS</Description>
            <Size>Sizes 1 to 10, 9mm to 23mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>222148</ARTG>
                <ARTG>230873</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI587</BillingCode>
            <Name>NexGen Prolong Flex Articulating Surface</Name>
            <Description>Highly Crosslinked - Ultra high Molecular Weight Polyethylene - Mobile Bearing - LPS</Description>
            <Size>Sizes 1 to 10, 9mm to 23mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>222990</ARTG>
                <ARTG>223747</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI934</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Persona PS Articular Surface</Description>
            <Size>10-20 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1370</GroupID>
            <ARTGs>
                <ARTG>261277</ARTG>
                <ARTG>261280</ARTG>
                <ARTG>261281</ARTG>
            </ARTGs>
            <MinimumBenefit>1020</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB352</BillingCode>
            <Name>EnduRo Rotating Hinge Knee Meniscal component includes Rotation Axle, PEEK bushing and Tibial locking nut</Name>
            <Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to&#xD;
treat complex revision knee arthoplasty as well as unstable knees</Description>
            <Size>Meniscal Components to match Femoral component 1-3 10mm-24mm includes rotation axle,&#xD;
PEEK bushing and Tibial locking nut.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <Suffix>Axle included</Suffix>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>1726</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB389</BillingCode>
            <Name>AS EnduRo Meniscal Component</Name>
            <Description>EnduRo Rotating Hinge Knee Meniscal Component AS (Advanced Surface)</Description>
            <Size>Sizes 1-3 10mm-24mm includes rotation axle, PEEK bushing and Tibial locking nut</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <Suffix>Axle included</Suffix>
            <ARTGs>
                <ARTG>312502</ARTG>
            </ARTGs>
            <MinimumBenefit>1726</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB392</BillingCode>
            <Name>Columbus Revision Tibial Insert</Name>
            <Description>Columbus Revision Gliding Surface</Description>
            <Size>10mm - 32mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>312587</ARTG>
                <ARTG>312588</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI904</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Tibial Bearing, PS, PS+.  UHMWPE</Description>
            <Size>(59 to 91)mm width x (10 to 24)mm thickness</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI939</BillingCode>
            <Name>Vanguard SSK Knee System</Name>
            <Description>Tibial Bearing Insert, PSC, UHMWPE</Description>
            <Size>59-75mm x (10-24mm)</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV010</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>totally constrained, UHMWPE, fixed tibial insert with reinforcing peg</Description>
            <Size>1, 2, 3, 4, 5, 6 in 10 - 30mm in 2mm increments</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>238894</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV056</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision CCK Tibial Insert</Description>
            <Size>Sizes 3-8  10mm - 24mm  Standard, Plus</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>317613</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP257</BillingCode>
            <Name>SROM Noiles Knee System tibial insert</Name>
            <Description>Tibial insert, rotating platform, hinged, with metal axis ring incorporated and polyethylene axis bearings</Description>
            <Size>Sizes: XS, S, M; Thickness: 12mm - 31mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>219089</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY367</BillingCode>
            <Name>PFC Sigma TC3 Knee System  Tibial Insert </Name>
            <Description>Tibial Insert, totally constrained, mobile bearing, UHMWPE, with post</Description>
            <Size>Size 1.5 to 5 thickness of 10mm to 30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX028</BillingCode>
            <Name>Optetrak Total Knee System Tibial Insert</Name>
            <Description>Tibial Insert, UHMWPE, fixed and totally stabilised with peg and reinforced with screw/post fixation (Spine stiffening screw)</Description>
            <Size>Size 1 - 5, 1 Delta</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>277743</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ532</BillingCode>
            <Name>LCS Complete Knee System tibial insert </Name>
            <Description>Tibial insert, UHMWPE, rotating platform, totally constrained, with reinforcing post  </Description>
            <Size>Sizes small to large+. 10-25mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>259354</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ664</BillingCode>
            <Name>PFC Sigma Knee System TC3 Tibial Insert</Name>
            <Description>Tibial insert, totally constrained, UHMWPE, with post</Description>
            <Size>Sizes 1-6.  8-30mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH701</BillingCode>
            <Name>MUTARS GenuX PE Insert</Name>
            <Description>MUTARS GenuX PE Insert</Description>
            <Size>Size: 2 - 6  Height : 12.5, 15, 17.5 mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>238794</ARTG>
                <ARTG>250453</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN223</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Revision totally constrained tibial insert, fixed and mobile bearing</Description>
            <Size>Size 1 - 10</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>298540</ARTG>
                <ARTG>298541</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU101</BillingCode>
            <Name>GMK Hinge fixed tibial insert</Name>
            <Description>Tibial Insert for GMK Hinge prosthesis, UHMWPE, fixed, includes hinge locking post</Description>
            <Size>1 to 6 10-26mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>211410</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH415</BillingCode>
            <Name>Samo TCK Revision Knee System</Name>
            <Description>TCK poly insert</Description>
            <Size>1-5,6-19mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>165471</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF135</BillingCode>
            <Name>SHiVA Modular Knee Prosthesis - Rotating Bearing</Name>
            <Description>Rotating Bearing</Description>
            <Size>Sizes 2,3 and 4 x 10mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>192962</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK438</BillingCode>
            <Name>Triathlon TS Knee System Tibial Insert</Name>
            <Description>Totally constrained, TS (Total Stabilizer) Insert, with metal post, UHMWPE (X3)</Description>
            <Size>Tibial Insert Sizes: Left &amp; right 9-31mm sizes 1-8&#xD;
Reinforced Post Sizes 9-31mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>219400</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL169</BillingCode>
            <Name>Journey II BCS Constrained Insert</Name>
            <Description>Tibial insert, UHMWPE, totally constrained</Description>
            <Size>1-8; Left/Right</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>370846</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM161</BillingCode>
            <Name>Legion Hinge Guided Motion Tibial Insert</Name>
            <Description>This tibial insert is used for the construction of the Legion hinge.</Description>
            <Size>Sizes 2-7 11,13,15,18,21mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>232075</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN863</BillingCode>
            <Name>Genesis II Knee System Tibial Insert</Name>
            <Description>Tibial insert, UHMWPE, fixed, totally constrained</Description>
            <Size>Left / Right 1 - 8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>207342</ARTG>
                <ARTG>231595</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST024</BillingCode>
            <Name>Scorpio Knee System Tibial Insert</Name>
            <Description>Totally constrained tibial insert, with metal post, UHMWPE (X3)</Description>
            <Size>8-24mm for all tibia sizes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>211475</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST601</BillingCode>
            <Name>Duracon TS Knee System Tibial Insert</Name>
            <Description>Totally constrained tibial insert, with metal post, UHMWPE (Duration)</Description>
            <Size>Extra Small, Small, Medium, Medium Large, Large, Extra Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>218199</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA092</BillingCode>
            <Name>Persona Revision CCK Vivacit-E Articular Surface</Name>
            <Description>Vitamin E blended polyethylene (Vivacit- E®) with a Tivanium® Ti- 6Al-4V insert and lockdown screw</Description>
            <Size>AB, CD, EF, GH, and J in left and right confugrations</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>374552</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI137</BillingCode>
            <Name>NexGen LCCK Tibial Insert</Name>
            <Description>Tibial Insert, totally constrained, UHMWPE, fixed, with post</Description>
            <Size>10 - 35mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>214760</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI307</BillingCode>
            <Name>Nexgen Rotating Hinge Tibial Insert</Name>
            <Description>Tibial insert for NexGen Rotating Hinge prosthesis, UHMWPE, mobile. Includes hinge locking post.</Description>
            <Size>12-26mm, sizes B-F</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>153</SubCategoryID>
            <GroupID>1371</GroupID>
            <ARTGs>
                <ARTG>220053</ARTG>
            </ARTGs>
            <MinimumBenefit>1090</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI861</BillingCode>
            <Name>Oxford Meniscal Knee System Uni Tibial Insert </Name>
            <Description>Uni Tibial Insert conforming surface, mobile bearing, UHMWPE (Phase III)</Description>
            <Size>(Small - Extra Large) x (3-9)</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>126863</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR060</BillingCode>
            <Name>Uniglide Uni Knee System Uni Tibial Insert </Name>
            <Description>Uni tibial insert, mobile bearing, UHMWPE</Description>
            <Size>Height 4, 5, 6, 7, 8, 9, 10, 11, 12mm; Size 1-4</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>106748</ARTG>
                <ARTG>115743</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Uni Tibial Insert</Name>
            <Description>Genus Uni Tibial Insert for use with Genus Uni Tibial Tray</Description>
            <Size>Heights 9-14, Size 1-6, RM/LL, LM/RL</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>287900</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW657</BillingCode>
            <Name>Restoris MCK System, X3® Uni Tibial Onlay Insert</Name>
            <Description>Uni Tibial Onlay Insert, Highly Crosslinked Polyethylene, fixed bearing</Description>
            <Size>sizes 1 - 8 &amp; thickness 8mm - 12mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>283846</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ779</BillingCode>
            <Name>Sigma HP Unicompartmental Knee - Fixed bearing insert</Name>
            <Description>Unicompartmental tibial insert, fixed bearing UHMWPE</Description>
            <Size>Size 1-6, 7-11mm LM/RL &amp; RM/LL</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>233187</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA454</BillingCode>
            <Name>BalanSys UNI tibial Insert </Name>
            <Description>Uni tibial insert, UHMWPE, fixed </Description>
            <Size>5,6,7,9</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>212830</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA548</BillingCode>
            <Name>balanSys Uni vitamys Inlay</Name>
            <Description>Uni tibial insert, vitamys</Description>
            <Size>5,6,7,9</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>312503</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU062</BillingCode>
            <Name>GMK Unicompartmental fixed tibia insert</Name>
            <Description>cemented unicompartmental polyethylene fixed tibial insert</Description>
            <Size>1 to 5, left and right, 8/9/10/11/12/14mm thiknesses</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>223023</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK498</BillingCode>
            <Name>Triathlon PKR - X3 Polyethylene Tibial insert</Name>
            <Description>Uni tibial insert, X3 polyethylene, fixed</Description>
            <Size>Size 1 to 6, thicknesses from 8mm to 12mm</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>224841</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK587</BillingCode>
            <Name>Restoris MCK Knee - Tibial Onlay Insert</Name>
            <Description>Tibial Onlay Insert</Description>
            <Size>Tibial Onlay Insert come in sizes 1 to 8, each size with 8, 9, 10 and 12mm thickness options</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>242173</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN837</BillingCode>
            <Name>Journey Knee System Uni Tibial Insert</Name>
            <Description>Uni Tibial Insert, for fixed bearing, UHMWPE</Description>
            <Size>size 1-6, 8-11mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>207002</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST656</BillingCode>
            <Name>UNIX Unicompartmental Knee System Tibial Insert</Name>
            <Description>Uni tibial insert, UHMWPE, Fixed</Description>
            <Size>1, 2, 3, 4 in 8, 10, 12, 15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>216613</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA076</BillingCode>
            <Name>Persona Partial Knee System</Name>
            <Description>Tibial insert</Description>
            <Size>8-14mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>336794</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI105</BillingCode>
            <Name>Unicompartmental Tibial Insert</Name>
            <Description>Uni Tibial Insert, UHMWPE, fixed </Description>
            <Size>8 - 14 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>154</SubCategoryID>
            <GroupID>1372</GroupID>
            <ARTGs>
                <ARTG>220168</ARTG>
            </ARTGs>
            <MinimumBenefit>689</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW988</BillingCode>
            <Name>RESTORIS MCK Patellofemoral (PF) Knee System - Patellofemoral component</Name>
            <Description>Trochlear component, CoCr, cemented</Description>
            <Size>sizes 2-8, Left &amp; Right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>155</SubCategoryID>
            <GroupID>1374</GroupID>
            <ARTGs>
                <ARTG>242175</ARTG>
            </ARTGs>
            <MinimumBenefit>2399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST600</BillingCode>
            <Name>Avon Patello Femoral System Femoral Component</Name>
            <Description>Trochlear component, CoCr (Vitallium), cemented</Description>
            <Size>Extra Small, Small, Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>155</SubCategoryID>
            <GroupID>1374</GroupID>
            <ARTGs>
                <ARTG>217761</ARTG>
            </ARTGs>
            <MinimumBenefit>2399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI563</BillingCode>
            <Name>Zimmer Gender Solutions Patellofemoral Joint System</Name>
            <Description>Patellofemoral joint fem implant PMMA precoat</Description>
            <Size>Sizes 1 - 5 - Left &amp; Right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>155</SubCategoryID>
            <GroupID>1374</GroupID>
            <ARTGs>
                <ARTG>212228</ARTG>
            </ARTGs>
            <MinimumBenefit>2399</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN834</BillingCode>
            <Name>Journey Knee System Patella Femoral Replacement Trochlear Component</Name>
            <Description>Trochlear Component,cemented, Oxinium</Description>
            <Size>Sm, Med Lg, XLg</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>155</SubCategoryID>
            <GroupID>1375</GroupID>
            <Suffix>Ceramic Surface</Suffix>
            <ARTGs>
                <ARTG>242492</ARTG>
            </ARTGs>
            <MinimumBenefit>2616</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AE050</BillingCode>
            <Name>Active Knee Patella</Name>
            <Description>Patella, cemented, UHMWPE</Description>
            <Size>Sizes 1 - 5</Size>
            <SupplierCode>AE</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>276965</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB375</BillingCode>
            <Name>Aesculap Patella 3-Pegs</Name>
            <Description>All poly patellar, UHMWPE cemented, 3 pegs</Description>
            <Size>P1 - P5</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>293939</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI176</BillingCode>
            <Name>Biomet Universal Patellar component</Name>
            <Description>All poly Patella, cemented, UHMWPE, domed  </Description>
            <Size>size 25 to 37mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>121186</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI899</BillingCode>
            <Name>ROCC Patellar Component</Name>
            <Description>All poly Patella, cemented, UHMWPE, anatomically shaped</Description>
            <Size>1-8</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>226054</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV011</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>All Poly Patella, Recessed, Onlay, Tri-Peg, Low-Dome, High-Dome</Description>
            <Size>25-41mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>278303</ARTG>
                <ARTG>278304</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR252</BillingCode>
            <Name>Unity Knee – Patella</Name>
            <Description>Patella Cemented</Description>
            <Size>Sizes 1 – 5</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>223558</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR268</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Patella component</Name>
            <Description>Patella component All poly, UHMWPE, cemented, 3 pegs</Description>
            <Size>24mm - 40mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>279233</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR282</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO189</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee, All-Poly Patella</Name>
            <Description>All-Poly Dome 3 Peg Patella, ECiMa or UHMWPE</Description>
            <Size>26mm x 10mm &amp; 8mm, 29mm x 10mm &amp; 8mm, 32mm x 10mm &amp; 8mm, 35mm x 10mm &amp; 8mm, 38mm x 10mm &amp; 8mm, 41mm x 10mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>388573</ARTG>
                <ARTG>278529</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DD022</BillingCode>
            <Name>3D Knee System Patellar component </Name>
            <Description>All poly, cemented patella, 3 pegs </Description>
            <Size>Size 26 to 38mm</Size>
            <SupplierCode>DD</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>161909</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP152</BillingCode>
            <Name>PFC Sigma Knee System</Name>
            <Description>Cemented, all poly, patella</Description>
            <Size>25-50mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>108414</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP264</BillingCode>
            <Name>SROM Noiles Knee System patella</Name>
            <Description>All poly, cemented patella </Description>
            <Size>Sizes 30 - 38mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>219087</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP524</BillingCode>
            <Name>LCS Complete Knee System patella component </Name>
            <Description>All Poly patella, UHMWPE, cemented</Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>108414</ARTG>
                <ARTG>97697</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX038</BillingCode>
            <Name>Optetrak Total Knee System</Name>
            <Description>Patellar</Description>
            <Size>26-41mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>279041</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FL009</BillingCode>
            <Name>iTotal Cruciate-Retaining (CR) Total Knee Replacement System – iTotal Patella Implant, iPoly XE</Name>
            <Description>Highly cross-linked ultra high molecular weight Vitamin-E enriched polyethylene (iPoly XE) patella component, cemented.</Description>
            <Size>29x6mm, 32x6mm, 35x7mm, 38x8.5mm, 41x10mm, 44x12mm </Size>
            <SupplierCode>FL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>377132</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FL010</BillingCode>
            <Name>iTotal Cruciate-Retaining (CR) Total Knee Replacement System – iTotal Patella Implant, iPoly</Name>
            <Description>Highly cross-linked ultra high molecular weight polyethylene (iPoly) patella component, cemented.</Description>
            <Size>29x6mm, 32x6mm, 35x7mm, 38x8.5mm, 41x10mm, 44x12mm </Size>
            <SupplierCode>FL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>377133</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Knee System - Genus PE Patella</Name>
            <Description>Polyethylene Patella</Description>
            <Size>20, 23, 26, 27, 30, 33, 36mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>232065</ARTG>
                <ARTG>232066</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW105</BillingCode>
            <Name>Duracon Knee System Patella Component</Name>
            <Description>Patella component, UHMWPE (Duration), cemented</Description>
            <Size>Small, Medium, Large, Xlarge</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>212696</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW140</BillingCode>
            <Name>Kinemax Knee System Patella Component</Name>
            <Description>Patella component Symmetric &amp; Asymmetric, UHMWPE (Duration), cemented</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>224198</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW182</BillingCode>
            <Name>PCA Modular Knee System Patella Component</Name>
            <Description>Patella component, UHMWPE, (Duration), cemented</Description>
            <Size>Small, Medium, Large, Extra Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>139146</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW989</BillingCode>
            <Name>RESTORIS MCK Patellofemoral (PF) Knee System - Patella component</Name>
            <Description>Patella component, UHMWPE, cemented</Description>
            <Size>Size 26 - 41</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>242172</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ959</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>All Poly Cemented Patella</Description>
            <Size>29-41mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>208794</ARTG>
                <ARTG>220505</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH605</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - PE patella implant</Name>
            <Description>ACS PE patella</Description>
            <Size>26mm, 29mm, 32mm, 35mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>265637</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH633</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO057</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Patella</Name>
            <Description>Mutars PE Patella</Description>
            <Size>Standard Large</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>227773</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI072</BillingCode>
            <Name>Score Knee System Patella Component </Name>
            <Description>All poly patella UHMWPE, cemented   Resurfacing and Inset</Description>
            <Size>7 Diameters</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>210604</ARTG>
                <ARTG>216375</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO042</BillingCode>
            <Name>LINK Knee Patella Component</Name>
            <Description>Patella Component, UHMWPE, cemented</Description>
            <Size>Diameter: 25, 28, 30, 31, 34, 35 and 40mm&#xD;
Height: 7, 8, 9 and 10mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>223374</ARTG>
                <ARTG>231794</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA111</BillingCode>
            <Name>Balansys Patella Component</Name>
            <Description>All Polyethylene, UHMWPE, cemented </Description>
            <Size>Dia 25, 28, 31, 34, 37mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>211143</ARTG>
                <ARTG>211442</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ014</BillingCode>
            <Name>MRK (Medial Rotation Knee) Total Knee System Patellar Component</Name>
            <Description>All Poly Patellar, UHMWPE, 1 central peg, This is a uncemented poly button</Description>
            <Size>20-30mm</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>117770</ARTG>
                <ARTG>192372</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MJ015</BillingCode>
            <Name>Saiph Knee System Patella Component</Name>
            <Description>Polyethylene Patella Component</Description>
            <Size>Diameter 23mm - 42mm</Size>
            <SupplierCode>MJ</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>209578</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU031</BillingCode>
            <Name>Evolis Knee System Patella Component </Name>
            <Description>All poly patella, cemented, UHMWPE</Description>
            <Size>20, 24,28, 30, 33, 36, 39mm diam</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>204598</ARTG>
                <ARTG>205561</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU061</BillingCode>
            <Name>GMK  Inset Patella</Name>
            <Description>Inset cemented polyethylene patella</Description>
            <Size>sizes 1-2; 3-4; 5-6 (20/24/28/32mm diameter)</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>210970</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU072</BillingCode>
            <Name>GMK Resurfacing Patella</Name>
            <Description>resurfacing three pegged cemented polyethylene patella</Description>
            <Size>sizes 1, 2, 3, 4.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>132459</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH423</BillingCode>
            <Name>Trekking Knee System, Patella Component</Name>
            <Description>Patella Component</Description>
            <Size>Size: 1, 2, 3&#xD;
Diam (mm): 30, 35, 40</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>287502</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF138</BillingCode>
            <Name>SHiVA Modular Knee Hinge Prosthesis - Patella Button</Name>
            <Description>Patella Button</Description>
            <Size>Sizes 2,3 and 4</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>192962</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF145</BillingCode>
            <Name>Active Knee Patella</Name>
            <Description>Patella, cemented, UHMWPE </Description>
            <Size>Sizes 1 - 5</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>276965</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK314</BillingCode>
            <Name>Avon Patello Femoral System Patella Component</Name>
            <Description>Patella component, UHMWPE (Duration), Fixed, cemented</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>216641</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK323</BillingCode>
            <Name>Triathlon Knee System Patella Component</Name>
            <Description>Patella Component, Cemented,  Asymmetric &amp; Symmetric, (X3) UHMWPE</Description>
            <Size>Symmetric: 27mm x 8mm, 29mm x 8mm, 31mm x 9mm, 33mm x 9mm, 36mm x 10mm, 39mm x 11mm; Assymetric: 29mm x 9mm, 32mm x 10mm, 35mm x 10mm, 38mm x 11mm, 40mm x 11mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>212699</ARTG>
                <ARTG>212700</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK415</BillingCode>
            <Name>Scorpio Knee System Patella Component</Name>
            <Description>Patella Component, Inset, Recessed, Medialized dome, Universal Dome, Concentric Dome, UHMWPE (X3), Fixed, Cemented</Description>
            <Size>Concentric &amp; Medialized Dome patella sizes: 5, 7, 9 &amp; 11; Universal Dome patella sizes: 3, 5, 7, 9 &amp; 11; Inset &amp; Recessed patella sizes: 26, 28, 30 and 32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>309143</ARTG>
                <ARTG>211463</ARTG>
                <ARTG>211481</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK419</BillingCode>
            <Name>Triathlon Knee System Patella Component</Name>
            <Description>Patella Component, Cemented,  Asymmetric &amp; Symmetric , (X3) UHMWPE</Description>
            <Size>Asymmetric - Width: M/L 33-44mm &amp; S/I 29-40mm Thickness: 9mm - 11mm  Symmetric - Width: 27-39mm Thickness: 8mm - 11mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>212701</ARTG>
                <ARTG>212702</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL245</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SN323</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Journey Patella</Name>
            <Description>Patella, cemented, UHMWPE </Description>
            <Size>23-41mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>278111</ARTG>
                <ARTG>206505</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL246</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SN323</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genesis II Patella</Name>
            <Description>Patella, cemented, UHMWPE, can be used for multiple systems (Genesis II, Journey, Legion)</Description>
            <Size>23-41mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>220595</ARTG>
                <ARTG>242034</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN382</BillingCode>
            <Name>Profix Knee System Patella Component</Name>
            <Description>Patella Component, UHMWPE, Inset and Onlay, cemented</Description>
            <Size>23-39mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>223619</ARTG>
                <ARTG>223620</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST636</BillingCode>
            <Name>Scorpio Knee System &amp; S7000 Knee System Patella Component</Name>
            <Description>Patella component, Inlay, UHMWPE (N2VAC), cemented</Description>
            <Size>3, 5, 7, 9, 11, 13</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>211462</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI148</BillingCode>
            <Name>NexGen/Persona Patella</Name>
            <Description>All poly, cemented, patella, UHMWPE</Description>
            <Size>26 - 41</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>198145</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI454</BillingCode>
            <Name>Natural Knee Patella CSTi</Name>
            <Description>All Poly, Cemented, Patella</Description>
            <Size>0-3</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1376</GroupID>
            <ARTGs>
                <ARTG>228016</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP523</BillingCode>
            <Name>LCS Complete Knee System patella component </Name>
            <Description>Metal backed, CoCr, rotating, cemented </Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1377</GroupID>
            <SubGroupID>3927</SubGroupID>
            <ARTGs>
                <ARTG>108414</ARTG>
                <ARTG>97697</ARTG>
            </ARTGs>
            <MinimumBenefit>971</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY502</BillingCode>
            <Name>LCS Complete Knee System patella component </Name>
            <Description>Metal backed, CoCr, rotating, uncemented </Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1378</GroupID>
            <SubGroupID>3928</SubGroupID>
            <ARTGs>
                <ARTG>108414</ARTG>
                <ARTG>138093</ARTG>
                <ARTG>97697</ARTG>
            </ARTGs>
            <MinimumBenefit>803</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI266</BillingCode>
            <Name>NexGen Trabecular Metal Augmented Patella</Name>
            <Description>Augmented trabecular metal  combined with NexGen all poly patella component (2 piece)</Description>
            <Size>Small, medium, large and x-large</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1378</GroupID>
            <SubGroupID>3929</SubGroupID>
            <Suffix>Revision</Suffix>
            <ARTGs>
                <ARTG>228294</ARTG>
            </ARTGs>
            <MinimumBenefit>1046</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI147</BillingCode>
            <Name>NexGen  Patella Component </Name>
            <Description>Metal backed, trabecular metal (Tantalum), patella component, with moulded UHMWPE, uncemented</Description>
            <Size>26 - 41</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1378</GroupID>
            <SubGroupID>3929</SubGroupID>
            <ARTGs>
                <ARTG>227807</ARTG>
            </ARTGs>
            <MinimumBenefit>599</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ697</BillingCode>
            <Name>LCS Total Knee System - Replacement Patella Polyethylene</Name>
            <Description>Replacement UHMWPE insert for LCS mobile bearing patella</Description>
            <Size>Small+ to Large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>156</SubCategoryID>
            <GroupID>1379</GroupID>
            <ARTGs>
                <ARTG>108414</ARTG>
            </ARTGs>
            <MinimumBenefit>431</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW645</BillingCode>
            <Name>METS Femoral Knee and Stem</Name>
            <Description>CoCR-molybdenum hinged component with stem includes axle, bushes and circlip</Description>
            <Size>Small and Std Left and Right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3930</SubGroupID>
            <Suffix>Hinge included</Suffix>
            <ARTGs>
                <ARTG>275995</ARTG>
            </ARTGs>
            <MinimumBenefit>4543</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW599</BillingCode>
            <Name>METS Femoral Knee</Name>
            <Description>CoCR-molybdenum hinged femoral component includes axle, bushes and circlip</Description>
            <Size>Small left; small right; standard left; standard right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <Suffix>Hinge included</Suffix>
            <ARTGs>
                <ARTG>269992</ARTG>
            </ARTGs>
            <MinimumBenefit>7619</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI865</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Femoral Component, Resurfacing or Segmental, CoCr,Ti</Description>
            <Size>30 - 70mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY188</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>Distal Femoral Replacement Component Left/Right</Description>
            <Size>XX Small and X Small</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW194</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Femoral Joint -  Vitallium</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>262258</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW227</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Rotating Hinge Distal Femur Component</Name>
            <Description>HMRS Rotating Hinge Distal Femur, CoCr (Vitallium) uncemented, porous coated, Fixed</Description>
            <Size>120, 140, 160mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>247672</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW640</BillingCode>
            <Name>METS Tibial Rotating Hinge Metal Casing</Name>
            <Description>Ti casing and CoCr-Mo tibial component</Description>
            <Size>Stem lengths 140mm and 180mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>278137</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW641</BillingCode>
            <Name>METS Tibial Rotating Hinge Polyethylene</Name>
            <Description>CoCr-Molybedenum tibial component</Description>
            <Size>Stem length 105mm and 114mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>278136</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH647</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO106</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars Distal Femur</Name>
            <Description>Mutars Distal Femur</Description>
            <Size>Left/Right 90mm -110mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>225901</ARTG>
                <ARTG>227769</ARTG>
                <ARTG>284225</ARTG>
                <ARTG>284226</ARTG>
                <ARTG>284581</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO156</BillingCode>
            <Name>Link Modular Knee Prosthesis  System</Name>
            <Description>Femoral Component</Description>
            <Size>Extra Small - Extra Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>222087</ARTG>
                <ARTG>225703</ARTG>
                <ARTG>225704</ARTG>
                <ARTG>226433</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK157</BillingCode>
            <Name>GMRS (Global Modular Replacement System) Distal Femoral Component</Name>
            <Description>GMRS Distal Femoral component, CoCr, uncemented, Fixed</Description>
            <Size>Small Left 65mm, Small Left 75mm, Small Left 85mm, Small Left 95mm, Small Right 65mm, Small Right 75mm, Small Right 85mm, Small Right 95mm, Standard Left, Standard Right</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>222994</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI570</BillingCode>
            <Name>Zimmer segmental system - distal femoral component</Name>
            <Description>Distal femoral component</Description>
            <Size>B &amp; C, left and right</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1380</GroupID>
            <SubGroupID>3931</SubGroupID>
            <ARTGs>
                <ARTG>292688</ARTG>
            </ARTGs>
            <MinimumBenefit>6984</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH134</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Tibial Component, Resurfacing or Segmental, Non-Modular tray, CoCr, Ti</Description>
            <Size>63-83mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3932</SubGroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>7066</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH135</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Tibial Component, Resurfacing or Segmental, Non-Modular tray, CoCr, Ti</Description>
            <Size>63-83mm</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3932</SubGroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>7066</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW196</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Tibial Joint (Baseplate)</Name>
            <Description>HMRS Tibial Joint (baseplate) - uncemented, CoCr (Vitallium), porous coated, w/medial &amp; lateral flanges moulde agaibnst tibia w/bar bolt fixation, and metal cHydroxyapatitember for axis of hinge</Description>
            <Size>5553</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3932</SubGroupID>
            <ARTGs>
                <ARTG>262256</ARTG>
            </ARTGs>
            <MinimumBenefit>7066</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW234</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Stemmed Tibial Baseplate</Name>
            <Description>HMRS stemmed tibial baseplate, CoCr (Vitallium), uncemented, porous coated, w/large connecting stem attached for diaphyseal fixation, Fixed</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3932</SubGroupID>
            <ARTGs>
                <ARTG>261674</ARTG>
            </ARTGs>
            <MinimumBenefit>7066</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW617</BillingCode>
            <Name>METS Tibial Component Rotating Hinge</Name>
            <Description>&#xD;
CoCr-Molybdenum with UHMWPE bumper pad</Description>
            <Size>Small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3932</SubGroupID>
            <ARTGs>
                <ARTG>278019</ARTG>
            </ARTGs>
            <MinimumBenefit>7066</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH650</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO109</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars – tibial plateau</Name>
            <Description>Tibial plateau for hinged knee</Description>
            <Size>X small, small, standard, large</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3932</SubGroupID>
            <ARTGs>
                <ARTG>225903</ARTG>
                <ARTG>284585</ARTG>
            </ARTGs>
            <MinimumBenefit>7066</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH654</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO113</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars – Proximal Tibia</Name>
            <Description>Mutars – Proximal Tibia</Description>
            <Size>100mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3932</SubGroupID>
            <ARTGs>
                <ARTG>227164</ARTG>
                <ARTG>284586</ARTG>
            </ARTGs>
            <MinimumBenefit>7066</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY195</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>Tibial Replacement Component</Description>
            <Size>XX Small - Med</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW606</BillingCode>
            <Name>METS Tibial Fixed Hinge</Name>
            <Description>CoCr-Molybdenum</Description>
            <Size>Stem lengths 140mm and 180mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>278135</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW608</BillingCode>
            <Name>METS Proximal Tibia Fixed Hinge</Name>
            <Description>CoCr-Molybdenum proximal tibial component including bumper</Description>
            <Size>Small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>278015</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW609</BillingCode>
            <Name>METS Proximal Tibia Fixed Hinge Coated</Name>
            <Description>CoCr-Molybdenum with HA coated patella tendon reattachment mechanism and bumper</Description>
            <Size>Small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>278016</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW616</BillingCode>
            <Name>METS Proximal Tibia Rotating Hinge</Name>
            <Description>Titanium with UHMWPE bearing</Description>
            <Size>Small and standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>278017</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW630</BillingCode>
            <Name>METS Proximal Tibia Rotating Hinge Coated</Name>
            <Description>Titanium with UHMWPE bearing and HA coated patella tendon reattachment mechanism</Description>
            <Size>Small and Std</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>278018</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO160</BillingCode>
            <Name>Link Modular Knee Prosthesis&#xD;
System</Name>
            <Description>Tibial Components</Description>
            <Size>Small, Medium and Large&#xD;
60, 65 and 70mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>225030</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK156</BillingCode>
            <Name>GMRS (Global Modular Replacement System) Proximal Tibial Component</Name>
            <Description>GMRS Proximal Tibial component, CoCr, uncemented, porous coated, 7 x tendon/suture holes for soft tissue re-attachment, Fixed</Description>
            <Size>Small, Standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>223660</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI740</BillingCode>
            <Name>Zimmer Segmental System - Proximal TM Tibia</Name>
            <Description>Zimmer Segmental System - Proximal TM Tibia</Description>
            <Size>1-3</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1381</GroupID>
            <SubGroupID>3933</SubGroupID>
            <ARTGs>
                <ARTG>229674</ARTG>
            </ARTGs>
            <MinimumBenefit>7006</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY189</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>LPS Diaphyseal Stem, Cemented, Bowed, with 2cm Beaded Collar</Description>
            <Size>11mm - 17mm diameter x 150 - 200mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <SubGroupID>3934</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>3991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY193</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>LPS Diaphyseal Stem, Cemented, Straight, with 2cm Beaded Collar</Description>
            <Size>9mm - 17mm diameter, 100 - 125mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <SubGroupID>3934</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>3991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK161</BillingCode>
            <Name>GMRS (Global Modular Replacement System) Extension Piece</Name>
            <Description>GMRS Extension Piece, uncemented Titanium, connects to anchorage piece (optional) for increases diaphyseal replacement</Description>
            <Size>30, 40, 50, 60, 70, 80, 100, 120, 140, 160, 180, 200, 220mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <SubGroupID>3934</SubGroupID>
            <ARTGs>
                <ARTG>242293</ARTG>
            </ARTGs>
            <MinimumBenefit>3991</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI868</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Diaphyseal Segment or Diaphyseal Coupler, Stacking Adapter and Locking Screws, Ti</Description>
            <Size>Diaphyseal Segment 1-23cm, Diaphyseal coupler 10-30cm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>3845</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW615</BillingCode>
            <Name>METS Tibial Shaft</Name>
            <Description>Titanium shaft</Description>
            <Size>45-115mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <ARTGs>
                <ARTG>246516</ARTG>
            </ARTGs>
            <MinimumBenefit>3845</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH649</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO108</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars Tumour System</Name>
            <Description>Mutars diaphyseal implant</Description>
            <Size>100mm length x 11-19mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <ARTGs>
                <ARTG>221740</ARTG>
                <ARTG>284222</ARTG>
            </ARTGs>
            <MinimumBenefit>3845</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH689</BillingCode>
            <Name>MUTARS intrameduallary connecting module</Name>
            <Description>MUTARS intramedullary connecting module</Description>
            <Size>100-440mm Length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <ARTGs>
                <ARTG>244052</ARTG>
                <ARTG>244656</ARTG>
            </ARTGs>
            <MinimumBenefit>3845</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK162</BillingCode>
            <Name>GMRS (Global Modular Replacement System) Connection Piece </Name>
            <Description>GMRS Connection Piece, uncemented Titanium, to replace varying lengths of diaphyseal bone loss</Description>
            <Size>Left 80, 90mm; Right 80, 90mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <ARTGs>
                <ARTG>242293</ARTG>
            </ARTGs>
            <MinimumBenefit>3845</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI576</BillingCode>
            <Name>Zimmer segmental system - segments - femoral/ tibial</Name>
            <Description>fem/tib segment male-female</Description>
            <Size>Male/female x 30 - 220mm. Male/Male x 80- 90mm.</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1382</GroupID>
            <ARTGs>
                <ARTG>95760</ARTG>
            </ARTGs>
            <MinimumBenefit>3845</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI963</BillingCode>
            <Name>Compress Compliant Prestress System</Name>
            <Description>Anchor Assembly: Plug, Transverse pin, spindle, nut, cap.</Description>
            <Size>10-28mm femoral canal diameter,</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1383</GroupID>
            <SubGroupID>3935</SubGroupID>
            <ARTGs>
                <ARTG>177878</ARTG>
            </ARTGs>
            <MinimumBenefit>9035</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH137</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Tibial bearing Insert UHMWPE</Description>
            <Size>12-22mm Thick</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1384</GroupID>
            <ARTGs>
                <ARTG>35667</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW251</BillingCode>
            <Name>MRS (Modular Replacement System) Tibial Insert </Name>
            <Description>Tibial insert UHMWPE (Duration) for MRS Metal Encapsulated Rotating Hinge Tibial component, Mobile.</Description>
            <Size>Small and Medium in 11, 13, 16, 21mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1384</GroupID>
            <ARTGs>
                <ARTG>141151</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW629</BillingCode>
            <Name>METS Tibial Rotating Hinge Polyethylene</Name>
            <Description>UHMWPE tibial bearing component</Description>
            <Size>N/A</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1384</GroupID>
            <ARTGs>
                <ARTG>278136</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH632</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO056</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - PE Inlay</Name>
            <Description>MUTARS - PE Inlay</Description>
            <Size>xsmall, Small, Standard, Large</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1384</GroupID>
            <ARTGs>
                <ARTG>227770</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI566</BillingCode>
            <Name>Zimmer segmental system - articulating surfaces</Name>
            <Description>Segmental articulating surface</Description>
            <Size>B, C, D, E &amp; F - 12, 14, 17, 20, 23 &amp; 26mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1384</GroupID>
            <ARTGs>
                <ARTG>95761</ARTG>
            </ARTGs>
            <MinimumBenefit>2007</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI866</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Femoral or Tibial Augment, Ti</Description>
            <Size>'Femoral Sleeve - One Size; OR Femoral Flange - One Size; OR Tibial Block Augment 10-20mm;  OR Tibial Augment Sleeve - Small/Large</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1385</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>1864</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW607</BillingCode>
            <Name>METS Tibial Plateau Plate</Name>
            <Description>CoCr</Description>
            <Size>Small and standard in 4 thicknesses</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1385</GroupID>
            <ARTGs>
                <ARTG>246518</ARTG>
            </ARTGs>
            <MinimumBenefit>1864</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW618</BillingCode>
            <Name>METS Femoral Plateau Plate</Name>
            <Description>Titanium</Description>
            <Size>Small &amp; Standard, 4 thicknesses</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1385</GroupID>
            <ARTGs>
                <ARTG>246518</ARTG>
            </ARTGs>
            <MinimumBenefit>1864</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH652</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO111</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars – Genux Augments</Name>
            <Description>Mutars – Genux Augments</Description>
            <Size>Size, small, 3,4,5, 5mm, 10mm, 15mm, 20mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1385</GroupID>
            <ARTGs>
                <ARTG>221737</ARTG>
                <ARTG>284269</ARTG>
            </ARTGs>
            <MinimumBenefit>1864</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH653</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO112</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars – Metaphyseal component</Name>
            <Description>Mutars – Genux metaphyseal tibial spacer</Description>
            <Size>Right/Left 25mm, 35mm, 45mm, 50mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1385</GroupID>
            <ARTGs>
                <ARTG>221737</ARTG>
                <ARTG>284267</ARTG>
                <ARTG>284269</ARTG>
            </ARTGs>
            <MinimumBenefit>1864</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO166</BillingCode>
            <Name>Link Modular Knee ProsthesisSystem</Name>
            <Description>Augments</Description>
            <Size>X-Small, Small, Medium and Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1385</GroupID>
            <ARTGs>
                <ARTG>224949</ARTG>
                <ARTG>245854</ARTG>
            </ARTGs>
            <MinimumBenefit>1864</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI864</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Stem, Cemented or Porous, Ti</Description>
            <Size>(9-19)mm diameter x  (90-300)mm length</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY190</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>LPS Diaphyseal Stem Fully Beaded, Bowed, with 2cm Beaded Collar</Description>
            <Size>Porocoat 12.5mm - 18.5mm diameter x 150mm - 200mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY194</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>LPS Diaphyseal Stem Fully Beaded, Straight, with 2cm Beaded Collar</Description>
            <Size>Porocoat 10.5mm - 18.5mm diameter x 100mm - 125mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW247</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>Oncology Femoral Stem -  Vitallium</Description>
            <Size>127mm and 203mm length 11, 13, 15, 17mm diameter</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>267612</ARTG>
                <ARTG>267613</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW612</BillingCode>
            <Name>METS Stem</Name>
            <Description>Titanium, curved and straight</Description>
            <Size>6 diameters, 10-15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>279902</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW613</BillingCode>
            <Name>METS Tibial Stem</Name>
            <Description>Titanium</Description>
            <Size>5 diameters 9-13mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>276635</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW646</BillingCode>
            <Name>METS Integral Shaft &amp; Stem Coated</Name>
            <Description>HA coated titanium collar, shaft and stem</Description>
            <Size>Shaft Length 15-55mm, stem length 120mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>277396</ARTG>
                <ARTG>278020</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW647</BillingCode>
            <Name>METS Intergral Shaft and Stem</Name>
            <Description>Titanium stem for use with tibial collar</Description>
            <Size>Shaft 30-70mm, stem 120mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>276914</ARTG>
                <ARTG>277396</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH631</BillingCode>
            <Name>MUTARS Stems</Name>
            <Description>MUTARS Stems</Description>
            <Size>120 -240 mm length, 11 - 23 mm diameter</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>236017</ARTG>
                <ARTG>244312</ARTG>
                <ARTG>244314</ARTG>
                <ARTG>244315</ARTG>
                <ARTG>245435</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO167</BillingCode>
            <Name>Link Modular Knee ProsthesisSystem</Name>
            <Description>Stems</Description>
            <Size>100, 120, 130, 160, 200, 240, 280, 320 and 360</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>157545</ARTG>
                <ARTG>222182</ARTG>
                <ARTG>245852</ARTG>
                <ARTG>245853</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK166</BillingCode>
            <Name>GMRS (Global Modular Replacement System) Long Bowed Stem</Name>
            <Description>GMRS Long Bowed Stem,Titanium, with Ti plasma coating, uncemented, proximal 3cm Hydroxyapatite coated (Purefix) </Description>
            <Size>200mm stem length in 11, 12, 13, 14, 15, 16, 17, 18, 19mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>152389</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK167</BillingCode>
            <Name>GMRS (Global Modular Replacement System) Short Bowed Pressfit Stem</Name>
            <Description>GMRS Short Bowed Stem,Titanium, with Ti plasma coating, uncemented, proximal 3cm Hydroxyapatite coated (Purefix) </Description>
            <Size>150mm in: 11, 12, 13, 14, 15, 16, 17, 18, 19mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>152389</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK168</BillingCode>
            <Name>GMRS (Global Modular Replacement System) Straight Fluted Stem</Name>
            <Description>GMRS Straight Fluted Stem,Titanium, with Ti plasma coating, uncemented, proximal 3cm Hydroxyapatite coated (Purefix) </Description>
            <Size>125mm length in 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>152389</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK330</BillingCode>
            <Name>MRS (Modular Replacement System) Femoral Stems</Name>
            <Description>MRS Femoral stems with female taper, Titanium, uncemented, </Description>
            <Size>11 x 127mm,    13 x 127mm,    15 x 127mm,    17 x 127mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>244952</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI574</BillingCode>
            <Name>Zimmer segmental system - cemented stem</Name>
            <Description>Segmental cemented stem</Description>
            <Size>9-19mm x 130mm; 190mm, 250mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1386</GroupID>
            <ARTGs>
                <ARTG>223825</ARTG>
            </ARTGs>
            <MinimumBenefit>2648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI964</BillingCode>
            <Name>Compress Compliant Prestress System</Name>
            <Description>Medullary Centering Sleeve</Description>
            <Size>13-28mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3936</SubGroupID>
            <ARTGs>
                <ARTG>177878</ARTG>
            </ARTGs>
            <MinimumBenefit>3923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW611</BillingCode>
            <Name>METS Stippled Collar</Name>
            <Description>Titanium, HA coated, round or oval</Description>
            <Size>4 sizes round, 4 sizes oval</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3936</SubGroupID>
            <ARTGs>
                <ARTG>246514</ARTG>
                <ARTG>246515</ARTG>
            </ARTGs>
            <MinimumBenefit>3923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW614</BillingCode>
            <Name>METS Tibial Collar Coated</Name>
            <Description>Titanium collar with HA coating</Description>
            <Size>5 diameters 20-32mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3936</SubGroupID>
            <ARTGs>
                <ARTG>278021</ARTG>
            </ARTGs>
            <MinimumBenefit>3923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW658</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>CR141</PriorBillingCode>
            </PriorBillingCodes>
            <Name>METS Smooth Collar</Name>
            <Description>Titanium, uncoated, round or oval</Description>
            <Size>4 sizes round, 4 sizes oval</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3936</SubGroupID>
            <ARTGs>
                <ARTG>246505</ARTG>
            </ARTGs>
            <MinimumBenefit>3923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO164</BillingCode>
            <Name>Link Modular Knee Prosthesis&#xD;
System</Name>
            <Description>Collar Couplings</Description>
            <Size>Terminal round: 14 and 16mm&#xD;
Oval Terminal: 26 x 34, 30 x 44, 34 x 48mm&#xD;
Support Ring: 10mm&#xD;
Coupling: Short and Long</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3936</SubGroupID>
            <ARTGs>
                <ARTG>257497</ARTG>
                <ARTG>257500</ARTG>
                <ARTG>257612</ARTG>
            </ARTGs>
            <MinimumBenefit>3923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI572</BillingCode>
            <Name>Zimmer segmental system - smooth stem collar</Name>
            <Description>Segmental smooth stem collar</Description>
            <Size>9-16mm &amp; 17-19mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3936</SubGroupID>
            <ARTGs>
                <ARTG>284868</ARTG>
            </ARTGs>
            <MinimumBenefit>3923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI583</BillingCode>
            <Name>Zimmer segmental system - TM stem collar</Name>
            <Description>Segmental TM stem collar</Description>
            <Size>12-16mm, 25mm: 12-16mm, 30mm: 12-16mm, 35mm; 17-19mm, 30mm; 17-19mm, 35mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3936</SubGroupID>
            <ARTGs>
                <ARTG>123926</ARTG>
            </ARTGs>
            <MinimumBenefit>3923</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY217</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>Intercalary Segment Component (Male/Female)</Description>
            <Size>55mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>6356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO161</BillingCode>
            <Name>Link Modular Knee Coupling</Name>
            <Description>Coupling</Description>
            <Size>One Size only</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>245852</ARTG>
            </ARTGs>
            <MinimumBenefit>6356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI965</BillingCode>
            <Name>Compress Compliant Prestress System</Name>
            <Description>Femoral Adapter</Description>
            <Size>OSS or Finn Adapter</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>177878</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ826</BillingCode>
            <Name>Limb Preservation System - Sleeve Base</Name>
            <Description>Modular revison diaphyseal sleeve base</Description>
            <Size>Extra small - large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>181712</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ827</BillingCode>
            <Name>Limb Preservation System - Sleeve Adapter</Name>
            <Description>Diaphyseal sleeve adapter</Description>
            <Size>+0 to +10mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>252532</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH646</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO105</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars Diaphyseal connecting piece</Name>
            <Description>Mutars Diaphyseal connecting piece</Description>
            <Size>100mm -120mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>221740</ARTG>
                <ARTG>284221</ARTG>
                <ARTG>284224</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH655</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO114</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars – reducer</Name>
            <Description>Mutars – reducer</Description>
            <Size>20mm/30mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>237292</ARTG>
                <ARTG>284271</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH656</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO115</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars – Proximal tibia connecting piece</Name>
            <Description>Mutars – Proximal tibia connecting piece</Description>
            <Size>105mm, 125mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>244316</ARTG>
                <ARTG>284223</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH690</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO141</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS RS Hip System. MUTARS RS coupling device</Name>
            <Description>RS coupling device</Description>
            <Size>30mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>237292</ARTG>
                <ARTG>284583</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK172</BillingCode>
            <Name>Howmedica Modular Resection System</Name>
            <Description>GMRS Adaptors Male/Female Taper, Titanium/Forged Cobalt Chrome</Description>
            <Size>Male Taper; Female Taper</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3937</SubGroupID>
            <ARTGs>
                <ARTG>224413</ARTG>
                <ARTG>224767</ARTG>
            </ARTGs>
            <MinimumBenefit>1482</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY191</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>Total Femoral Segment Component (Male/Male)</Description>
            <Size>55 mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3938</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY192</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>Segmental Component (Male/Male)</Description>
            <Size>25 to 125mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3938</SubGroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH648</BillingCode>
            <Name>Mutars Diaphyseal extension piece</Name>
            <Description>Mutars Diaphyseal extension piece</Description>
            <Size>30/100mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3938</SubGroupID>
            <ARTGs>
                <ARTG>284224</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO162</BillingCode>
            <Name>Link Modular Knee ProsthesisSystem</Name>
            <Description>Stem extender, segment</Description>
            <Size>30mm - 250mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>157</SubCategoryID>
            <GroupID>1387</GroupID>
            <SubGroupID>3938</SubGroupID>
            <ARTGs>
                <ARTG>245852</ARTG>
            </ARTGs>
            <MinimumBenefit>3838</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB320</BillingCode>
            <Name>Emotion Total Knee System Tibial and Femoral Augments</Name>
            <Description>Medial/Lateral Tibial, Distal Femoral and Postero-Distal Augments</Description>
            <Size>4mm to 12mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB355</BillingCode>
            <Name>EnduRo Rotating Hinge Knee Tibial and Femoral Augments/Spacers</Name>
            <Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to&#xD;
treat complex revision knee arthoplasty as well as unstable knees</Description>
            <Size>Tibial Spacer(augment) to match Tibial component 4, 8, 12 &amp; 16mm Femoral Spacer distal (augment) to match femoral component 4, 8 &amp; 12mm&#xD;
Femoral Spacer posterior/distal (augment) to match femoral component&#xD;
4x4,4x8,4x12,8x4,8x8,8x12, 12x4, 12x8 and 12x12</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>247596</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB380</BillingCode>
            <Name>Aesculap AS Tibial and Femoral Augments</Name>
            <Description>Tibial and Femoral Augments/Spacers CoCr with ZrN coating</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>247596</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI952</BillingCode>
            <Name>Vanguard Total Knee System</Name>
            <Description>Femoralor Tibial Augments, anatomic, distal or posterior, Ti alloy</Description>
            <Size>5-15mm x 55-80mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>98449</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV043</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Tibial, femoral&#xD;
Augment, wedge, block, offset&#xD;
Distal, posterior&#xD;
Screw fixation</Description>
            <Size>1-7&#xD;
5-15mm&#xD;
Standard, plus</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>196520</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV045</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision Tibial Base Augment</Description>
            <Size>Sizes 1 - 8+  5mm - 15mm  Medial, Lateral  Left, Right</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>196520</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV052</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Femoral Distal and Posterior Augments</Description>
            <Size>4-12mm thickness, &#xD;
Size 3-8</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>196520</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR253</BillingCode>
            <Name>Unity Knee - Augments</Name>
            <Description>Tibial Full and Half block Augments, Femoral distal and posterior augments</Description>
            <Size>All components available in Size: 1-9;&#xD;
Thickness: 5 and 10mm&#xD;
&#xD;
Tibia: Full, LM-RL, RM-LL,</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>274559</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR276</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO116</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Tibial Augments</Name>
            <Description>Tibial hemi blocks and wedges, CoCr, Titanium</Description>
            <Size>5mm and 10mm thick</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>246978</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR291</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO260</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Revision Knee</Name>
            <Description>Apex Revision Knee Femoral and Tibial Augments</Description>
            <Size>Femoral, Size 0-6+, 5mm/10mm/15mm  Tibial, Size 0-6, 4mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>252312</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP158</BillingCode>
            <Name>PFC Sigma Knee System femoral  augments</Name>
            <Description>Distal and posterior femoral augments, CoCr , with screws</Description>
            <Size>Sizes  1 - 6.  4-16mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
                <ARTG>137608</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP161</BillingCode>
            <Name>PFC Sigma Knee System tibial augments </Name>
            <Description>Tibial wedges (full and hemi) and  hemi blocks, CoCr, with screw</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>136903</ARTG>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP269</BillingCode>
            <Name>SROM Noiles Knee System femoral augments </Name>
            <Description>Distal or posterior and combined distal and posterior femoral augments</Description>
            <Size>Sizes xxsmall - xlarge.  5-10mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY153</BillingCode>
            <Name>LCS Complete Knee System Augments </Name>
            <Description>Femoral distal and posterior augments, CoCr, with screws</Description>
            <Size>Sizes small to large+.  5-15mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY159</BillingCode>
            <Name>MBT Knee System tibial augments </Name>
            <Description>Tibial blocks, with screws, CoCr </Description>
            <Size>Sizes 1-7. 5-15mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX025</BillingCode>
            <Name>Optetrak Total Knee System Tibial Augments</Name>
            <Description>Tibial Augments for CCK tibial component, half and third blocks, titanium, screw fixation</Description>
            <Size>Size 1 - 6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX026</BillingCode>
            <Name>Optetrak Total Knee System Femoral Augments</Name>
            <Description>Femoral Augments for CCK femoral component, distal and posterior blocks, titanium, screw fixation</Description>
            <Size>Size 1-6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA022</BillingCode>
            <Name>Optetrak Logic Total Knee System Tibial Augments</Name>
            <Description>Tibial Augments for Logic CC tibial component, half and third blocks, titanium, screw fixation</Description>
            <Size>Size 0 - 6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA025</BillingCode>
            <Name>Optetrak Logic Total Knee System Femoral Augments</Name>
            <Description>Femoral Augments for Logic CC femoral component, distal and posterior blocks, titanium, screw fixation</Description>
            <Size>Size 1 - 5</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW099</BillingCode>
            <Name>Duracon Knee System Tibial Augments </Name>
            <Description>Tibial Augments Full wedge (angled) &amp; Full block (flat), CoCr (Vitallium), cemented</Description>
            <Size>Left &amp; right, full &amp; angled, 5mm &amp; 10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242298</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW153</BillingCode>
            <Name>Kinemax Knee System &amp; Modular Rotating Hinge Distal &amp; Posterior Femoral Augments &amp; Spacers</Name>
            <Description>Distal &amp; posterior femoral blocks &amp; spacers, CoCr (Vitallium), cemented</Description>
            <Size>Kinemax: Full, Distal &amp; Posterior Augments: xs-xl; 5mm /10mm         MRH Distal Femoral Augments xs-xl; 5mm / 10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242300</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH614</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System-ACS spacer (tibial and femoral)</Name>
            <Description>ACS tibial and femoral augments for use with mobile bearing and Revision FB tibial base plates</Description>
            <Size>Left and Right, medial, lateral, posterior and distal.</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>221737</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH678</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO160</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS GenuX MK Augments</Name>
            <Description>MUTARS GenuX MK Augments</Description>
            <Size>1-6 Femoral distal,  Femoral posterior and 2- 6 Tibial spacers. 5-20mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>221737</ARTG>
                <ARTG>284264</ARTG>
                <ARTG>284265</ARTG>
                <ARTG>284266</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI065</BillingCode>
            <Name>Score Knee System Tibial and Femoral Augments </Name>
            <Description>Tibial and Femoral half blocks, CoCr, screw fixation used for femoral blocks, tibial blocks cemented </Description>
            <Size>31 sizes</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>135327</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI120</BillingCode>
            <Name>Anatomic Knee Tibial Half Blocks</Name>
            <Description>Tibial Half Blocks Cemented</Description>
            <Size>Sizes 0/1/2, 3/4/5, 6/7/8  Thickness 5mm to 15mm  </Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>241999</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO180</BillingCode>
            <Name>Endo-Model Rotational and Hinge Knee Prosthesis</Name>
            <Description>Augments, spacers, segments</Description>
            <Size>(5-15) mm height, (X-Small, Small, Medium or Large) footprint  UHMWPE</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>245854</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA508</BillingCode>
            <Name>Balansys Revision Knee, Augments</Name>
            <Description>Revision Femoral/Tibial Augments, complete with screws</Description>
            <Size>5 and 10mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>257053</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN225</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Femoral and tibial augments</Description>
            <Size>Size 1 to 10</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>298543</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU085</BillingCode>
            <Name>GMK Revision femoral distal wedge</Name>
            <Description>Screwed femoral distal augmentation</Description>
            <Size>Size 1 to 6, each one available in 5 thicknesses: 4mm, 8mm, 12mm, 16 mm, 20 mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>254755</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU087</BillingCode>
            <Name>GMK Revision femoral posterior wedge</Name>
            <Description>Screwed femoral posterior augmentation</Description>
            <Size>Size 1 to 6, each one available in 4 thicknesses: 4mm, 5mm, 8mm 10mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>254755</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU094</BillingCode>
            <Name>GMK Revision tibial wedge</Name>
            <Description>Cemented tibial baseplate augmentation</Description>
            <Size>Size 0 to 6   4 thicknesses available: 5, 10, 15, 20 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>254755</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH416</BillingCode>
            <Name>Trekking Knee System - TCK Revision Tibial and Femoral Augments</Name>
            <Description>TCK Revision Tibial and Femoral Augments (Knee Wedge)</Description>
            <Size>Size: T1 - T5&#xD;
Size: 5mm - 10mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>283166</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF132</BillingCode>
            <Name>SHiVA Modular Knee Hinge Prosthesis</Name>
            <Description>SHiVA Modular Knee Hinge Prosthesis - Tibial Spacer</Description>
            <Size>Size 2,3 and 4 x 5mm and 10mm thick</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>192962</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF133</BillingCode>
            <Name>SHiVA Hinge Knee Revision System - Spacer</Name>
            <Description>SHiVA Hinge Knee Revision  Spacer including locking screws</Description>
            <Size>Size 2 -4, Thickness 5 and 10 mm for Distal Femoral and Posterior Femoral Reference&#xD;
Size 2-5 , Thickness 5 and 10 mm for Tibial Reference</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>192962</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK441</BillingCode>
            <Name>Triathlon Knee System Femoral Augments</Name>
            <Description>Femoral blocks distal &amp; posterior, CoCr, mechanical attachment</Description>
            <Size>Left &amp; Right 5mm size 1-8 10mm size 1-8 15mm size 1-8</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242298</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM153</BillingCode>
            <Name>Legion Hinge Femoral Wedge</Name>
            <Description>A distal femoral Wedge for use with the Legion Hinge system.</Description>
            <Size>Size 2 to 7 5,10,15,20mm</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>238696</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN330</BillingCode>
            <Name>Genesis II Knee System Tibial and Femoral Augments</Name>
            <Description>Tibial Augments, half blocks and half wedges, (CoCr) and Femoral Augments, distal and posterior or distal and posterior combined</Description>
            <Size>1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>238696</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN821</BillingCode>
            <Name>Legion Knee System Femoral Augment</Name>
            <Description>Femoral Augment, posterior, distal and combined posterior and distal, Titanium, includes screws for fixation</Description>
            <Size>size 1-8, 5-15mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>238696</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN822</BillingCode>
            <Name>Legion Knee System Tibial Augement</Name>
            <Description>Tibial Augments, half blocks and half wedges, full blocks and full wedges, Titanium includes screws for fixation</Description>
            <Size>5-15mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>238696</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR036</BillingCode>
            <Name>Triathlon Knee System Hemi Augments</Name>
            <Description>Half (hemi) tibial blocks, CoCr, mechanical attachment </Description>
            <Size>LM/RL &amp; LL/RM, 1 to 8, 5mm and 10mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242298</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST018</BillingCode>
            <Name>Scorpio Knee System Femoral &amp; Tibial Augment</Name>
            <Description>Femoral &amp; tibial blocks distal, posterior and full, CoCr, cemented</Description>
            <Size>5mm &amp; 10mm for all sizes of femur and tibia. 5 degrees for all tibia sizes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242298</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST604</BillingCode>
            <Name>Duracon Knee System Tibial Augments </Name>
            <Description>Tibial Augments Half (hemi) wedge (angled) &amp; Half (hemi) block (flat), CoCr (Vitallium), cemented</Description>
            <Size>LM/RL &amp; LL/RM in 5mm, 10mm thicknesses</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242298</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI140</BillingCode>
            <Name>Tibial Augments</Name>
            <Description>Tibial Augments, wedges, hemi and one third and tibial blocks hemi, titanium</Description>
            <Size>5-20MM</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242592</ARTG>
                <ARTG>357912</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI143</BillingCode>
            <Name>NexGen Knee Tibial Augments</Name>
            <Description>NexGen Tibial Blocks - half and full, Titanium</Description>
            <Size>1 - 10</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>109936</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI144</BillingCode>
            <Name>Femoral Augments</Name>
            <Description>Femoral blocks, posterior, distal and anterior, titanium </Description>
            <Size>5-20MM</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>242593</ARTG>
                <ARTG>357912</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI145</BillingCode>
            <Name>NexGen  Femoral Augments</Name>
            <Description>Femoral blocks, combined posterior distal block </Description>
            <Size>A - H</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1390</GroupID>
            <ARTGs>
                <ARTG>95760</ARTG>
            </ARTGs>
            <MinimumBenefit>1119</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW201</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Fixed Hinged Knee Axle Pin </Name>
            <Description>HMRS Fixed Hinged Knee Axle Pin, CrCo, (Vitallium), uncemented, Fixed</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1391</GroupID>
            <ARTGs>
                <ARTG>262257</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ705</BillingCode>
            <Name>LPS &amp; SROM Systems - Hinge Pin</Name>
            <Description>Rotating Hinge Axle - uncemented, CoCr</Description>
            <Size>xxsmall - medium</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1391</GroupID>
            <ARTGs>
                <ARTG>243112</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH635</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO089</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Genux Locking screw for locking mechanism</Name>
            <Description>Locking screw, axel, for Genux hinge locking mechanism</Description>
            <Size>1 Size</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1391</GroupID>
            <ARTGs>
                <ARTG>250192</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN901</BillingCode>
            <Name>Legion Hinge Axle</Name>
            <Description>Is used to secure the Legion Hinge femoral component to baseplate.</Description>
            <Size>Sizes 2-7</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1391</GroupID>
            <ARTGs>
                <ARTG>232073</ARTG>
            </ARTGs>
            <MinimumBenefit>635</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB404</BillingCode>
            <Name>Aesculap Knee System Insert Bolt</Name>
            <Description>Tibial insert locking bolt</Description>
            <Size>10mm - 24mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1392</GroupID>
            <ARTGs>
                <ARTG>277357</ARTG>
                <ARTG>277359</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR283</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO190</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee, Locking Bolt</Name>
            <Description>Tibial Insert Locking Bolt</Description>
            <Size>One size</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1392</GroupID>
            <ARTGs>
                <ARTG>309120</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR315</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO313</PriorBillingCode>
            </PriorBillingCodes>
            <Name>APEX knee Retaining Bolt</Name>
            <Description>Tibial insert, Retaining Bolt, Uncoated knee tibia prosthesis, metallic  for PS, PS-C, PS-R, Congruent, Ultra inserts/ Tibial Baseplates</Description>
            <Size>10-32 mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1392</GroupID>
            <ARTGs>
                <ARTG>309120</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP155</BillingCode>
            <Name>PFC Sigma Knee System femoral stem bolts</Name>
            <Description>Bolts to connect femoral stem, straight and offset </Description>
            <Size>Neutral +/- 2mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1392</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO158</BillingCode>
            <Name>RBK Universal Knee System Insert Bolt </Name>
            <Description>Insert bolt for RBK universal pegged and non pegged inserts</Description>
            <Size>10mm - 20mm</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1392</GroupID>
            <ARTGs>
                <ARTG>143926</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH636</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO090</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Genux Locking screws</Name>
            <Description>Locking screws for augments</Description>
            <Size>Various</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1392</GroupID>
            <ARTGs>
                <ARTG>221737</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH693</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO145</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - KRI Screw M8</Name>
            <Description>KRI Screw M8 - Tumour System and Arthrodesis Interlocking System</Description>
            <Size>25mm - 50mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1392</GroupID>
            <ARTGs>
                <ARTG>250193</ARTG>
            </ARTGs>
            <MinimumBenefit>239</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH136</BillingCode>
            <Name>Orthopaedic Salvage System</Name>
            <Description>Femoral/Tibial Interlocking devices:locking pin, femoral and tibial bushings, tibial bearing. Axle, reinforced Yoke, locking screws CoCr, Ti</Description>
            <Size>One size only except srew - small or large, Tibial bearing 12-22mm</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>251392</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY196</BillingCode>
            <Name>Limb Preservation System</Name>
            <Description>Tibial Hinge Insert</Description>
            <Size>XX-Small, X-Small, Small, Medium, Height (mm) 12 - 31</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>228695</ARTG>
                <ARTG>314170</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO119</BillingCode>
            <Name>RBK Total Knee System Rotating hinge bushing mechanism </Name>
            <Description>Rotating Hinge Bushing Mechansim</Description>
            <Size>Complete mechanism</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>143926</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW144</BillingCode>
            <Name>KRH (Kinematic Rotating Hinge) Tibial Bearing Component</Name>
            <Description>KRH Rotating Hinge Tibial bearing component, CoCr, Mobile</Description>
            <Size>Small and Medium 11mm/15mm by 110mm/180mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>247934</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW145</BillingCode>
            <Name>GMRS (Global Modular Replacement System) MRH (Modular Rotating Hinge) Kinematic Rotating Hinge (KRH) Femoral Bushings &amp; Bumpers </Name>
            <Description>GMRS, MRH, KRH Rotating Hinge Femoral Bushings &amp; Bumpers UHMWPE, (Duration) </Description>
            <Size>Small &amp; standard</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>247296</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW228</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Rotating Hinge Axle</Name>
            <Description>HMRS Rotating Hinge Axle - uncemented, CoCr (Vitallium)</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>246993</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW229</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Rotating Hinge Femoral Bushing</Name>
            <Description>HMRS Rotating Hinge Femoral Bushing - UHMWPE, (Duration) </Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>242298</ARTG>
                <ARTG>247554</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW230</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) &amp; MRH (Modular Rotating Hinge) Rotating Hinge Bumper</Name>
            <Description>HMRS &amp; MRH Rotating Hinge Bumper - (Duration) UHMWPE</Description>
            <Size>HMRS: 0°, 3°, 5°       MRH: 0°, 3°</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>247297</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW231</BillingCode>
            <Name>GMRS (Global Modular Replacement System) &amp; MRH (Modular Rotating Hinge) Tibial Rotating Component</Name>
            <Description>GMRS &amp; MRH Tibial Rotating Hinge component (not baseplate) separated from femoral component by bumper and rotates on top of tibial insert , Fixed</Description>
            <Size>GMRS-small  MRH/crossover                      MRH - xs-xl  &amp; l-xl</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>222421</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH640</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO098</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS Genux Hinge locking mechanism</Name>
            <Description>Connecting piece; connecting distal femoral and proximal tibial replacement.</Description>
            <Size>Genux Hinge Component</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>234172</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH699</BillingCode>
            <Name>MUTARS GenuX MK Coupling</Name>
            <Description>MUTARS GenuX MK Coupling</Description>
            <Size>12.5, 15, 17.5mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>244653</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO163</BillingCode>
            <Name>Link Modular Knee ProsthesisSystem</Name>
            <Description>Hinge components</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>223279</ARTG>
                <ARTG>226253</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN322</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>ATTUNE Revision LPS Insert</Description>
            <Size>XX-Small, X-Small, Small and Medium; 12-32 mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>375180</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK331</BillingCode>
            <Name>MRH (Modular Rotating Hinge) Rotating Hinge Assembly Pack</Name>
            <Description>MRH Assembly pack consists of: Tibial sleeve, Bumper insert &amp; Femoral Bushing components UHMWPE (Duration)</Description>
            <Size>1 Tibial Sleeve, 1  Bumper Insert, 2 Femoral Bushing Components</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>223925</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SM154</BillingCode>
            <Name>Legion Hinge Sleeve and Bolt</Name>
            <Description>Is used to secure the Legion Hinge femoral component to the hinge mechanism attached to the baseplate.</Description>
            <Size>Sizes 2-7</Size>
            <SupplierCode>SM</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>232076</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI309</BillingCode>
            <Name>Nexgen Rotating Hinge Replacement </Name>
            <Description>Rotating hinge replacement which includes metal rotating hinge plus Polyethylene bushing and fixation pin</Description>
            <Size>B-F</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>109936</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI571</BillingCode>
            <Name>Zimmer segmental system - segmental poly insert</Name>
            <Description>Segmental poly insert</Description>
            <Size>B &amp; C</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>292689</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI573</BillingCode>
            <Name>Zimmer segmental system - hinge servicing kit</Name>
            <Description>Segmental femoral hinge servicing kit</Description>
            <Size>B &amp; C</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1393</GroupID>
            <ARTGs>
                <ARTG>292690</ARTG>
            </ARTGs>
            <MinimumBenefit>2724</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB210</BillingCode>
            <Name>Columbus Total Knee System (TKS) Tibial Stems</Name>
            <Description>Tibial Stem (cap), cemented or uncemented, short (mini) (obturator stem) CoCr, usually required when stem not used</Description>
            <Size>Small &amp; Large D: 12mm &amp; D: 14mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1395</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB241</BillingCode>
            <Name>Emotion Total Knee System (TKS) Tibial Stem</Name>
            <Description>Tibial Stem (cap), cemented or uncemented, short (mini) (obturator stem) CoCr, usually required when stem not used</Description>
            <Size>12mm, 14mm &amp; 16mm in cemented and uncemented</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1395</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV037</BillingCode>
            <Name>Advance Medial Pivot Stem Cap</Name>
            <Description>Modular Tibial Base Stem Cap</Description>
            <Size>N/A</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1395</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV050</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision Stem Cap</Description>
            <Size>one size</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1395</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR293</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO284</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Revision Knee Modular Tibia Cup</Name>
            <Description>Modular Tibia Cup</Description>
            <Size>Only One size</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1395</GroupID>
            <ARTGs>
                <ARTG>276775</ARTG>
            </ARTGs>
            <MinimumBenefit>633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH651</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO110</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mutars – end piece</Name>
            <Description>Mutars – end piece</Description>
            <Size>1 size</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1395</GroupID>
            <ARTGs>
                <ARTG>221738</ARTG>
                <ARTG>284235</ARTG>
            </ARTGs>
            <MinimumBenefit>633</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI956</BillingCode>
            <Name>Offset Tibial Tray System </Name>
            <Description>Offset Adapter for connection to tibial stems and baseplate, titanium </Description>
            <Size>0mm, 2.5mm, 5mm, 7.5mm Offset</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV047</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision Offset Stem Adapter</Description>
            <Size>4mm - 8mm x 25mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV053</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision CCK Femoral Offset Adapters</Description>
            <Size>4 and 8mm offset</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA026</BillingCode>
            <Name>Optetrak Logic Offset Stem Extension Couplers</Name>
            <Description>Cemented Offset Couplers with 2, 4, 6, or 8mm of offset</Description>
            <Size>2mm - 8mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ654</BillingCode>
            <Name>PFC Sigma - Femoral Adaptor</Name>
            <Description>Offset Adaptor</Description>
            <Size>5 and 7 degree</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH615</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - ACS double taper adapter</Name>
            <Description>ACS offset adapters for use with ACS FB, MB tibial and femoral components and stems</Description>
            <Size>0, +2mm, +4mm, +6mm.</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>265635</ARTG>
                <ARTG>265644</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH637</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO093</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Genux offset adapter</Name>
            <Description>Offset Adapter</Description>
            <Size>0, 2.5mm, 5mm, 7.5mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>250452</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH680</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO162</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS GenuX MK Offset Adapter</Name>
            <Description>MUTARS GenuX MK Offset Adapter</Description>
            <Size>Offset adapter 0mm, +2mm, +4mm, +6mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>245856</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI067</BillingCode>
            <Name>Score Knee System Offset Connector</Name>
            <Description>Connector for stems to alter stem offset morse taper but also including screw for additional fixation, titanium</Description>
            <Size>2mm, 4mm, 6mm</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>135327</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN228</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Offset adaptor</Description>
            <Size>2 to 6mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>288501</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU088</BillingCode>
            <Name>GMK Revision offset adaptor</Name>
            <Description>Offset adaptor for tibial and femoral revision extension stem</Description>
            <Size>3mm and 5mm offset</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>211488</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH414</BillingCode>
            <Name>Trekking Knee System - TCK Femoral and Tibial Offsets</Name>
            <Description>TCK Femoral, Tibial Offset Adaptors</Description>
            <Size>Size (mm): 2, 4, 6&#xD;
Offsets: Straight, Posterior, Lateral, Medial</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>287512</ARTG>
                <ARTG>287513</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK435</BillingCode>
            <Name>Triathlon Knee System Tibial / Femoral Offset Adaptor </Name>
            <Description>Tibial &amp; femral offset adaptor, CoCr</Description>
            <Size>2,4,6,8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>242297</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN885</BillingCode>
            <Name>Genesis II/Legion Knee System Offset Couplers</Name>
            <Description>Offset Coupler, titanium</Description>
            <Size>2-6</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>246212</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST603</BillingCode>
            <Name>Duracon Knee System Tibial / Femoral Offset Adaptor</Name>
            <Description>Tibial / Femoral Offset Adaptor, CoCr, (Vitallium)</Description>
            <Size>2mm, 4mm, 6mm, 8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1396</GroupID>
            <ARTGs>
                <ARTG>242297</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI173</BillingCode>
            <Name>Maxim Complete Knee System Tibial Locking Bar</Name>
            <Description>Insert locking pin, Titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP255</BillingCode>
            <Name>SROM Noiles Knee System bumper and hinge bearing replacements </Name>
            <Description>Replacements for UHMWPE axis bearings and bumpers, for hinged prosthesis </Description>
            <Size>Sizes xxsmall - medium.</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>131657</ARTG>
                <ARTG>132151</ARTG>
                <ARTG>97698</ARTG>
                <ARTG>97981</ARTG>
                <ARTG>98088</ARTG>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GO262</BillingCode>
            <Name>Apex Revision Knee - Tibial Insert Locking Peg/Bolt</Name>
            <Description>Tibial Insert Locking Peg/Bolt</Description>
            <Size>10; 11; 12; 14; 16; 18; 20; 24 and 28mm</Size>
            <SupplierCode>GO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>276775</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ659</BillingCode>
            <Name>LCS Complete Knee System APG arm</Name>
            <Description>APG arm for use with APG mobile tibial insert only</Description>
            <Size>Sizes small to large+</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>136903</ARTG>
                <ARTG>138289</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO043</BillingCode>
            <Name>LINK Endo Model Rotational and Hinge Knee Prosthesis System</Name>
            <Description>Full tibial blocks made of UHMWPE </Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>140652</ARTG>
                <ARTG>51002</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO159</BillingCode>
            <Name>LINK Endo Model M Modular Knee Prostheses System</Name>
            <Description>Centering Stars</Description>
            <Size>Small, medium, large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>257592</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN318</BillingCode>
            <Name>Genesis II</Name>
            <Description>Lugs</Description>
            <Size>Various sizes</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>230143</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN342</BillingCode>
            <Name>Genesis</Name>
            <Description>Custom Flex Lock Peg</Description>
            <Size>Left &amp; right</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>230143</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI406</BillingCode>
            <Name>Natural Knee Tibial Augment Fixation </Name>
            <Description>Tibial Augment Fixation peg and screws  </Description>
            <Size>One size only</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>109936</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI741</BillingCode>
            <Name>Zimmer Segmental System - TM Tibia Washer Kit</Name>
            <Description>Zimmer Segmental System - TM Tibia Washer Kit</Description>
            <Size>one size only</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1397</GroupID>
            <ARTGs>
                <ARTG>95761</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV017</BillingCode>
            <Name>Cancellous Bone Screw</Name>
            <Description>Option bone screw for tibial component</Description>
            <Size>6.5mm x 1.5 - 6cm in 0.5cm increments long</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>247558</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV049</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision System Screws</Description>
            <Size>Pass Through, Stem Extension, Side Lock, CCK Pass Through 10-24mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>247558</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR277</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO120</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System</Name>
            <Description>Screw, Ti</Description>
            <Size>5mm to 5.7mm x 5mm to 17.5mm long</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>246509</ARTG>
                <ARTG>246508</ARTG>
                <ARTG>246510</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR285</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO192</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Knee, Bone Screw</Name>
            <Description>6.5mm Bone Screw</Description>
            <Size>15mm, 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 65mm, 70mm.</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>242554</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR290</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO259</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Revision Knee - Femoral and Tibial Augment Locking Screw/Bolt</Name>
            <Description>Femoral and Tibial Locking Screw/Bolt</Description>
            <Size>Femoral Augment Locking Screw/Bolt - one size only  Tibial Augment Locking Screw/Bolt - 4mm, 8mm, 12mm</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>252312</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX030</BillingCode>
            <Name>Optetrak Total Knee System Tibial Stem Extension Screw</Name>
            <Description>Tibial Stem Screw for Tibial stem fixation</Description>
            <Size>One size only</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>252474</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HT021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TZ022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Genus Uni Tibial Screw</Name>
            <Description>Bone Screws for use with the Genus Uni Tibia</Description>
            <Size>6.5mm 20-50mm</Size>
            <SupplierCode>HT</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>237073</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW195</BillingCode>
            <Name>HMRS (Howmedica Modular Replacement System) Plug screw Axis</Name>
            <Description>HMRS Plug Screw Axis, UHMWPE, (Duration) for fixation of HMRS Axis within HMRS bearing component of HMRS Distal Femur / Proximal Tibia and HMRS Femoral / Tibial Joint. </Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>261512</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH616</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee System - ACS Screws</Name>
            <Description>Screw for spacers and augments</Description>
            <Size>2 sizes</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>221737</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU036</BillingCode>
            <Name>Evolis Knee System Fixation Screw </Name>
            <Description>Tibial screw for baseplate fixation to bone, titanium, optional </Description>
            <Size>20/25/30/35/40/45mm (6.5mm diameter)</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>219907</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN329</BillingCode>
            <Name>Genesis II</Name>
            <Description>Tibial screws</Description>
            <Size>15-50mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>230143</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI089</BillingCode>
            <Name>Miller Galante II</Name>
            <Description>Bone Screw - Ti</Description>
            <Size>20 - 80mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1398</GroupID>
            <ARTGs>
                <ARTG>112735</ARTG>
            </ARTGs>
            <MinimumBenefit>123</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB200</BillingCode>
            <Name>Emotion Total Knee System (TKS) Tibial and Femoral Stems</Name>
            <Description>Tibial and femoral stems, CoCr, cemented or uncemented</Description>
            <Size>Short, D: 10mm to 20mm , Medium, D: 10mm to 20mm, Long, D: 10mm to 20mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB242</BillingCode>
            <Name>Columbus Total Knee System (TKS) Tibial Stem</Name>
            <Description>Tibial Stem, cemented or uncemented, CoCr</Description>
            <Size>12mm &amp; 14mm,  in uncemented, 12mm &amp; 14mm in cemented. </Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB353</BillingCode>
            <Name>EnduRo Rotating Hinge Knee Tibial and Femoral Extension Stems cementless and cemented</Name>
            <Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to&#xD;
treat complex revision knee arthoplasty as well as unstable knees</Description>
            <Size>Length Tibial: 52,92&amp;172mm Length Femoral: 77,117,157&amp;177mm - Tibial Cemented: x 12,15,18mm - Tibial Cementless: x 11-20cm - Femoral Cemented: x 12,15,18mm - Femoral Cementless: x 13-20mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB379</BillingCode>
            <Name>Aesculap AS Tibial and Femoral Stems</Name>
            <Description>Tibial and Femoral Stems, cemented or uncemented, CoCr with ZrN coating</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>277356</ARTG>
                <ARTG>277357</ARTG>
                <ARTG>277359</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI171</BillingCode>
            <Name>Maxim Complete Knee System Femoral and Tibial Stems </Name>
            <Description>Femoral and Tibial Stems, Titanium, curved and straight, cemented </Description>
            <Size>40mm 80mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BI184</BillingCode>
            <Name>Biomet Universal Tibial and femoral stems</Name>
            <Description>Tibial and Femoral Stems, Titanium, curved and straight, cemented</Description>
            <Size>40-200mm</Size>
            <SupplierCode>BI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>177878</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV044</BillingCode>
            <Name>Advance Medial Pivot Knee System</Name>
            <Description>Uncemented, Cemented Stems&#xD;
Femoral, Tibial</Description>
            <Size>55-200mm&#xD;
10-23mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV048</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision Stems - Cemented, Canal Filling</Description>
            <Size>17mm - 18mm x 25mm - 75mm&#xD;
10mm - 24mm x 100m - 150mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR274</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO114</PriorBillingCode>
            </PriorBillingCodes>
            <Name>RBK Total Knee System Stems </Name>
            <Description>Tibial and Femoral Stems, cemented, Titanium including locking bolt</Description>
            <Size>10mm to 24mm thick x 80mm to 170mm long</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>278990</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR292</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GO283</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Apex Revision Knee Stems</Name>
            <Description>Apex Revision Knee Femoral and Tibial Stems</Description>
            <Size>Modular Stem - 9-25mm x 75-150mm  Offset - 9-25mm x 75-15mm x 2-4mm  Angled Stem - 9-25mm x 75x150mm  Modular Tibial Keels 1-16</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>276775</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP143</BillingCode>
            <Name>PFC Sigma Knee System tibial stems</Name>
            <Description>Tibial stems cemented and fluted uncemented, titanium</Description>
            <Size>Sizes 30-150mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>238732</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX027</BillingCode>
            <Name>Optetrak Total Knee System Femoral and Tibial Stems</Name>
            <Description>Femoral and Tibial Stems for Optetrak Knee System, titanium, cemented or uncemented, femoral stem requires stem extension adapter on every occasion, tibial stem requires screw fixation</Description>
            <Size>Size 1 - 6</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>250112</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA021</BillingCode>
            <Name>Optetrak Logic Stem Extension Femoral and Tibial</Name>
            <Description>Femoral and Tibial Stems for Logic CC System, titanium, cemented or uncemented</Description>
            <Size>10mm - 24mm, length 25mm - 160mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>250112</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW171</BillingCode>
            <Name>Duracon Knee System / Kinemax Knee System stem</Name>
            <Description>Stem, femoral &amp; tbial, CoCr, (Vitallium), cemented</Description>
            <Size>40mm, 80mm, 155mm for each size</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>242297</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ655</BillingCode>
            <Name>PFC Knee System - Universal Slotted Stem</Name>
            <Description>Tibial/Femoral Stem-Titanium</Description>
            <Size>Lengths 75, 115, 150mm; widths 10 to 24mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>98092</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH638</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO094</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS - Genux stems</Name>
            <Description>Genux cemented. Press fit stems</Description>
            <Size>130-240mm length, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20mm wide</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>241989</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH662</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO122</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACS Knee system, ACS stems, straight and offset</Name>
            <Description>ACS tibial and femoral stems</Description>
            <Size>12/14/16/18/20/22mm dia stems, 25/50/75/100/150/200mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>241989</ARTG>
                <ARTG>265633</ARTG>
                <ARTG>265634</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH679</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO161</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MUTARS GenuX MK Stems</Name>
            <Description>MUTARS GenuX MK Stems</Description>
            <Size>11/12/13/14/15/16/17/18/19/20/22/24/26/28mm dia. 125/150/200/250 length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>241989</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LI066</BillingCode>
            <Name>Amplitude Femoral and Tibial Stems</Name>
            <Description>Femoral and Tibial Stems, Titanium, cemented</Description>
            <Size>7 diameters (10-22), 4 lengths (75-200mm)</Size>
            <SupplierCode>LI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>275851</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO173</BillingCode>
            <Name>Link Endo Model Rotational and Hinge Knee Prostheses</Name>
            <Description>Stems</Description>
            <Size>Extra small - Extra large</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>157545</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MA507</BillingCode>
            <Name>Balansys Revision Knee, Stems</Name>
            <Description>Ti uncemented Stem, straight and offset, complete with locking screw</Description>
            <Size>80 to 200mm, straight and offset 4mm</Size>
            <SupplierCode>MA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>257054</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN208</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Revision Stems</Description>
            <Size>14mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>288501</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN226</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Revision stems</Description>
            <Size>10 to 24mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>288501</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU035</BillingCode>
            <Name>Evolis Knee System Tibial Stem </Name>
            <Description>Tibial stems, titanium, cemented</Description>
            <Size>30/60mm length (12mm diameter)</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>254754</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU069</BillingCode>
            <Name>GMK Tibial Extension Stem</Name>
            <Description>Tibial Baseplate extension stem</Description>
            <Size>diameter 11mm, length 65mm &amp; 30mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>241989</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU082</BillingCode>
            <Name>GMK Revision cemented extension stem</Name>
            <Description>Cemented tibia and femur extension stem</Description>
            <Size>Diameters 11, 13 and 16mm, available in 2 or 3 lengths (65, 105, 150mm)</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>254754</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU086</BillingCode>
            <Name>GMK Revision uncemented extension stem</Name>
            <Description>Uncemented tibia and femur extension stem</Description>
            <Size>Multiple diameters (10, 11, 12, 13, 14, 15, 16, 18, 19, 20, 22mm) each one available in 3 lengths (65, 105, 150mm)</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>254754</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH418</BillingCode>
            <Name>Trekking Knee System - TCK Femoral and Tibial Stems</Name>
            <Description>TCK Femoral and Tibial Stems</Description>
            <Size>Size (mm): 10 - 23&#xD;
Size (mm): 40 - 120</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>283167</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF137</BillingCode>
            <Name>SHiVA Hinge Knee Revision System - Stems</Name>
            <Description>Knee revision Extension Stem</Description>
            <Size>Straight 10 - 18mm Diameter; 50 to 150mm Length&#xD;
Offset 10 - 16 mm Diameter; 75mm Length</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>192962</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK434</BillingCode>
            <Name>Triathlon Knee System TS Titanium stem</Name>
            <Description>Stem, Titanium, uncemented</Description>
            <Size>10-25 (100mm) 10-25 (150mm)</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>242297</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN316</BillingCode>
            <Name>Genesis II Knee System Tibial and Femoral Stems</Name>
            <Description>Tibial and Femoral Stems, titanium, cemented or press fit</Description>
            <Size>10-24x100mm, 10-20 x 150mm 10-16x 200mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>246212</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN319</BillingCode>
            <Name>Genesis II</Name>
            <Description>Metaphyseal Stem</Description>
            <Size>1-8</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>246212</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN377</BillingCode>
            <Name>Profix</Name>
            <Description>Metaphyseal Tibial Stem</Description>
            <Size>14-20mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>246212</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SN823</BillingCode>
            <Name>Legion Knee System Femoral and Tibial Stems</Name>
            <Description>Femoral and Tibial stems, Titanium, Cemented or press fit</Description>
            <Size>120-280mm</Size>
            <SupplierCode>SN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>246212</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR035</BillingCode>
            <Name>Triathlon Knee System TS stem</Name>
            <Description>Tibial stem, Titanium, cemented</Description>
            <Size>9x50mm, 9x100mm, 9x150mm, 12x50mm, 12x100mm, 12x150mm, 15x50mm, 15x100mm, 15x150mm</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>242297</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR037</BillingCode>
            <Name>Triathlon Knee System Femoral Distal Fixation Peg</Name>
            <Description>Modular Femoral Distal Fixation Peg CoCr</Description>
            <Size>one size</Size>
            <SupplierCode>SR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>242294</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST606</BillingCode>
            <Name>Duracon Knee System Tibial &amp; Femoral stem</Name>
            <Description>Stem, femoral &amp; tibial, titanium, cemented</Description>
            <Size>10mm-19mm, 21mm, 23mm in 80mm and 155mm lengths</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>242297</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZA094</BillingCode>
            <Name>Persona Revision Stem Extension, Splined, Smooth and Tapered</Name>
            <Description>Composed of Tivanium alloy, for hybrid or cemented fixation</Description>
            <Size>Length-     +30, +75 mm (tapered)  +135, +175 mm ( splined and smooth)           Diameter-     11, 14 mm (tapered)   10, 12, 14, 16, 18, 20, 22, 24 mm (smooth)  10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 22, 24 mm (splined)</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>374554</ARTG>
                <ARTG>374553</ARTG>
                <ARTG>374555</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI146</BillingCode>
            <Name>NexGen Femoral and Tibial Stems </Name>
            <Description>Femoral and Tibial Stems, straight and offset, cemented </Description>
            <Size>Length - 35 - 155mm, Diameters - 10 - 24 mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>95761</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI936</BillingCode>
            <Name>Persona Knee System</Name>
            <Description>Stem Extension</Description>
            <Size>14mm x 30mm</Size>
            <SupplierCode>ZI</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1399</GroupID>
            <ARTGs>
                <ARTG>250072</ARTG>
            </ARTGs>
            <MinimumBenefit>1098</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BH063</BillingCode>
            <Name>Regenerex Sleeve Augment</Name>
            <Description>Augment, cone or finned sleeve, SSK/OSS Systems, Ti</Description>
            <Size>(25mm to 40mm, Type A or B) x Extra small/Large</Size>
            <SupplierCode>BH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>98451</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY156</BillingCode>
            <Name>LCS, PFC and SROM  Knee Systems, femoral metaphyseal sleeve</Name>
            <Description>Universal femoral metaphyseal sleeve, Porocoat, smaller size cemented, larger sizes uncemented, titanium</Description>
            <Size>20 - 46mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>237112</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY157</BillingCode>
            <Name>MBT  Knee Systems tibial metaphyseal sleeve</Name>
            <Description>Universal tibial metaphyseal sleeve, Porocoat, smaller size cemented or uncemented, larger sizes uncemented, titanium</Description>
            <Size>29 - 61mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>237112</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA023</BillingCode>
            <Name>Optetrak Logic Femoral Metaphyseal Cones</Name>
            <Description>3D printed titanium femoral metaphyseal cones to achieve metaphyseal fixation in cases where bone stock is compromised.</Description>
            <Size>Femoral cones: small, medium, large, and x-large with heights 32mm, 42mm, and 52mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FA027</BillingCode>
            <Name>Optetrak Logic Tibial Metaphyseal Cones</Name>
            <Description>3D printed titanium tibial metaphyseal cones to achieve metaphyseal fixation in cases where bone stock is compromised.</Description>
            <Size>29, 32, 39, 48, 57, and 65mm</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW574</BillingCode>
            <Name>Triathlon Tritanium Femoral Cone Augments</Name>
            <Description>3D printed Tritanium Cone Augments intended for filling bone voids in metaphyseal region of bone. CPTi porous foam for biological fixation or cement interdigitation, for use with Triathlon TS cemented or uncemented stems</Description>
            <Size>Femoral Cone Augments, 6 sizes, L &amp; R (Size 1-2, Size 3, 4, 5, 6 and Size 7-8)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>262263</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW575</BillingCode>
            <Name>Triathlon Tritanium Symmetric Tibial Cone Augments</Name>
            <Description>3D printed Tritanium Cone Augments intended for filling bone voids in metaphyseal region of bone. CPTi porous foam for biological fixation or cement interdigitation, for use with Triathlon TS cemented or uncemented stems</Description>
            <Size>Symmetric Tibial Cone Augments, 5 sizes (A – E)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>262263</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW576</BillingCode>
            <Name>Triathlon Tritanium Asymmetric Tibial Cone Augments</Name>
            <Description>3D printed Tritanium Cone Augments intended for filling bone voids in metaphyseal region of bone. CPTi porous foam for biological fixation or cement interdigitation, for use with Triathlon TS cemented or uncemented stems.</Description>
            <Size>Asymmetric Tibial Cone Augments, 4 sizes, LM/RL &amp; RM/LL, (B-E).</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>262263</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ706</BillingCode>
            <Name>LCS, PFC &amp; SROM Knee System - Universal Fully Porous Femoral Metaphyseal Sleeve</Name>
            <Description>Universal Fully Beaded (Porocoat) Femoral Metaphyseal Titanium Sleeve</Description>
            <Size>31-46mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>131657</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH684</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OO174</PriorBillingCode>
            </PriorBillingCodes>
            <Name>EPORE Cones/Components</Name>
            <Description>Femoral/Tibial metaphyseal Cones and Components, 3D Printed titanium</Description>
            <Size>Sizes 2-6 for Femur and Tibia, Left and Right</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>221737</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO189</BillingCode>
            <Name>TrabecuLink Tibial Cones</Name>
            <Description>Trabecular Tilastan Tibial void filling cone intended for proximal metaphyseal bone surrounding stem, full or stepped</Description>
            <Size>Full; right half; left half  XS - x-small; S - small; M - medium; L - large  Depth: 33.00 mm - 37.50 mm  Width: 48 mm - 66 mm  Height: 12 mm - 30 mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>373076</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LO190</BillingCode>
            <Name>TrabecuLink Femoral Cones</Name>
            <Description>Trabecular Tilastan Femoral void filling cone intended for proximal metaphyseal bone surrounding stem, full or stepped</Description>
            <Size>3 - Zones: 2- Zones: Proximal:  right; left:  XS - x-small; S - small; M - medium; L - large:  Depth: 26.00 mm - 32 mm:  Width: 37 mm - 52 mm:  Height: 30 mm - 60 mm</Size>
            <SupplierCode>LO</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>373076</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN227</BillingCode>
            <Name>Attune Knee System</Name>
            <Description>Metaphyseal Sleeves, femoral and tibial</Description>
            <Size>29 to 69mm plus cemented</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>298543</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU152</BillingCode>
            <Name>3D Metal Tibial Cone</Name>
            <Description>Tibial Cone</Description>
            <Size>Centred cones, sizes from XS to L, Height 20-25 mm&#xD;
Eccentric cones, sizes from S to L, Height 20-25 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>254755</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU175</BillingCode>
            <Name>3DMetal Diaphyseal Femoral Cones</Name>
            <Description>Femoral cone</Description>
            <Size>Small, Medium, Large, Extra Large</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>254755</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL073</BillingCode>
            <Name>Legion Tibial Cone</Name>
            <Description>Tibial cone augment intended to fill cavitary bone defects in the proximal tibial metaphyseal bone.</Description>
            <Size>Short-long, 18-30 mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>238696</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL074</BillingCode>
            <Name>Legion Femoral Cone</Name>
            <Description>Femoral cone augment intended to fill cavitary bone defects in the femoral metaphyseal bone</Description>
            <Size>left/right, 18-30mm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>238696</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI485</BillingCode>
            <Name>Trabecular Metal Tibial Cone</Name>
            <Description>Trabecular Metal Tibial void filling cone for proximal metaphyseal bone surrounding stem, full or stepped</Description>
            <Size>XSMALL/SMALL/MED/LARGE/XL</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>242592</ARTG>
                <ARTG>357912</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZI516</BillingCode>
            <Name>Trabecular Metal Femoral Cone </Name>
            <Description>Trabecular Metal femoral void filling cone for distal metaphyseal bone surrounding stem</Description>
            <Size>SMALL/MED/LARGE/XL</Size>
            <SupplierCode>ZA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <Suffix>Metaphyseal</Suffix>
            <ARTGs>
                <ARTG>242592</ARTG>
                <ARTG>357912</ARTG>
            </ARTGs>
            <MinimumBenefit>2356</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB319</BillingCode>
            <Name>Emotion Total Knee System Femoral Stem Extension</Name>
            <Description>Revision nut for Femur Extension Stem</Description>
            <Size>One size only</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB351</BillingCode>
            <Name>Enduro Rotating Hinge Knee Femoral Stem locking nut neutral</Name>
            <Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthroplasty as well as unstable knees.</Description>
            <Size>1 size neutral (for all femoral stems)</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>96481</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB381</BillingCode>
            <Name>Aesculap AS Femoral Stem Locking Nut</Name>
            <Description>Femoral Stem Locking Nut, CoCr with ZrN coating</Description>
            <Size>One size</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>277359</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV046</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision Stem Extension Adapter</Description>
            <Size>25mm - 50mm</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BV051</BillingCode>
            <Name>Evolution Medial Pivot Knee System</Name>
            <Description>Revision Tibial Base Modular Keel</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>BV</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>196521</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CR265</BillingCode>
            <Name>Unity Knee – Stem Extenders</Name>
            <Description>Tibial Stem extenders and offset couplings -cemented</Description>
            <Size>3mm, 6mm  Diameter Ø10-18  Length 60 , 30 and 100mm  Offset and straight</Size>
            <SupplierCode>CR</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>274747</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EX029</BillingCode>
            <Name>Opetrak Total Knee System Femoral Stem Extension Adpater</Name>
            <Description>Femoral Stem Extension Adapter that provides for set changes in angulation of stem needs to be used on every occasion</Description>
            <Size>2 - 7 Degree</Size>
            <SupplierCode>FA</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>250092</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW233</BillingCode>
            <Name>KRH (Kinemax Knee System Rotating Hinge) &amp; MRH (Modular Rotating Hinge) Rotating Hinge Sleeve</Name>
            <Description>KRH &amp; MRH Rotating Hinge Tibial Sleeve, UHMWPE, (Duration) houses Rotating Hinge Tibial Rotating component sHydroxyapatiteft</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>247298</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK442</BillingCode>
            <Name>Triathlon Knee System Stem Extender</Name>
            <Description>Stem extender, cemented, CoCr </Description>
            <Size>25mm &amp; 50mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1400</GroupID>
            <ARTGs>
                <ARTG>242297</ARTG>
            </ARTGs>
            <MinimumBenefit>681</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UK005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER297</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spacer-K</Name>
            <Description>Temporary implantable device for the treatment of infected total knee replacement, Composition - stainless steel core surrounded by PMMA impregnated with Gentamicin</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>UK</SupplierCode>
            <CategoryID>17</CategoryID>
            <SubCategoryID>159</SubCategoryID>
            <GroupID>1401</GroupID>
            <ARTGs>
                <ARTG>155141</ARTG>
            </ARTGs>
            <MinimumBenefit>1814</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB367</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Monoaxial Cannulated Screw</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR036</BillingCode>
            <Name>Z-Medical Pedicle Screw System - Pedicle Screws, Monoaxial</Name>
            <Description>Z-Medical Pedicle Screw System - Pedicle Screws, Monoaxial, Cannulated</Description>
            <Size>Dia (5-8)mm x Length (35-55)mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>343676</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER330</BillingCode>
            <Name>Ulrich Pedicle Screw System-Pedicle Screw, monoaxial, cannulated</Name>
            <Description>Ulrich Pedicle Screw System (cosmicMIA, uCentum)-Pedicle Screw, monoaxial, cannulated, with or without HA coating or fenestrations</Description>
            <Size>dia (4.5-10 mm) x length (25-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>279706</ARTG>
                <ARTG>289054</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW581</BillingCode>
            <Name>ES2 Augmentable Monoaxial Screw</Name>
            <Description>Fenestrated Cannulated Monoaxial Screw</Description>
            <Size>Dia 5.5mm to 7.5mm, length 30mm to 90mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>315418</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH355</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medyssey Spinal Fixation System</Name>
            <Description>Cannulated Monoaxial Screw</Description>
            <Size>4.0-8.5</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG007</BillingCode>
            <Name>VENTOTENE Fixed Screw</Name>
            <Description>Standard Cannulated</Description>
            <Size>5.5/6.5/7.5mm Diameter  25-80mm Length</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>397231</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ820</BillingCode>
            <Name>Viper Spinal System - monoaxial screw</Name>
            <Description>Monoaxial screw</Description>
            <Size>30 - 80mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH081</BillingCode>
            <Name>ZINA MIS Monoaxial Screw </Name>
            <Description>ZINA MIS Spine System - Cannulated Monoaxial Screw</Description>
            <Size>Diameter x Length ( mm )   4.5×30   4.5×35  4.5×40  4.5×45  4.5×50  4.5×55  4.5×60  4.5×65  5.0×30  5.0×35  5.0×40  5.0×45  5.0×50  5.0×55  5.0×60  5.0×65  5.5×30  5.5×35  5.5×40  5.5×45  5.5×50  5.5×55  5.5×60  5.5×65  6.0×30  6.0×35  6.0×40  6.0×45  6.0×50  6.0×55  6.0×60  6.0×65  6.5×30  6.5×35  6.5×40  6.5×45  6.5×50  6.5×55  6.5×60  6.5×65  7.0×30  7.0×35  7.0×40  7.0×45  7.0×50  7.0×55  7.0×60  7.0×65  7.5×30  7.5×35  7.5×40  7.5×45  7.5×50  7.5×55  7.5×60  7.5×65  </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB215</BillingCode>
            <Name>CREO® Side Loading Monoaxial Screw, Cannulated</Name>
            <Description>Cannulated monoaxial pedicle screw</Description>
            <Size>Diameter: 4.0 - 10.5mm  Length: 20 -120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU125</BillingCode>
            <Name>M.U.S.T Monoaxial Pedicle Screws Cannulated</Name>
            <Description>Monoaxial screws cannulated</Description>
            <Size>5 - 7 mm: Length 30- 60 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV151</BillingCode>
            <Name>Reline (Cannulated Monoaxial Screw)</Name>
            <Description>Cannulated Fixed Pedicle Screw</Description>
            <Size>4.5-12.5mm diameter; 25-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB059</BillingCode>
            <Name>TINA Minimally Invasive Spine System</Name>
            <Description>Monoaxial Cannulated Screw</Description>
            <Size>All sizes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI039</BillingCode>
            <Name>HPS™ Monoaxial Pedicle Screw</Name>
            <Description>Monaxial pedicle screw</Description>
            <Size>Diameter: 5-8mm  Length: 30-60mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>345870</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY708</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Matrix Preassembled Monoaxial Pedicle Screw, Cannulated</Description>
            <Size>5.00mm - 9.00mm Diameter; 20mm - 65mm Length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>889</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER239</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial (closed)</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial (closed)</Description>
            <Size>dia (3.5-4.0 mm) x length (20-35 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC823</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Legacy Fixed Iliac Screw</Description>
            <Size>5.5mm to 8.5mm Diameter</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC636</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Eclipse Dual Head Screws</Description>
            <Size>20-60mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>904</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW756</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER202</PriorBillingCode>
            </PriorBillingCodes>
            <Name> Mesa Monoaxial Screw    </Name>
            <Description>Monoaxial screw, rotating head    </Description>
            <Size>Diameter: 4.5mm - 8.5mm, Length: 25mm - 55mm </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>Integrated Locking Mechanism</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>911</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH354</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Novel/Zenius Reduction Mono screw</Name>
            <Description>Monoaxial Reduction pedicle screw</Description>
            <Size>5.5-8.5</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <Suffix>With cap/cover plate</Suffix>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>862</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB373</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Monoaxial Screw - titanium alloy</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW022</BillingCode>
            <Name>Libra Pedicle Screw System  </Name>
            <Description>Monoaxial Screw  </Description>
            <Size>Diameter: 4.5mm - 8.5mm     Length: 20mm - 100mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>355051</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE625</BillingCode>
            <Name>Malibu Spinal System Monoaxial Screw</Name>
            <Description>Monoaxial Bone Screw</Description>
            <Size>4.5mm x 25mm - 9.5mm x 80mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE801</BillingCode>
            <Name>Mariner Uniaxial Screw</Name>
            <Description>Uniaxial Screw</Description>
            <Size>4.5-7.5mm Diameter, 20-110mm Lengths    </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR005</BillingCode>
            <Name>Life Spine Pedicle Screw System - Pedicle Screw, Monoaxial</Name>
            <Description>Life Spine Pedicle Screw System - Pedicle Screw, Monoaxial, Standard/Reduction</Description>
            <Size>dia (4.5-8.5)mm x length (30-125)mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU017</BillingCode>
            <Name>Romeo 2  Posterior Thoraco-lumbar Fixation System - Monoxial Screw</Name>
            <Description>Monomial pedicle screw</Description>
            <Size>Diameter: 4mm, 5mm, 6mm, 7mm, 8mm  Length: 25m, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 70mm, 80mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU040</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - monoaxial screw</Name>
            <Description>Monoaxial pedicle screws</Description>
            <Size>Diameter: 4.5 - 9.5mm.  Length: 25 - 120mm.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER222</BillingCode>
            <Name>SIGNUS Diplomat Pedicle Screw System - Monoaxial Screw</Name>
            <Description>SIGNUS Diplomat Pedicle Screw System - Monoaxial Screw</Description>
            <Size>dia (5.5-9.5 mm) xlength (30-70 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER231</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Monoaxial</Description>
            <Size>dia (4-7 mm) x length (25-55 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER331</BillingCode>
            <Name>Ulrich Pedicle Screw System-Pedicle Screw, monoaxial</Name>
            <Description>Ulrich Pedicle Screw System (uCentum,flamenco)-Pedicle Screw, monoaxial, standard or long arm</Description>
            <Size>dia (4.5-10 mm) x length (25-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER445</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Pedicle Screw, monoaxial</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Pedicle Screw, monoaxial;self tapping and non self tapping; standard and reduction; accommodates rods 5.0, 5.5, 6.0 and 6.35 mm dia.</Description>
            <Size>dia (4.0-8.5mm) x length (20-150mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER615</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Firebird mono axial screws</Name>
            <Description>Firebird mono axial pedicle screws in various diameters and lengths. Titanium.</Description>
            <Size>4.0, 4.5, 5.5, 6.5, 7.5. 8.5; 25mm-100mm in 5mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER658</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-Monoaxial screw</Name>
            <Description> AccelFix S/AccelFix DS/AccelFix SS Monoaxial screws, reduction or non-reduction, Ti, sterile.</Description>
            <Size>Diameter: 4-8.5 mm  Length:    34.5-176.5 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW020</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Monoaxial screws </Description>
            <Size>All sizes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW385</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Monoaxial Screw</Description>
            <Size>Dia 4.5 - 8.5mm Length 25 - 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
                <ARTG>279159</ARTG>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Monoaxial Screw</Name>
            <Description>Monoaxial Pedicle Screw</Description>
            <Size>4.5 - 7.5mm diameter   25 - 55mm length</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH357</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medyssey Spinal Fixation System</Name>
            <Description>Monoaxial Screw</Description>
            <Size>4.0-8.5</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG008</BillingCode>
            <Name>VENTOTENE Fixed Screw</Name>
            <Description>Standard Solid</Description>
            <Size>4.5/5.5/6.5/7.5mm Diameter  25-110mm Length</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>397231</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ936</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Monoaxial Screw</Description>
            <Size>4 - 10mm Diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ941</BillingCode>
            <Name>Moss Miami Spinal System</Name>
            <Description>Monoaxial Screw</Description>
            <Size>5-8mm Diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB015</BillingCode>
            <Name>AnyPlus II Mono Screw</Name>
            <Description>Monaxial Pedicle Screw and Mono Reduction Screws</Description>
            <Size>Diameter: 4.5-7.5mm  Length: 35-55mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>353891</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH050</BillingCode>
            <Name>Monoaxial Screws</Name>
            <Description>Dual Head Screws</Description>
            <Size>35-45mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH059</BillingCode>
            <Name>Monoaxial Screws</Name>
            <Description>Monoaxial Screws</Description>
            <Size>20-55mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB083</BillingCode>
            <Name>REVERE Monoaxial Screw</Name>
            <Description>Monoaxial Screw</Description>
            <Size>4.0mm x 20-35mm in 5mm increments&#xD;
4.5mm x 20-45mm in 5mm increments&#xD;
5.0mm x 25-55mm in 5mm increments&#xD;
5.5mm x 20 -50mm in 5mm increments&#xD;
5.5 x 27mm in 5mm increments and 25mm-6mm increments in 5mm increments&#xD;
6.5mm x 25-65mm in 5mm increments&#xD;
6.5mm x 27mm -55mm in 5mm increments and 25mm - 65mm in 5mm increments&#xD;
8.5mm x 25mm-65mm in 5mm increments&#xD;
9.0mm x 25- 25mm-120mm in 5mm increments&#xD;
10.0mm x 25mm-120mm in 5mm increments</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB084</BillingCode>
            <Name>REVERE TRANSITION HA Coated Monoaxial Screw</Name>
            <Description>Monoaxial Screw HA Coated</Description>
            <Size>6.5mm - 8.5mm x 35mm - 65mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB089</BillingCode>
            <Name>CREO Stabilization System Preassembled Monoaxial Screw</Name>
            <Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description>
            <Size>4.75 and 5.5  4.0mm diameter to 8.5mm diameter  20mm to 90mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <Note>The Prostheses List (PL) billing code does not cover the use of the device for vertebral body tethering (VBT) for the management of adolescent idiopathic scoliosis (AIS).</Note>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB213</BillingCode>
            <Name>CREO® Side Loading Monoxial Screw</Name>
            <Description>Monoaxial screw</Description>
            <Size>Diameter: 4-10.5mm  Length: 20-120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH519</BillingCode>
            <Name>DSS Spinal System</Name>
            <Description>Monoaxial Pedicle Screw - cannulated</Description>
            <Size>5-9mm Diam x 30-60mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>186733</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM448</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK064</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella Uniplanar Pedicle Screw</Name>
            <Description>Excella Pedicle Screw System Uniplanar Pedicle Screw</Description>
            <Size>4.0 to 6.5mm diameter  25 to 55 long</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM493</BillingCode>
            <Name>Pedicle Screw</Name>
            <Description>Pedicle Screw</Description>
            <Size>Diameter 4.5 - 9.5 mm  Length 25 - 110 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC967</BillingCode>
            <Name>CD HORIZON Spinal System - Fixed Angle Screw</Name>
            <Description>CD HORIZON SOLERA Fixed Angle Screw</Description>
            <Size>Diameter: 4.0mm - 10.5mm

Length:  15mm - 110mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU126</BillingCode>
            <Name>M.U.S.T Monoaxial Pedicle Screws</Name>
            <Description>Monoaxial Screws</Description>
            <Size>4.5 - 8mm; Length 25-90 mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV056</BillingCode>
            <Name>Armada (Fixed Screw)</Name>
            <Description>Fixed screw</Description>
            <Size>4.0/4.5/5.0/5.5/6.5/7.5 x 25-55mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV112</BillingCode>
            <Name>Reline (Monoaxial Screw)</Name>
            <Description>Fixed Screw</Description>
            <Size>4.0mm-12.5mm in diameter; 15-120mm in length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV121</BillingCode>
            <Name>Precept (Fixed Screw)</Name>
            <Description>Fixed Screw</Description>
            <Size>4.5-12.5mm diameter; 25-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI993</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Monoaxial Pedicle Screws</Name>
            <Description>Monoaxial pedicle Screws Titanium</Description>
            <Size>Diameter = 4.0mm-7.5mm  Length= 20mm-55mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH580</BillingCode>
            <Name>Venus Spinal Fixation System - Pedicle Screws - Mono</Name>
            <Description>Venus - Monoaxial Pedicle Screws</Description>
            <Size>D 4.0-7.2mm L 25-70mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB008</BillingCode>
            <Name>DPS Spine System - Monoaxial Pedicle Screw</Name>
            <Description>Mono-axial pedicle screws</Description>
            <Size>Diameter 4/5/6/7mm; Length 25 - 55mm.</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ012</BillingCode>
            <Name>Centaur Monoaxial Screw</Name>
            <Description>Monoaxial screw</Description>
            <Size>Diameter 4mm-10mm, lengths 20mm-110mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI013</BillingCode>
            <Name>Streamline TL- Fixed Pedicle Screws</Name>
            <Description>Fixed Pedicle Screws in various diameters and lengths (Titanium Alloy)</Description>
            <Size>4.5mm diameter x 20mm to 45mm in 5mm increments; 5.5,6.5 &amp; 7.5mm diameters x 30mm to 60mm in 5mm increments</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ103</BillingCode>
            <Name>RESPONSE Spine System – Uniaxial Screw</Name>
            <Description>Pedicle Uniaxial Screw</Description>
            <Size>4-7mm diameter, 20mm-100mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY597</BillingCode>
            <Name>Universal Spine System</Name>
            <Description>Pedicle screw</Description>
            <Size>25mm - 140mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY707</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Matrix Preassembled Monoaxial Pedicle Screw</Description>
            <Size>4.00mm - 9.00mm; 20mm - 100mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB006</BillingCode>
            <Name>Lumfix Monoaxial Screw </Name>
            <Description>Self Tapping Screw, single or dual thread , std or reduction castle. </Description>
            <Size>(4.0 - 8.5)mm diameter x (20- 60)mm length </Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1462</GroupID>
            <ARTGs>
                <ARTG>327225</ARTG>
            </ARTGs>
            <MinimumBenefit>789</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB364</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Polyaxial Cannulated Screw</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH591</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pedicle Screw</Name>
            <Description>Cannulated Screw,  Carbon Fiber Reinforced Polymer</Description>
            <Size>(6.5-7.5)mm x (35-55) mm length</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>288089</ARTG>
            </ARTGs>
            <Note>To be reimbursed only when used in patients with spinal tumours</Note>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW021</BillingCode>
            <Name>Libra Pedicle Screw System</Name>
            <Description>Polyaxial Cannulated Pedicle screws</Description>
            <Size>Diameter: 5.5mm - 8.5mm   Length: 20mm - 100mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>355051</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE593</BillingCode>
            <Name>Newport MIS Extended Tab Polyaxial Screw</Name>
            <Description>Cannulated Polaxial Pedicle Screw</Description>
            <Size>4.75, 5.5, 6.5, 7.5, 8.5 and 9.5mm diameter&#xD;
Lengths 30 - 60mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR006</BillingCode>
            <Name>Life Spine Pedicle Screw System - Pedicle Screw, Polyaxial, Cannulated</Name>
            <Description>Life Spine Pedicle Screw System (Nautilus, Avatar)-Pedicle Screw, Polyaxial, Cannulated,</Description>
            <Size>dia (4.5-10 mm) x length (25-125 mm)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR034</BillingCode>
            <Name>Z-Medical Pedicle Screw System - Pedicle Screws, Cannulated</Name>
            <Description>Z-Medical Pedicle Screw - Cannulated (polyaxial and uniplanar)</Description>
            <Size>Dia. (5-8)mm x Length (35-55)mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>343676</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR048</BillingCode>
            <Name>Ulrich Medical Pedicle Screw System - Pedicle Screws, polyaxial, cannulated</Name>
            <Description>Ulrich Medical Pedicle Screw System - Pedicle Screws, polyaxial, cannulated</Description>
            <Size>4.5-10.0mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>365230</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU026</BillingCode>
            <Name>Romeo 2 MIS Posterior Thoraco-lumbar Fixation System - Cannulated Polyaxial Screw</Name>
            <Description>Cannulated polyaxial pedicle screw, perforated cannulated polyaxial pedicle screw</Description>
            <Size>Cannulated Screw -  Diameter: 5mm, 6mm, 7mm  Length: 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm  Perforated Cannulated Screw -  Diameter: 5mm,  6mm, 7mm, 8mm  Length: 35mm, 40mm, 45mm, 50mm, 55mm, 60mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU057</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - cannulated polyaxial screw</Name>
            <Description>Cannulated polyaxial screws, cannulated sagittal screws: cannulated /cannulated &amp; fenestrated</Description>
            <Size>Diameter: 4.5-10.5mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY556</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Polyaxial Screws</Description>
            <Size>4.35 - 12mm diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER144</BillingCode>
            <Name>Signus Pedicle Screw System-Pedicle Screw Polyaxial Cannulated</Name>
            <Description>Signus Pedicle Screw System-Pedicle Screw Polyaxial Cannulated</Description>
            <Size>4.5 - 7.5mm x 30 - 70mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER288</BillingCode>
            <Name>Premia Spine Versalink Fixation System-Polyaxial Pedicle Screw</Name>
            <Description>Premia Spine Versalink Fixation System-Cannulated Polyaxial Pedicle Screw</Description>
            <Size>dia (5.5-8.5)mm x length (25-60)mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>267145</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER292</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial, MIS, Cannulated</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial, MIS, Cannulated</Description>
            <Size>dia (4.5-8.0 mm) x length (25-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER311</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Pedicle Screws, cannulated</Name>
            <Description>Ulrich posterior OCT System (neon3)-Pedicle Screws, cannulated</Description>
            <Size>dia (4-5.5 mm) x length (20-55 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER332</BillingCode>
            <Name>Ulrich Pedicle Screw System-Pedicle Screw, polyaxial, cannulated</Name>
            <Description>Ulrich Pedicle Screw System (uCentum)-Pedicle Screw, polyaxial, cannulated, with or without fenestrations</Description>
            <Size>dia (4.5-10 mm) x length (25-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER406</BillingCode>
            <Name>LnK MIS Spinal System/PathLoc-L MIS Spinal System-Pedicle Screw</Name>
            <Description>LnK MIS Spinal System /PathLoc-L MIS Pedicle screw, polyaxial,cannulated,self-tapping, double Thread, with sleeve</Description>
            <Size>dia (5.5-7.5mm) x length (30-60 mm); sleeve length (47-127 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>286124</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER659</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-MIS Polyaxial screw</Name>
            <Description>AccelFix MIS Polyaxial screw, open or closed, cannulated, sterile, Ti</Description>
            <Size>Diameter: 5.5-9.5 mm  Length:    30-150 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW045</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Cannulated polyaxial screws </Description>
            <Size>All sizes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC026</BillingCode>
            <Name>G2S Cannulated Polyaxial Screw</Name>
            <Description>Cannulated Polyaxial screw</Description>
            <Size>W:5.5-7.5mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>274075</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW484</BillingCode>
            <Name>ES2 Spinal System, Screw</Name>
            <Description>Polyaxial cannulated screw with integrated blades</Description>
            <Size>Diam 4.5mm to 8.5mm, Length 25mm to 90mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>278581</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW521</BillingCode>
            <Name>Mantis Augmentable Screw</Name>
            <Description>Augmentable Pedicle Screw</Description>
            <Size>5.5-8.5mm diameter, 40-65mm Length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>279142</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW580</BillingCode>
            <Name>ES2 Augmentable Polyaxial Screw</Name>
            <Description>Fenestrated Cannulated Polyaxial Screw</Description>
            <Size>Dia 5.5mm to 8.5mm, length 30mm to 90mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>279143</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW594</BillingCode>
            <Name>Xia 4.5 CT Cannulated Polyaxial Screw</Name>
            <Description>Cannulated Cortical Thread Polyaxial Screw</Description>
            <Size>Dia 4.5mm to 6.5mm, length 20mm to 45mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW632</BillingCode>
            <Name>Xia Serrato Cannulated Polyaxial Screw</Name>
            <Description>Cannulated Polyaxial Screw</Description>
            <Size>Dia 4.5mm-7.5mm; Length 20mm-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>279159</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW734</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Denali cannulated polyaxial screw</Name>
            <Description>Cannulated polyaxial pedicle screw</Description>
            <Size>Diameter:  5.5mm, 6.5mm and 7.5mm  Length:  35 to 55mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW760</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER214</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Everest Spinal System -Cannulated Screw</Name>
            <Description>Polyaxial Screw, Cannulated</Description>
            <Size>(4.5 -10.5)mm diam x (20-110)mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW761</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER215</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Everest Spinal System-Fenestrated Screw</Name>
            <Description>Polyaxial Screw, Fenestrated</Description>
            <Size>(4.5 -9.5)mm diam x (20-110)mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY004</BillingCode>
            <Name>Katana Polyaxial Screw</Name>
            <Description>Polyaxial Pedicle Screw</Description>
            <Size>4.5 – 9.5mm diameter  25 - 100mm length</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH356</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medyssey Spinal Fixation System</Name>
            <Description>Cannulated Polyaxial Screw</Description>
            <Size>4.0-8.5</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV070</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ sterile Multiaxial Pedicle Screws</Name>
            <Description>Cannulated: Fenestrated/ Multi Axial Cannulated Extended Head/ Extended Head Max and Auto Adjust screw</Description>
            <Size>Cannulated, Multi Axial Cannulated Extended Head, Extended Head Max and Auto Adjust  4.5mm x 25; 30; 35 mm  5.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  6.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  7.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  Fenestrated  4.5mm x 30;35;40 mm  5.5mm x 30; 35; 40; 45; 50; 55; 60 mm  6.5mm x 30; 35; 40; 45; 50; 55; 60 mm  7.5mm x 30; 35; 40; 45; 50; 55; 60 mm  Fenestrated Extended Head Max  4.5mm x30; 35; 40 mm  5.5mm x 30; 35; 40; 45; 50; 55; 60 mm  6.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  7.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB014</BillingCode>
            <Name>AnyPlus Long Arm Screw</Name>
            <Description>Polyaxial cannulated pedicle screws</Description>
            <Size>Diameter: 5.0 - 7.5mm  Length 25 -100mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>353891</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH046</BillingCode>
            <Name>Polyaxial Screws</Name>
            <Description>Cannulated</Description>
            <Size>50-110mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH080</BillingCode>
            <Name>ZINA MIS Polyaxial Screw</Name>
            <Description>ZINA MIS Spine System - Cannulated Polyaxial Screw</Description>
            <Size> Diameter x Length ( mm )    4.5×25      4.5×30      4.5×35      4.5×40      4.5×45      4.5×50      4.5×55      4.5×60      4.5×65      5.0×30      5.0×35      5.0×40      5.0×45      5.0×50      5.0×55      5.0×60      5.0×65      5.5×30      5.5×35      5.5×40      5.5×45      5.5×50      5.5×55      5.5×60      5.5×65      6.0×30      6.0×35      6.0×40      6.0×45      6.0×50      6.0×55      6.0×60      6.0×65      6.5×30      6.5×35      6.5×40      6.5×45      6.5×50      6.5×55      6.5×60      6.5×65      7.0×30      7.0×35      7.0×40      7.0×45      7.0×50      7.0×55      7.0×60      7.0×65      7.5×30      7.5×35      7.5×40      7.5×45      7.5×50      7.5×55      7.5×60      7.5×65      8.0×30      8.0×35      8.0×40      8.0×45      8.0×50      8.0×55      8.0×60      8.0×65      8.5×30      8.5×35      8.5×40      8.5×45      8.5×50      8.5×55      8.5×60      8.5×65    </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB018</BillingCode>
            <Name>REVOLVE Stabilization System Poliaxial Screw</Name>
            <Description>Polyaxial, cannulated pedicale screw</Description>
            <Size>5.5mm - 8.5mm diameter 30mm - 90mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>190043</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB060</BillingCode>
            <Name>REVLOK Fenestrated Screw System Screw</Name>
            <Description>Fenestrated Screw</Description>
            <Size>5.5mm -10.5mm x 30mm -120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>196054</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB081</BillingCode>
            <Name>REVERE Cannulated Polyaxial Screw</Name>
            <Description>Cannulated Polyaxial Screw</Description>
            <Size>5.5mm x 25 - 8.5 x 65mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB082</BillingCode>
            <Name>REVERE TRANSITION HA Coated Cannulated Polyaxial Screw</Name>
            <Description>Polyaxial Screw HA Coated, Cannulated</Description>
            <Size>6.5mm - 8.5mm x 35mm - 6mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>196585</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB199</BillingCode>
            <Name>CREO S2AI Preferred Angle</Name>
            <Description>Cannulated CoCr polyaxial screw</Description>
            <Size>Diameter 6.0 -10.5mm  Length 60-120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH484</BillingCode>
            <Name>DSS HP Spinal System - Pedicle Screw</Name>
            <Description>Cannulated Pedicle Screw, Titanium</Description>
            <Size>(5 - 10)mm diam x (30 - 110(mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>186733</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH704</BillingCode>
            <Name>HPS 2.0 Pedicle Screw</Name>
            <Description>Pedicle Screw with Reduction and Extended tabs - Cannulated &amp; Fenestrated</Description>
            <Size>4.5-9.5mm diameters</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>186733</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM436</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK116</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Amendia Savannah-T Pedicle Screw System-Polyaxial Pedicle Screw-Cannulated</Name>
            <Description>Pedicle Screw System-Polyaxial Pedicle Screw-Cannulated, Low, Mid, High Top standard and Grip Quick Threads</Description>
            <Size>dia (5.5-7.5 mm) x length (30-65 mm)</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>281992</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM444</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK059</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella Cannulated Pedicle Screw</Name>
            <Description>Cannulated Pedicle Screw</Description>
            <Size>4.75 to 8.5mm diameter  25 to 60 mm length</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC586</BillingCode>
            <Name>CD Horizon Sextant Percutaneous Cannulated Multi Axial Screw</Name>
            <Description>Cannulated titanium percutaneous multi axial screw</Description>
            <Size>Dia 3.5 to 9.5mm, Length 15 to 65mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC736</BillingCode>
            <Name>Vertex Max Cannulated Screw</Name>
            <Description>Posterior cannulated cervical screw</Description>
            <Size>Diameter 3.5 - 4.5mm
Length 20 - 60mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC968</BillingCode>
            <Name>CD HORIZON Spinal System - Cannulated Multi-Axial Screw</Name>
            <Description>CD HORIZON Cannulated Multi-Axial Screw</Description>
            <Size>Diameter: 4.5mm - 12.5mm&#xD;
&#xD;
Length:  15mm - 140mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI036</BillingCode>
            <Name>CD HORIZON Fenestrated Screw</Name>
            <Description>Fenestrated multi-axial screw</Description>
            <Size>Diameter:4.5 - 10.5mm, Length: 30 - 80mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>187126</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI395</BillingCode>
            <Name>CD HORIZON Voyager Fenestrated Screws</Name>
            <Description>Fenestrated multi-axial screw</Description>
            <Size>Diameter:4.5mm-10.5mm, Length: 30mm-80mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>187126</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI465</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK080</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cannulated Polyaxial Pedicle Screws</Name>
            <Description>Cannulated Polyaxial Pedicle Screws</Description>
            <Size>4.5 to 9.5mm diameter  all lengths</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI467</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK082</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cannulated Polyaxial Pedicle Screw</Name>
            <Description>Cannulated Polyaxial Pedicle Screw</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN198</BillingCode>
            <Name>Viper Spine System</Name>
            <Description>Polyaxial, uniplanar cannulated screws</Description>
            <Size>4.35 to 10mm diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>145290</ARTG>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN324</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Polyaxial cannulated screws</Description>
            <Size>3.5-5.5mm diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU106</BillingCode>
            <Name>M.U.S.T Polyaxial Pedicle Screws Cannulated</Name>
            <Description>Polyaxial Cannulated Screws</Description>
            <Size>4.5-10mm; Length 25 -100mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU147</BillingCode>
            <Name>M.U.S.T. Fenestrated Polyaxial Cannulated Pedicle Screw</Name>
            <Description>Fenestrated Polyaxial Cannulated Pedicle Screw</Description>
            <Size>Diameter 4.5-10mm, Length 25-100mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU154</BillingCode>
            <Name>MUST MINI Cannulated Polyaxial Screw</Name>
            <Description>Cannulated Polyaxial Screw</Description>
            <Size>Diameter: 4 - 4.5  Lenght: 10 - 50 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV087</BillingCode>
            <Name>Precept (Polyaxial Screw)</Name>
            <Description>Polyaxial Screw</Description>
            <Size>4.5 x 25-45mm, 5.5-8.5 x 30-100mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV089</BillingCode>
            <Name>Armada (Fenestrated Screw)</Name>
            <Description>Fenestrated Screw</Description>
            <Size>5.5 - 8.5 x 30-65mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV122</BillingCode>
            <Name>Precept (Reduction Screw)</Name>
            <Description>Reduction Screw</Description>
            <Size>4.5-7.5mm diameter; 25-60mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV123</BillingCode>
            <Name>Precept (Fenestrated Screw)</Name>
            <Description>Fenestrated Screw</Description>
            <Size>4.5-12.5mm diameter; 25-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV133</BillingCode>
            <Name>Reline System (cannulated polyaxial screw)</Name>
            <Description>Cannulated Polyaxial Screw</Description>
            <Size>4.5-12.5 mm diameter, 25-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV134</BillingCode>
            <Name>Reline System (cannulated polyaxial reduction screw)</Name>
            <Description>Cannulated Polyaxial Reduction Screw</Description>
            <Size>4.5-12.5mm diameter, 25-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV146</BillingCode>
            <Name>Reline (Fenestrated screw)</Name>
            <Description>Pedicle Screw</Description>
            <Size>4.5-12.5mm diameter; 25-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV148</BillingCode>
            <Name>Reline (Cannulated Fenestrated screw)</Name>
            <Description>Pedicle Screw</Description>
            <Size>4.5-12.5mm diameter; 25-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH578</BillingCode>
            <Name>Venus Spinal Fixation Systems - Pedicle Screws - Poly Cannulated</Name>
            <Description>Polyaxial Pedicle Screws - Cannulated</Description>
            <Size>D 4.0-8.5mm L 25-100mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB060</BillingCode>
            <Name>TINA Minimally Invasive Spine System</Name>
            <Description>Polyaxial Cannulated Screw</Description>
            <Size>All sizes</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ049</BillingCode>
            <Name>Centaur Screw System</Name>
            <Description>Cannulated Polyaxial Screw</Description>
            <Size>4mm - 10mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI009</BillingCode>
            <Name>Streamline Cannulated Polyaxial Pedicle Screws, including MIS.</Name>
            <Description>Cannulated Polyaxial Pedicle Screws in various diameters and lengths (Titanium Alloy)</Description>
            <Size>4.5 x 20mm to 45mm in 5mm increments;  5.5 x 30mm to 60mm in 5mm increments;  6.5 x 30mm to 100mm in 5mm increments;  7.5 x 30mm to 100mm in 5mm increments;  8.5 x 30mm to 100mm in 5mm increments;  9.5 x 40 to 60mm in 5mm increments and 9.5 x 70mm to 100mm in 10mm increments;</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI034</BillingCode>
            <Name>HPS™ Polyaxial Screws</Name>
            <Description>Polyaxial cannulated pedicle screws.</Description>
            <Size>Diameter: 5-9mm  Length: 30-60mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>345870</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI043</BillingCode>
            <Name>HPS™ 2.0 Polyaxial Pedicle Screw</Name>
            <Description>Cannulated polyaxial screws with MIS option</Description>
            <Size>Diameter: 4.5- 9.5mm  Length: 20mm-60mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>345870</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI045</BillingCode>
            <Name>Streamline Polyaxial Screws</Name>
            <Description>Polyaxial cannulated pedicle screws including MIS, reduction and fenestrated screws</Description>
            <Size>Diameter: 4.5 - 9.5mm  Length: 20-60mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>345870</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF113</BillingCode>
            <Name>Freedom Cannulated Pedicle Screws</Name>
            <Description>Polyaxial Cannulated Pedicle Screws</Description>
            <Size>Diameter 5.5 to 7.5mm, lengths from 35 to 55mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ125</BillingCode>
            <Name>NEO Pedicle Screw System - Polyaxial Screw</Name>
            <Description>Pedicle Screw, Iliac Screw, Titanium Alloy</Description>
            <Size>Diameter: 4.5mm - 8.0mm  Length: 25mm - 100mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>289017</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR042</BillingCode>
            <Name>MANTIS</Name>
            <Description>Screw, Cannulated, Multiaxial, Ti</Description>
            <Size>4.5mm - 7.5mm x 25mm - 60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>278581</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY336</BillingCode>
            <Name>Click'x Spinal System</Name>
            <Description>Cannulated Screws</Description>
            <Size>4.0mm to 9.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY706</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Matrix Preassembled Pedicle Screw, Cannulated</Description>
            <Size>5.00mm - 9.00mm; 20mm - 65mm Length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>293276</ARTG>
                <ARTG>293275</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT016</BillingCode>
            <Name>SOLFIX2 Pedicle Screws</Name>
            <Description>Cannulated and fenestrated screws</Description>
            <Size>Diameter: 5.4mm - 9.4mm  Length: 30mm - 110mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>1178</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ738</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>DI Favoured Angle Reduction Tab Polyaxial Screw</Description>
            <Size>4.35-10mm Diameter 20 - 100mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV068</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ sterile Multiaxial non cannulated Pedicle Screw</Name>
            <Description>Non Cannulated pedicle screws</Description>
            <Size>Multiaxial screws  Diameter: 5.5-7.5 mm   Length: 25-60 mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH048</BillingCode>
            <Name>Polyaxial Screws</Name>
            <Description>Dual Head Screws</Description>
            <Size>35-45mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI272</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Dual Rod Multi-Axial Screw</Description>
            <Size>Diameter: 5.5-8.5mm  Length: 30-55mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW726</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mesa Spinal System / Polyaxial Pedicle Screw</Name>
            <Description>Polyaxial Pedicle Screw, Titanium</Description>
            <Size>(3.5 - 12.5)mm diam, lengths (10-110)mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Integrated Locking Mechanism</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>1304</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM508</BillingCode>
            <Name>Polyaxial Pedicle Screws</Name>
            <Description>Polyaxial Pedicle Screws</Description>
            <Size>Diameter 5.5 - 7.5mm  Length 35 - 55mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Integrated Locking Mechanism</Suffix>
            <ARTGs>
                <ARTG>366793</ARTG>
            </ARTGs>
            <MinimumBenefit>1304</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW759</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER212</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mesa Polyaxial Cannulated Screw</Name>
            <Description>Cannulated Pedicle Screw, polyaxial </Description>
            <Size>Diameter: 5.5-6.5mm Length: 30-45mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Integrated Locking Mechanism, Cannulated</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>1271</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB011</BillingCode>
            <Name>Spine System Evolution</Name>
            <Description>Screw</Description>
            <Size>Dia 5 - 8mm, length 30 - 55mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE664</BillingCode>
            <Name>Mariner Pedicle Screw Shank</Name>
            <Description>Posterior Fixation System</Description>
            <Size>4.5, 5.5, 6.5, 7.5, 8.5, 9.5 and 10.5mm Diameters  25-110mm Length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE704</BillingCode>
            <Name>Mariner Cannulated Pedicle Screw Shanks</Name>
            <Description>Posterior Fixation System</Description>
            <Size>4.5-10.5mm Diameters.  20-110mm Lengths.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE788</BillingCode>
            <Name>Mariner Screw</Name>
            <Description>Polyaxial and Extended Tab Uni-Planar Screws  </Description>
            <Size>4.5mm. 5.5mm, 6.5mm &amp; 7.5mm Diameters, 20mm to 110mm Lengths  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU041</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - polyaxial screw-shank</Name>
            <Description>Polyaxial screw shanks: cortical bone screw shanks, degenerative bone screw shanks</Description>
            <Size>Diameter (cortical bone screw shank): 4.5 - 7.5mm, Diameter (degenerative bone screw shank): 4.5 - 9.5mm.  Length (cortical bone screw shank): 25 - 50mm. Length (degenerative bone screw shank): 25 - 120mm.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU058</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - cannulated polyaxial screw-shank</Name>
            <Description>Modular cannulated polyaxial bone screw shanks, modular cannulated fenestrated polyaxial bone screw shanks</Description>
            <Size>Diameter: 4.5 - 8.5mm  Length: 25 - 60mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER221</BillingCode>
            <Name>SIGNUS Diplomat Pedicle Screw System-Polyaxial Screw-Shank</Name>
            <Description>SIGNUS Diplomat Pedicle Screw System-Polyaxial Screw-Shank</Description>
            <Size>dia (4.5-9.5 mm) x length (30-100 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER544</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti Pedicle Screw</Name>
            <Description>Polyaxial Screw shank-solid and cannulated/fenestrated</Description>
            <Size>Ø4.3mm - Ø10.0 mm diameter, 20-120mm length</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER571</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF076</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Firebird Modular Screws</Name>
            <Description>Modular pedicle screws - shank</Description>
            <Size>Diameter - 4mm -11.5mm   Length - 25mm - 110mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY008</BillingCode>
            <Name>Reform Modular Polyaxial Screws</Name>
            <Description>Module Polyaxial Screws</Description>
            <Size>Diameter 4.5mm to 10.5mm  Length 25mm to 120mm  Cannulated and Non-Cannulated</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG009</BillingCode>
            <Name>VENTOTENE Modular Screw</Name>
            <Description>Standard Solid</Description>
            <Size>4.5/5.5/6.5/7.5mm diameter  25-100mm length</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>397231</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG010</BillingCode>
            <Name>VENTOTENE Modular Screw</Name>
            <Description>Standard Cannulated</Description>
            <Size>5.5/6.5/7.5mm diameter  30-70mm length</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>397231</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH077</BillingCode>
            <Name>Kumafix Pedicle Shank Screw </Name>
            <Description>Shank Screw </Description>
            <Size>Diameter : 5.5 mm - 6.6 mm   Length :     40 mm - 55 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB069</BillingCode>
            <Name>BEACON™ Stabilization System Posted Screw</Name>
            <Description>Posted Screw and Reduction Screw</Description>
            <Size>4.5mm - 9.5mm diameter 25mm - 90mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>219169</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB100</BillingCode>
            <Name>CREO AMP™ Modular Screw Shaft</Name>
            <Description>Modular screw shaft</Description>
            <Size>4.0mm - 10.5mm x 20mm - 120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB122</BillingCode>
            <Name>CREO MIS Posterior Stabilization System - Bone Screws</Name>
            <Description>Cannulated self-tapping polyaxial screws - Shank</Description>
            <Size>Diameter 4.5-10.5mm, Length 25-120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB129</BillingCode>
            <Name>CREO MCS - Screw Post</Name>
            <Description>Double threaded, dual outer diameter screw post</Description>
            <Size>Diameter 5.0-7.5mm, Length 20-45mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB210</BillingCode>
            <Name>CREO One</Name>
            <Description>Monaxial pedicle screw  </Description>
            <Size>Diameter: 5.5 -7.5mm  Length: 35-55mm  </Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH708</BillingCode>
            <Name>Athena Polyaxial screw shank</Name>
            <Description>Polyaxial screw shank intended for pedicle or cortical bone trajectory screw insertion. The shanks have a quad to dual lead thread for increased cortical bone purchase. The screw shanks are also fenestrated to enable screw augmentation with bone cement</Description>
            <Size>5mm -8.5mm diameter   30mm to 100mm screw lengths   </Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>337150</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC458</BillingCode>
            <Name>TSRH 3D </Name>
            <Description>Screw</Description>
            <Size>4.5 -8.5mm diameter</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC459</BillingCode>
            <Name>TSRH 3D </Name>
            <Description>Extended Post Screw</Description>
            <Size>30 - 60mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI457</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK068</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Polyaxial Spinal System Pedicle Screws</Name>
            <Description>Polyaxial Spinal System Pedicle Screws</Description>
            <Size>4.5 to 9.5mm diameter</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI472</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK087</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Polyaxial Pedicle Screws</Name>
            <Description>Polyaxial Pedicle Screws</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV084</BillingCode>
            <Name>Precept (Screw Shank)</Name>
            <Description>Screw shank</Description>
            <Size>4.8-8.5mm x (25-50mm)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV120</BillingCode>
            <Name>Precept (MP Screw Shank)</Name>
            <Description>Screw Shank</Description>
            <Size>4.5-7.5mm diameter; 25-60mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV139</BillingCode>
            <Name>Reline (Mod Shank) Cannulated</Name>
            <Description>Screw Shank</Description>
            <Size>4.5-12.5mm x 25-120mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV142</BillingCode>
            <Name>Reline (Mod Shank)</Name>
            <Description>Screw Shank</Description>
            <Size>4.0-10.5mm x 25-90mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY598</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Pedicle: Screw, Head</Description>
            <Size>4mm - 9mm D</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <Suffix>Shank</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>566</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB224</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Polyaxial Screw - titanium alloy</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF006</BillingCode>
            <Name>Smartloc Spinal Fixation System/ Polyaxial Pedicle Screw &amp; Reduction Screw</Name>
            <Description>Polyaxial Pedicle Screw and Reduction Screw</Description>
            <Size>Length 30mm – 55mm; Diameter 4.5mm, 5.5mm, 6.0mm, 6.5mm, 7.0mm, 7.5mm, 8.0mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>150778</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH590</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pedicle Screw</Name>
            <Description>Polyaxial Screw</Description>
            <Size>(5.5 - 7.5)mm x (35-55) mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>288089</ARTG>
            </ARTGs>
            <Note>To be reimbursed only when used in patients with spinal tumours</Note>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW023</BillingCode>
            <Name>Libra Pedicle Screw System</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Diameter: 4.5mm - 8.5mm   Length: 20mm - 100mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>355051</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE595</BillingCode>
            <Name>Sierra Polyaxial OCT Screw</Name>
            <Description>Posterior Cervical Polyaxial Screw</Description>
            <Size>3.5, 4.0 and 4.5mm diameter &#xD;
10-50mm length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE626</BillingCode>
            <Name>Malibu Spinal System Polyaxial Screw</Name>
            <Description>Polyaxial screw</Description>
            <Size>4.5mm x 20mm - 8.5mm x 110mm in 5mm increments</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE627</BillingCode>
            <Name>Malibu Spinal System Polyaxial Reduction Screw</Name>
            <Description>Malibu Spinal System Polyaxial or Uni Planar Reduction Screw</Description>
            <Size>4.5mm x 25mm - 40mm in 5mm increments  5.5mm x 25mm - 50mm in 5mm increments  6.5mm x 30mm - 55mm in 5mm increments  7.5mm x 35mm - 55mm in 5mm increments</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE669</BillingCode>
            <Name>icotec Pedicle System Polyaxial Screw</Name>
            <Description>Polyaxial Pedicle Screw</Description>
            <Size>Size(s):* 5.5, 6.5 and 7.5mm diameter   25-60mm length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>283853</ARTG>
            </ARTGs>
            <Note>“To be reimbursed only when used in patients with spinal tumours.”</Note>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE769</BillingCode>
            <Name>NorthStar OCT  </Name>
            <Description>NorthStar OCT Polyaxial Screw  </Description>
            <Size>3.5, 4.0, 4.5, 5.5mm Diameter  8-40mm Lengths  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR013</BillingCode>
            <Name>Life Spine Pedicle Screw System - Pedicle Screw, Polyaxial</Name>
            <Description>Life Spine Pedicle Screw System (Nautilus) - Pedicle Screw, Polyaxial Standard or Reduction</Description>
            <Size>dia (4.5-8.5mm) x length (25-125mm)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU001</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Polyaxial Screw</Name>
            <Description>Polyaxial lateral mass screws: polyaxial screws, smooth shank screws, preferred angle screws</Description>
            <Size>Diameter: 3.5mm, 4.0mm, 4.5 mm Length (polyaxial and preferred angle): 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 24mm, 28mm, 32mm, 36mm, 40mm, 44mm, 48mm, 52mm Length (smooth shank): 18mm, 20mm, 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU018</BillingCode>
            <Name>Romeo 2 Posterior Thoraco-lumbar Fixation System - Polyaxial Screw, Reduction Screw, 25D Screw</Name>
            <Description>Polyaxial screw, polyaxial reduction screw</Description>
            <Size>Diameter: 4mm, 5mm, 6mm, 7mm, 8mm  Length: 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 70mm, 80mm, 90mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU052</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - polyaxial screw</Name>
            <Description>Polyaxial lateral mass screws: polyaxial screws, reduction screws, 25D screws</Description>
            <Size>Diameter (polyaxial screws, reduction screws): 4.5 - 10.5mm. Diameter (25D screws): 4.5 - 6.5mm  Length (polyaxial screws, reduction screws): 25 - 120mm. Length: 25 - 90mm.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER143</BillingCode>
            <Name>Signus Pedicle Screw System-Pedicle Screw Polyaxial</Name>
            <Description>Signus Pedicle Screw</Description>
            <Size>4.5 - 7.5mm x 30 - 70mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER293</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Pedicle Screw, Polyaxial</Description>
            <Size>dia (4-8 mm) x length (25-110 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER310</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Pedicle Screws</Name>
            <Description>Ulrich posterior OCT System (neon3)-Pedicle Screws, non-cannulated, lateral mass screws</Description>
            <Size>dia (3.5-4 mm) x length (10-28 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER333</BillingCode>
            <Name>Ulrich Pedicle Screw System-Pedicle Screw, Polyaxial</Name>
            <Description>Ulrich Pedicle Screw System (uCentum, flamenco)-Pedicle Screw, Polyaxial, standard or long arm</Description>
            <Size>dia (4.5-10 mm) x length (25-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER435</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Polyax. Screw</Name>
            <Description>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Polyaxial Screw, standard, semi-reduction and reduction</Description>
            <Size>Dia (3.5-4.0 mm) x length (10-50 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>286122</ARTG>
                <ARTG>384816</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER446</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Pedicle Screw, polyaxial</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Pedicle Screw; polyaxial; self tapping or non self tapping; standard or reduction; accommodates rods of 5.0, 5.5, 6.0 and 6.35mm in diameter</Description>
            <Size>dia (4.0-8.5mm) x length (20-150mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER512</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>e.Spine PEDICULAR SCREW</Name>
            <Description>spine Pedicular Screw for sacral-thoraco-lumbar osteosynthesis</Description>
            <Size>Pedicle or Reduction pedicle;&#xD;
Diameter 4.35 Length 25 to 55 mm,&#xD;
Diameter 5 Length 25 to 60 mm,&#xD;
Diameter 6 Length 25 to 65 mm,&#xD;
Diameter 6.5 Length 25 to 70 mm,&#xD;
Diameter 7 Length 30 to 80 mm.</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER620</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF059</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Multi-Axial Screws</Name>
            <Description>Multi-Axial and Smooth Shank Multi-Axial Screws</Description>
            <Size>3.5mm Diameter – 10mm - 52mm in 2mm increments  4.0mm Diameter – 10mm - 52mm in 2mm increments  4.5mm Diameter – 10mm – 50mm in 5mm increments  5.0mm Diameter – 10mm – 50mm in 5mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER662</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-polyaxial screw  </Name>
            <Description>AccelFix S/AccelFix DS/AccelFix SS polyaxial screws, sterile, single or double lead, standard or variable pitch, closed or open, Ti, sterile</Description>
            <Size>Diameter: 4-8,5 mm  Length: 34.2-176.5 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY001</BillingCode>
            <Name>Reform Polyaxial Screw</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Diameter 4.5mm to 10.5mm  Length 25mm to 120mm  Cannulated and Non-Cannulated</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY009</BillingCode>
            <Name>Reform POCT Polyaxial Screw</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Length 8mm to 50mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW027</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Polyaxial screws </Description>
            <Size>All sizes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC016</BillingCode>
            <Name>KM POLYAXIAL</Name>
            <Description>Polyaxial Screw</Description>
            <Size>W:3.5-7.5mm L:10-55mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>201492</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC033</BillingCode>
            <Name>SAXXO SCREW</Name>
            <Description>POLYAXIAL SCREW</Description>
            <Size>W:4.5-8mm L:30-55mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>331780</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC034</BillingCode>
            <Name>G2S-KM SCREW</Name>
            <Description>POLYAXIAL SCREW</Description>
            <Size>W;4.5-7.5mm , L:25-60mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>274075</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW384</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Dia: 4mm - 10.5mm Length: 20mm - 100mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>139620</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW593</BillingCode>
            <Name>Xia 4.5 CT Polyaxial  Screw</Name>
            <Description>Cortical Thread Polyaxial Screw</Description>
            <Size>Dia 4mm to 6.5mm, length 20mm to 45mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW631</BillingCode>
            <Name>Xia Serrato Polyaxial Screw</Name>
            <Description>Polyaxial Screw, Reduction Polyaxial Screw, Medial Biased Angle Screw</Description>
            <Size>Dia 4mm-10.5mm, Length 20mm-130mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>279159</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW724</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Denali Spinal System / Polyaxial Pedicle Screw</Name>
            <Description>Polyaxial Pedicle Screw</Description>
            <Size>Diameter: 3.5 - 8.5mm, Length: 10 - 100mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>159828</ARTG>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW745</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER049</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Everest Spinal System -Pedicle Screw</Name>
            <Description>Polyaxial Pedicle Screw, Ti</Description>
            <Size>Diameter: 4.5mm-10.5mm,  Length: 25mm - 110mm (open or closed)</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
                <ARTG>293862</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW775</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER476</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Yukon OCT System</Name>
            <Description>Polyaxial Posterior Cervical Screws</Description>
            <Size>3.5-5.0 diameter, length 10-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB005</BillingCode>
            <Name>Vertefix II Poly-Axial Screw</Name>
            <Description>Multi/ Poly-Axial Pedicle Screw</Description>
            <Size>Diameters: 5.5, 6.5, 7.5mm length: 35, 40, 45, 50mm</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>188902</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV042</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BA Posterior Screw</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Ø3.5, Ø4.0, Ø4.5  8mm to 50mm in length.</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>329318</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH358</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medyssey Spinal Fixation System</Name>
            <Description>Polyaxial Screw</Description>
            <Size>4.0-8.5</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH353</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Novel/Zenius Reduction Poly Screw</Name>
            <Description>Polyaxial Reduction pedicle screw</Description>
            <Size>5.5-8.5</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ593</BillingCode>
            <Name>Mountaineer OCT Spinal System</Name>
            <Description>CT Minipolyaxial Screw - Favoured Angle and Medial/Lateral</Description>
            <Size>3.5-4.35mm x 10 - 50mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ940</BillingCode>
            <Name>Moss Miami Spinal System</Name>
            <Description>Polyaxial Screw</Description>
            <Size>4.35 to 8mm diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ944</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Polyaxial screws</Description>
            <Size>4.35 - 12mm diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>145290</ARTG>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB012</BillingCode>
            <Name>AnyPlus II Poly Screw</Name>
            <Description>Polyaxial pedicle screws and reduction screws</Description>
            <Size>Diameter:4.5-7.5mm  Length: 35-55mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>353891</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH045</BillingCode>
            <Name>Polyaxial Screws</Name>
            <Description>Polyaxial &amp; Reduction Polyaxial Screws</Description>
            <Size>20-55mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH052</BillingCode>
            <Name>Polyaxial Screws</Name>
            <Description>Polyaxial Screws</Description>
            <Size>10-52mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH076</BillingCode>
            <Name>Adena™ CBT Polyaxial Screw</Name>
            <Description>Cortical Thread Polyaxial Screw</Description>
            <Size>4.0 mm - 6.5 mm Diameter  20 mm - 45 mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH089</BillingCode>
            <Name>Polyaxial Pedicle Screw   </Name>
            <Description>Polyaxial Pedicle Screw </Description>
            <Size>Diameter : 4.5 mm - 9.5 mm   Length : 35 mm - 120 mm </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>380418</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB043</BillingCode>
            <Name>ELLIPSE Stabilization System, Polyaxial Screw</Name>
            <Description>Polyaxial Bone Screw</Description>
            <Size>3.5mm - 4.5mm diameter 8mm x 50mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB079</BillingCode>
            <Name>REVERE Polyaxial Screw</Name>
            <Description>Polyaxial screw</Description>
            <Size>5.5 Titanium, Alloy and Stainless Steel- 4.0-8.5mm x 20mm to 90mm in 5mm increments&#xD;
5.5 Reduction screws - 5.5mm-7.5mm x 30mm-90mm in 5mm increments&#xD;
6.35 Titanium Alloy and Stainless Steel - 5.5mm - 90mm x 25mm to 120mm in 5mm increments&#xD;
5.5 Dual Diameter Screw Titanium Alloy and Stainless Steel - 5.5mm, 6.0mm 7.0mm, 7.5mm x 30mm to 100mm in 5mm increments&#xD;
6.35 Dual Diameter Screws Titanium Alloy and Stainless Steel - 5.5mm, 6.0mm, 7.0mm, 7.5mm x 30mm to 65mm in 5mm increments&#xD;
4.0-8.0mm diameter 20-90mm length&#xD;
4.5 - 6.5mm diameter uniplanar fracture reduction screws, 25-55mm in 5mm increments</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB080</BillingCode>
            <Name>REVERE TRANSITION HA coated Pedicle Screw</Name>
            <Description>Polyaxial Screw HA Coated, Dual Outer Diameter, Prefered Angle</Description>
            <Size>5.5mm-8.5mm x 35mm - 100mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>196585</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB090</BillingCode>
            <Name>CREO Stabilization System Preassembled Polyaxial Screw</Name>
            <Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description>
            <Size>4.0mm diameter to 10.5mm diameter&#xD;
20mm to 120mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB130</BillingCode>
            <Name>CREO MCS - Polyaxial Screw</Name>
            <Description>Pre-assembled dual outer diameter polyaxial screw</Description>
            <Size>Diameter: 5.0- 6.5 mm, Length 20-45mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB146</BillingCode>
            <Name>CAPITOL Polyaxial Screw</Name>
            <Description>Self-tapping polyaxial screw</Description>
            <Size>3.5 - 4.0mm diameter, 8-26mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB153</BillingCode>
            <Name>QUARTEX Polyaxial Screws</Name>
            <Description>Polyaxial screws</Description>
            <Size>3.5-5.5mm diameter&#xD;
8-50mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB191</BillingCode>
            <Name>CREO DLX Polyaxial Screw</Name>
            <Description>Polyaxial screws</Description>
            <Size>Diameter: 4.0mm to 10.5mm  Length: 20mm to 120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB211</BillingCode>
            <Name>CREO® Side Loading Polyaxial Screw</Name>
            <Description>Side Loading Polyaxial screw with CoCr head and Ti shank</Description>
            <Size>Diameter: 4.0 - 10.5mm  Length: 20 -120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM401</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fortex Pedicle Screw system - Pedicle Screw</Name>
            <Description>Polyaxial pedicle screw</Description>
            <Size>4.75, 5.5, 6.5, 7.5, 8.25mm diameter. 30, 35, 40, 45, 50, 55mm lengths</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
                <ARTG>170220</ARTG>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM413</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Certex Spinal Implant System Screw</Name>
            <Description>Screws</Description>
            <Size>Diameter 3.5mm - 4.5mm  Length 10mm – 42mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM441</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK056</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella Polyaxial Pedicle Screw</Name>
            <Description>Polyaxial Pedicle Screw</Description>
            <Size>5.5 to 7.5 mm diameter  35 to 60 mm length</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM460</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>X90 Pedicle Screw</Name>
            <Description>Capless, Polyaxial pedicle screw</Description>
            <Size>Diameter 4.75 - 8.25mm  Length 30 -55mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC545</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Screws</Description>
            <Size>Diameter 3.5 - 4.5mm Length 6 - 52mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC675</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Legacy Screw</Description>
            <Size>Diameter 3.5 - 10.5mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC822</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Legacy Multiaxial Iliac Screw</Description>
            <Size>Dia 5.5 to 10.5mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC969</BillingCode>
            <Name>CD HORIZON Spinal System - Multi-Axial Screw</Name>
            <Description>CD HORIZON SOLERA Multi-Axial Screw, HA coated Multi-Axial Screw</Description>
            <Size>Diameter:  4.0mm - 10.5mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI260</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Multi-Axial Screws</Description>
            <Size>Diameter 3.0 - 5.5mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI466</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK081</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Non-Cannulated Polyaxial Pedicle Screws</Name>
            <Description>Non-Cannulated Polyaxial Pedicle Screws</Description>
            <Size>4.5mm to 9.5mm diameter</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN263</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Polyaxial screws</Description>
            <Size>3.0-5.5mm diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU109</BillingCode>
            <Name>M.U.S.T. Polyaxial Pedicle Screws</Name>
            <Description>Polyaxial Screws</Description>
            <Size>4.0 -10mm; length 20 -100mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU148</BillingCode>
            <Name>M.U.S.T. Fenestrated Polyaxial Pedicle Screw</Name>
            <Description>Fenestrated Polyaxial Pedicle Screw</Description>
            <Size>Diameter 5-10mm, Length 30-90mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU153</BillingCode>
            <Name>MUST MINI Polyaxial Screws</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Diameter from 3.5 to 4.5  Lenght  from 10 to 50 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV024</BillingCode>
            <Name>VuePoint screw (multi axial)</Name>
            <Description>Screw (mulit-axial)</Description>
            <Size>3.5 - 5.5mm diameter, 10-40mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV057</BillingCode>
            <Name>Armada (Reduction Screw)</Name>
            <Description>Reduction Screw</Description>
            <Size>4.5-8.5mm x 20-120mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV067</BillingCode>
            <Name>Armada (Polyaxial Screws)</Name>
            <Description>Polyaxial screw</Description>
            <Size>Polyaxial Screw 
4.5-10.0mm x 25-120mm
lliac Screw
6.5/7.5/8.5/9.5mm
(60/70/80/90/100mm)
Provisional locking screw size ranges from 
4.0mmx25-45mm,
4.5mmx25-45mm,
5.0mmx25-50mm,
5.5mmx25-55mm,
6.5mmx30-55mm
Uniplanar Screw 5.0/5.5/6.5mm x 25/30/35/40/45/5</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV115</BillingCode>
            <Name>Reline (Polyaxial Screw)</Name>
            <Description>Polyaxial Screw</Description>
            <Size>4.0-12.5mm diameter, 15-120mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV117</BillingCode>
            <Name>Reline (Reduction Screw)</Name>
            <Description>Reduction Screw</Description>
            <Size>4.0-12.5mm in diameter; 15-120mm in length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV119</BillingCode>
            <Name>Precept (MP Polyaxial Screw)</Name>
            <Description>Polyaxial Screw</Description>
            <Size>4.5-7.5mm diameter; 25-60mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI905</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Pedicle Polyaxial Screws</Name>
            <Description>Pedicle polyaxial screws</Description>
            <Size>3.5mm-5.0mm x 10-45mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI994</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Polyaxial Pedicle Screws</Name>
            <Description>Polyaxial Pedicle Screws Titanium</Description>
            <Size>Diameter = 4.0mm-10.5mm  Length= 20mm-120mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH579</BillingCode>
            <Name>Venus Spinal Fixation Systems - Pedicle Screws - Poly Non Cannulated</Name>
            <Description>Venus - Pedicle Screws - Polyaxial Non Cannulated</Description>
            <Size>D 4.0-8.5mm L20-120mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB009</BillingCode>
            <Name>DPS Spine System - Polyaxial Pedicle Screw</Name>
            <Description>Polyaxial pedicle screws</Description>
            <Size>Diameter 4/5/6/7mm; Length 25 - 55mm  Wide Angle 5.5/6.0/6.5/7.0/7.5/8.0 mm; Length 25 - 135 mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ013</BillingCode>
            <Name>Centaur Screw System</Name>
            <Description>Polyaxial Screw</Description>
            <Size>4mm-13mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ035</BillingCode>
            <Name>Corvus Spinal System</Name>
            <Description>Polyaxial Screws</Description>
            <Size>10-34mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ054</BillingCode>
            <Name>Centaur Screw System</Name>
            <Description>Polyaxial Screw HA Coated</Description>
            <Size>4mm - 10mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI016</BillingCode>
            <Name>Streamline TL- Polyaxial Pedicle Screws</Name>
            <Description>Polyaxial Pedicle Screws and Reduction Screws in various diameters and lengths (Titanium Alloy)</Description>
            <Size>4.5 x 20mm to 45mm in 5mm increments;&#xD;
5.5 x 20mm to 60mm in 5mm increments;&#xD;
6.5 x 20mm to 100mm in 5mm increments;&#xD;
7.5 x 30mm to 100mm in 5mm increments;&#xD;
8.5 x 35mm to 100mm in 5mm increments;&#xD;
9.5 x 35 to 60mm in 5mm increments and 9.5 x 70mm to 100mm in 10mm increments;&#xD;
10.5 &amp; 11.5 x 35mm to 55mm in 5mm increments.&#xD;
Reduction: 5.5 &amp; 6.5 &amp; 7.5 x 30mm to 60mm in 5mm increments</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF112</BillingCode>
            <Name>Freedom Polyaxial Screws</Name>
            <Description>Polyaxial reduction screws with standard and extended tabs</Description>
            <Size>Diameter 4.5 to 9.5mm, lengths from 25 to 60mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF177</BillingCode>
            <Name>Freedom Posterior Screw</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Ø3.5, Ø4.0, Ø4.5  8mm to 50mm in length.</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK225</BillingCode>
            <Name>Oasys-Occipito Cervico Thoracic System</Name>
            <Description>Polyaxial Screw</Description>
            <Size>Dia: 3.5mm x Length: 10mm - 40mm  Dia: 4.0mm x Length: 10mm - 50mm  Dia: 4.5mm x Length: 20mm - 52mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>279144</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ100</BillingCode>
            <Name>RESPONSE Spine System – Polyaxial Screw</Name>
            <Description>Pedicle Polyaxial Screw</Description>
            <Size>4-9mm diameter, 20mm-110mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY007</BillingCode>
            <Name>Click'X Spinal Fixation System</Name>
            <Description>Pedicle Screw: Preassembled</Description>
            <Size>Length 25-80mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY289</BillingCode>
            <Name>USS llio-Sacral Fixation system</Name>
            <Description>Polyaxial screw</Description>
            <Size>20mm to 140mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY309</BillingCode>
            <Name>Axon Spinal System</Name>
            <Description>Variable axis screw</Description>
            <Size>3.0mm - 4.5mm diameter, 4mm to 60mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY337</BillingCode>
            <Name>Universal Spinal System (USS)</Name>
            <Description>Polyaxial Pedicle Screw, titanium</Description>
            <Size>4.0mm to 9.00mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY441</BillingCode>
            <Name>Synapse</Name>
            <Description>Posterior Cervical Polyaxial Screw System</Description>
            <Size>3.5mm-4.5mm Diameter; 8mm-50mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY447</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Universal Reduction Screw</Description>
            <Size>4.0mm - 9.0mm Diameter; 20mm-100mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY566</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Matrix Reduction Screw</Description>
            <Size>4.0mm - 8.00mm; 20mm - 65mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY705</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Matrix Preassembled Polyaxial Pedicle Screw</Description>
            <Size>4.00mm - 9.00mm; 20mm  - 100mm Length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>293276</ARTG>
                <ARTG>293275</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB007</BillingCode>
            <Name>Lumfix Polyaxial Screw</Name>
            <Description>Std or double threaded, std or extended castle  self tapping </Description>
            <Size>(4.0 -8.5)mm diameter x (20-90)mm length </Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1463</GroupID>
            <ARTGs>
                <ARTG>327225</ARTG>
            </ARTGs>
            <MinimumBenefit>1111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF015</BillingCode>
            <Name>Redmond Lumbar Cage System - Locking screw, cannulated</Name>
            <Description>Cannulated titanium screw</Description>
            <Size>Diameter: 5.5mm; Length: 15, 20, 25, 30, 35mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB053</BillingCode>
            <Name>CORRIDOR Fixation System Screw Cannulated Screws</Name>
            <Description>Bone Screws</Description>
            <Size>3.5mm - 4.5 diameter. 3&#xD;
0mm - 60mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>190041</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB058</BillingCode>
            <Name>ZYFUSE Facet Fixation System Screw with washer</Name>
            <Description>Facet Screw</Description>
            <Size>5.0 - 6.0mm diameter x 30 - 60mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>196053</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB059</BillingCode>
            <Name>ZYFUSE Facet Fixation System Screw</Name>
            <Description>Facet Screw</Description>
            <Size>5.0 - 6.0mm diameter x 30 - 60mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>196053</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH558</BillingCode>
            <Name>Atlas (Anterior Odontoid Fixation System)</Name>
            <Description>Cannulated Bone Screw</Description>
            <Size>(4.0 - 4.5)mm diameter  x  (28-55)mm  length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>275605</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM462</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fixcet Spinal Facet Screw</Name>
            <Description>Spinal facet screw</Description>
            <Size>25mm - 45mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC447</BillingCode>
            <Name>UCSS</Name>
            <Description>Cortical Screws </Description>
            <Size>30 - 50mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC448</BillingCode>
            <Name>UCSS</Name>
            <Description>Cortical Lag Screws</Description>
            <Size>36 - 50mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY141</BillingCode>
            <Name>Spinal Plate/Plate System AO/ASIF Spinal Implants</Name>
            <Description>Cannulated/self tapping screw (odontoid)</Description>
            <Size>3.5mm dia, 36-50mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY302</BillingCode>
            <Name>TeleFix Spinal System</Name>
            <Description>Posterior Screw</Description>
            <Size>20mm to 70mm in length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY303</BillingCode>
            <Name>TeleFix Spinal System</Name>
            <Description>Anterior Screw</Description>
            <Size>20mm to 70mm in length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Cannulated</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF014</BillingCode>
            <Name>Redmond Lumbar Cage System - Locking screw, closed</Name>
            <Description>Titanium screw</Description>
            <Size>Diameter: 5.5mm; Length: 15, 20, 25, 30, 35mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC462</BillingCode>
            <Name>Zephir</Name>
            <Description>Cancellous Screw</Description>
            <Size>13-17mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI483</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK075</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PASS Spinal System Screw</Name>
            <Description>PASS Spinal System Closed Iliac Screw</Description>
            <Size>all sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV099</BillingCode>
            <Name>Archon Plate (Bone Screw)</Name>
            <Description>The Archon system, of which the bone screw is a component, is intended for anterior screw fixation of the cervical spine. These implants have been designed to provide stabilisation as an adjunct to cervical fusion.</Description>
            <Size>4/4.5 x 10-23mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BF014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Redmond Lumbar Cage System - Locking screw, closed</Name>
            <Description>Titanium screw</Description>
            <Size>Diameter: 5.5mm; Length: 15, 20, 25, 30, 35mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY148</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Pedicle Hook Screw</Description>
            <Size>Length 20- 40mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Closed</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER321</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Toggle</Name>
            <Description>Ulrich posterior OCT System (neon3)-Toggle, incl. nut and washer</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER374</BillingCode>
            <Name>Ulrich Sacroiliac Joint Fixation Device</Name>
            <Description>Ulrich Sacroiliac Joint Fixation Device-Bone Screw</Description>
            <Size>dia (7.5-10 mm) x length (40-140 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW772</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER473</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KEYS Polyaxial Screw</Name>
            <Description>Polyaxial screw</Description>
            <Size>6.0 -7.0mm diameter, length 25-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI320</BillingCode>
            <Name>Titan Spine Bone Screws-locking</Name>
            <Description>Titan Spine Endoskeleton TCS Bone Screws-locking</Description>
            <Size>dia (3.5-3.8mm) x length (13-20mm)</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>334300</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC007</BillingCode>
            <Name>Advantage Cage System, Screw</Name>
            <Description>Cage Screw</Description>
            <Size>4.5mm and 5mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>268797</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF100</BillingCode>
            <Name>Advantage Cage System, Screw</Name>
            <Description>Cage Screw</Description>
            <Size>4.5mm and 5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>241</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF030</BillingCode>
            <Name>Redmond Lumbar Rescue Screw - Dual thread screw</Name>
            <Description>Redmond Lumbar Screw is a Dual thread screw that is used with the Redmond Lumbar Cage System - Fusion Cage (BF013) and the Redmond Cervical Cage (BF022)</Description>
            <Size>5.5mm (d) 25mm (l), 5.5m (d) 30mm (l), 5.5 mm (d) 35mm (l)</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE678</BillingCode>
            <Name>icotec Anterior Cervical Plate System - Screw</Name>
            <Description>Self-tapping bone screws</Description>
            <Size>Diameter: 4mm and 4.25mm&#xD;
Length: 13mm and 15mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>283853</ARTG>
            </ARTGs>
            <Note>Limited to use in patients with spinal tumours only.</Note>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EV034</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF105</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACDF cage screw</Name>
            <Description>ACDF cage screw</Description>
            <Size>12-17mm</Size>
            <SupplierCode>EV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>248233</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EV035</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF156</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ALIF cage screw</Name>
            <Description>ALIF cage screw</Description>
            <Size>Diameter 5.5 and 6mm</Size>
            <SupplierCode>EV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>248233</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY020</BillingCode>
            <Name>Slimplicity HP Screws</Name>
            <Description>Screws</Description>
            <Size>12mm - 18mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW725</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pyrenees Cervical Plate System - Screw</Name>
            <Description>Self-drilling, self-tapping and bone reduction screws</Description>
            <Size>(3.5 - 4.7)mm diam x (10-20)mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW732</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cayman Thoracolumbar Plate System / Bone Screw</Name>
            <Description>Self tapping screw, Ti</Description>
            <Size>Length: 20mm to 60mm  Diameter:  5mm and 7mm, titanium</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW741</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Caspian OC screw</Name>
            <Description>The Caspian OC screw is used to fixate the Caspian OC plate to the occiput</Description>
            <Size>4.5mm diameter. 6-16mm length in 1mm increments 5.25mm diameter. 6-16mm length in 1mm increments</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW744</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER047</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Chesapeake Spinal System - Fixation Screw</Name>
            <Description>Locking screw for the Chesapeake Spinal System</Description>
            <Size>Diameter: 3.5mm, 3.85mm. 5.5mm  Lengths: 12mm to 35mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>193652</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW773</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER474</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KEYS Supplemental Screw</Name>
            <Description>Dual lead thread bone screw</Description>
            <Size>5.5 - 6.0mm diameter, length 20-40mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW777</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER490</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cayman United Bone Screw</Name>
            <Description>Bone Screw</Description>
            <Size>Length 20-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution Altus Dual Thread Screw</Name>
            <Description>Thoraco Lumbar Cage Dual Thread Bone Screw</Description>
            <Size>diameter: 5.5 - 6mm  Length: 20 - 35mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Revolution Standalone ACDF bone screw</Name>
            <Description>Anterior cervical fusion cage system Standalone screw</Description>
            <Size>Diameter 4 - 4.5mm  Length 12 -17mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV063</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ Bone Screws with dual thread</Name>
            <Description>Standard with dual thread</Description>
            <Size>12mm x 3.5mm; 4.0 mm  13mm x 3.5mm; 4.0 mm  15mm x 3.5mm; 4.0 mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH589</BillingCode>
            <Name>Cervical Spine Truss System - Stand Alone  Starloc Screw</Name>
            <Description>Starloc Screw</Description>
            <Size>(3.5-3.85)mm diam x (12-16mm Length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM423</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Silex Bone Screw</Name>
            <Description>Dual-Thread Sacroiliac Locking Screw</Description>
            <Size>7mm x 30-70mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>228758</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM461</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fixcet Spinal Facet Screw</Name>
            <Description>Spinal facet screw</Description>
            <Size>30mm - 45mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI153</BillingCode>
            <Name>ZEVO Anterior Cervical Plate System</Name>
            <Description>Dual thread, self-drilling/self-tapping screw</Description>
            <Size>Diameter: 3.5mm - 4.5mm; Length 10mm - 24mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI170</BillingCode>
            <Name>Divergence-L Anterior/Oblique Lumbar Fusion System </Name>
            <Description>Self-drilling and Self-tapping Screws</Description>
            <Size>20-40 mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI176</BillingCode>
            <Name>Divergence Anterior Cervical Fusion Mini-Plate System</Name>
            <Description>Divergence Miniplate Screw - Dual thread self drilling/self tapping screw</Description>
            <Size>4.0mm x 9-24mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI177</BillingCode>
            <Name>Divergence Anterior Cervical Fusion Mini-Plate System</Name>
            <Description>Divergence Miniplate Screw - Dual thread self drilling/self tapping screw</Description>
            <Size>3.5mm x 9-24mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI178</BillingCode>
            <Name>Divergence Anterior Cervical Fusion Standalone System</Name>
            <Description>Divergence anterior cervical fusion system Standalone screw</Description>
            <Size>4.0mm x 9 -17mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI179</BillingCode>
            <Name>Divergence Anterior Cervical Fusion Standalone System</Name>
            <Description>Divergence anterior cervical fusion system Standalone screw</Description>
            <Size>3.5mm x 9 -17mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI188</BillingCode>
            <Name>PIVOX Oblique Lateral Spinal System</Name>
            <Description>Bone Screw</Description>
            <Size>Length: 20-50mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI481</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK151</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fusion Cage Screws</Name>
            <Description>Fusion Cage Screws</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>295284</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC006</BillingCode>
            <Name>Alias Cage Screw</Name>
            <Description>Alias Cage - Screw</Description>
            <Size>12-17mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>268797</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF156</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Advantage Dual Thread Screw</Name>
            <Description>Dual thread ALIF cage screw</Description>
            <Size>Diameter 5.5 and 6mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF150</PriorBillingCode>
            </PriorBillingCodes>
            <Name>XM Plate Screws</Name>
            <Description>Dual thread screws for XM Plate</Description>
            <Size>Diameter 5.5 &amp; 6.0mm, 20-32mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ015</BillingCode>
            <Name>Pegasus Plate System</Name>
            <Description>Bone Screw</Description>
            <Size>12-26mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ016</BillingCode>
            <Name>Aurora Spine System</Name>
            <Description>Bone screw</Description>
            <Size>20mm - 36mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ043</BillingCode>
            <Name>Australis Spine System</Name>
            <Description>Bone Screw</Description>
            <Size>15mm-45mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ047</BillingCode>
            <Name>Borealis Spine System</Name>
            <Description>Bone Screw</Description>
            <Size>10-20mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ053</BillingCode>
            <Name>Aquila Plate System</Name>
            <Description>Bone Screw</Description>
            <Size>10mm-20mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF063</BillingCode>
            <Name>Aurora Screw</Name>
            <Description>Bone Screw</Description>
            <Size>20-36mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF105</BillingCode>
            <Name>Alias Cage Screw</Name>
            <Description>Alias Cage - Screw</Description>
            <Size>12-17mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF150</BillingCode>
            <Name>XM Plate Screws</Name>
            <Description>Dual thread screws for XM Plate</Description>
            <Size>Diameter 5.5 &amp; 6.0mm, 20-32mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF156</BillingCode>
            <Name>Advantage Dual Thread Screw</Name>
            <Description>Dual thread ALIF cage screw</Description>
            <Size>Diameter 5.5 and 6mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF168</BillingCode>
            <Name>Spoiler ALIF Dual thread Screw</Name>
            <Description>Dual Thread ALIF Cage Screw</Description>
            <Size>5.5 and 6mm screws</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF170</BillingCode>
            <Name>Hornet ALIF Screw</Name>
            <Description>Hornet Screw</Description>
            <Size>Multiple diameters and lengths</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY140</BillingCode>
            <Name>AO/ASIF Spinal Implants</Name>
            <Description>Locking Screws</Description>
            <Size>Length 12 - 55mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY251</BillingCode>
            <Name>Ventrofix - MIS</Name>
            <Description>Screw</Description>
            <Size>25-65mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY291</BillingCode>
            <Name>Anterior Tension Band</Name>
            <Description>Locking Screw</Description>
            <Size>22mm to 36mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY297</BillingCode>
            <Name>SynFix Spinal system</Name>
            <Description>Locking Screw</Description>
            <Size>10mm to 40mm, 4.0mm diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Dual Thread</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>417</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB158</BillingCode>
            <Name>Aesculap Cervical System</Name>
            <Description>Titanium with locking mechanism</Description>
            <Size>Dia 4 - 4.5mm, length 10 - 28mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF016</BillingCode>
            <Name>Redmond Cage System - Locking screw, expandable</Name>
            <Description>Expandable titanium screw</Description>
            <Size>Diameter: 4.0mm; Length: 12, 14, 16, 18mm&#xD;
Diameter: 5.5mm; Length: 15, 20, 25, 30, 35mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER163</BillingCode>
            <Name>Signus Anterior Cervical Plate - Bone Screws</Name>
            <Description>Provides stability in patients undergoing anterior cervical spine fusion procedures. It consists of a pre-contoured titanium plate, secured onto the spinal vertebrae by either fixed or variable angle colour coded screws. These screws have an integral lock</Description>
            <Size>4.0-4.5mm diameter x 12-22mm length</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER188</BillingCode>
            <Name>SIGNUS Contact Thoracolumbar Plating System-Expansion Screw</Name>
            <Description>SIGNUS Contact Thoracolumbar Plating System-Expansion Screw</Description>
            <Size>6 mm dia, 25-40 mm long in 5 mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER352</BillingCode>
            <Name>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, expansion</Name>
            <Description>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, expansion,  include bolt.</Description>
            <Size>dia (4-5 mm) x length (12-18 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>279702</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB116</BillingCode>
            <Name>Unify Dynamic Anterior Cervical Plate System – Screws</Name>
            <Description>Variable and fixed angle expanding titanium alloy screws</Description>
            <Size>Diameter – 4.2mm and 4.6mm&#xD;
Length – 10mm – 20mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB121</BillingCode>
            <Name>Assure-X Anterior Cervical Plate System - Screws</Name>
            <Description>Variable Angle and Fixed Angle Self-drilling and Self-tapping Expansion Bone Screws</Description>
            <Size>Diameter 4.2-4.6 mm, Length 10-20mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU131</BillingCode>
            <Name>Mecta C Screws</Name>
            <Description>Expansion Head Screws</Description>
            <Size>Diameters 4 - 4.5. Length 12 - 22mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>222456</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU132</BillingCode>
            <Name>Mecta C Screws 2x</Name>
            <Description>Expansion Head Screws</Description>
            <Size>Diameter 4 - 4.5. Length 12 - 22 mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>222456</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU133</BillingCode>
            <Name>Mecta C Screws 4x</Name>
            <Description>Expansion Head Screws</Description>
            <Size>Diameters 4 - 4.5. Length 12 - 22 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>222456</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV106</BillingCode>
            <Name>Decade Lateral Plate System (screw)</Name>
            <Description>The Nuvasive Decade Lateral Plate System is indicated for use in the treatment of lumbar and lumbosacral (L1-S1) spine instability.</Description>
            <Size>5.0-6.5mm diameter, length 15-75mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>209200</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV144</BillingCode>
            <Name>Base (Screw)</Name>
            <Description>Bone Screw</Description>
            <Size>5.0-6.0mm diameter, 17.5-30mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH617</BillingCode>
            <Name>HumanTech - Hero Cervical Plate System - Expansion Head Screws</Name>
            <Description>Cervical Plate Expansion Head Screws</Description>
            <Size>D: 4.0mm L: 12 - 22mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>316053</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY181</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>Expansion Head Screw</Description>
            <Size>Dia 3.5 - 4.5mm,  Length 12 - 25mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY449</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>QuickLock Screw</Description>
            <Size>4.0 or 4.5mm Diameter, 12-20mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <Suffix>Expansion Screw / Expansion Head Screw</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>274</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB069</BillingCode>
            <Name>Aesculap Bone Screws</Name>
            <Description>Titanium alloy</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF011</BillingCode>
            <Name>WinLoc Cervical Plate System - screw</Name>
            <Description>Variable self drilling screw/self tapping screw/oversized screw, expandable screw</Description>
            <Size>Length: 12mm, 14mm, 16mm, 18mm&#xD;
Diameter:  4.0mm, 4.5mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>218438</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF023</BillingCode>
            <Name>Redmond Screw</Name>
            <Description>Variable or constrained self-drilling/self-tapping/oversized screw</Description>
            <Size>Length: 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 20mm &#xD;
Diameter: 4.0m (self-drilling and self-tapping); 4.5mm (oversized)</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE628</BillingCode>
            <Name>Zuma bone screw</Name>
            <Description>Bone screw</Description>
            <Size>5.5mm - 6.0mm x 20mm - 35mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>275780</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE653</BillingCode>
            <Name>Vu aPOD Prime Bone Screw</Name>
            <Description>Locking Bone Screw</Description>
            <Size>6.0 and 6.5mm diameter&#xD;
20, 25 and 30mm length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE660</BillingCode>
            <Name>Shoreline ACS Bone Screws</Name>
            <Description>Self drilling and self tapping bone screws</Description>
            <Size>3.5 and 4.0mm diameters&#xD;
10-18mm length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE703</BillingCode>
            <Name>Sierra Occipital Screw</Name>
            <Description>Occipital Screw</Description>
            <Size>5mm diameter x 6mm-14mm lengths</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE770</BillingCode>
            <Name>NorthStar OCT</Name>
            <Description>NorthStar OCT Occipital Screw  </Description>
            <Size>4.0, 4.5mm Diameter  7-16mm Lengths  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE793</BillingCode>
            <Name>Admiral Cervical Plate</Name>
            <Description>Admiral Cervical Plate Screws</Description>
            <Size>4.0 &amp; 4.3mm Diameter, 10-18mm Lengths</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>275780</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR032</BillingCode>
            <Name>Choice Spine Cervical Screw</Name>
            <Description>Screw for cervical plate (Variable, Fixed &amp; Rescue)</Description>
            <Size>4.0mm - 4.5mm x 10mm - 18mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>330080</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR039</BillingCode>
            <Name>Tesera Screws</Name>
            <Description>Tesera Fusion Cage Screws</Description>
            <Size>Dia. (3.5 - 5.0mm) x (12-35mm) Length </Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>354092</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR041</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DR026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screw </Name>
            <Description>Bone screw, Dual Thread</Description>
            <Size>Diameter (4.0mm); Length (20-35mm)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>330365</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR042</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DR030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Bone Screws</Name>
            <Description>Bone Screws</Description>
            <Size>3-4mm, 12-14mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>330365</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU012</BillingCode>
            <Name>Scarlet AC-T Screw, Reduction Screw</Name>
            <Description>Screw, reduction screw</Description>
            <Size>Diameter: 3mm, 3.5mm  Length: 12mm, 14mm, 16mm, 18mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>166154</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU015</BillingCode>
            <Name>Tryptik 2 Screw</Name>
            <Description>Self-tapping screws, self-drilling screws - variable and fixed angle</Description>
            <Size>Diameter: 4.0mm, 4.5mm&#xD;
Length: 12mm, 14mm, 16mm, 18mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>166154</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU029</BillingCode>
            <Name>Tryptik cervical screws</Name>
            <Description>Tryptik cervical screws</Description>
            <Size>Diameter: 4.0 and 4.5 mm;  Length: 12 to 18 mm  </Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>166154</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU038</BillingCode>
            <Name>Scarlet AL-T Bone Screw</Name>
            <Description>Bone Screw</Description>
            <Size>Diameter 5.0-5.5mm&#xD;
Length 25-40mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>166154</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU047</BillingCode>
            <Name>Juliet Ti LL screw</Name>
            <Description>Bone screw</Description>
            <Size>Diameter: 5mm, 5.5mm  Length: 45mm, 50mm, 55mm, 60mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>338461</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU055</BillingCode>
            <Name>Perla Posterior Occipito-Cervico-Thoracic fixation system - occipital screw</Name>
            <Description>Occipital screw</Description>
            <Size>Diameter: 4.5, 5 mm. Length: 6 - 16 mm.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY478</BillingCode>
            <Name>Uniplate ACP System</Name>
            <Description>Rescue Screw</Description>
            <Size>12-18mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY479</BillingCode>
            <Name>Uniplate ACP System</Name>
            <Description>Primary Screw</Description>
            <Size>12-18mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ088</BillingCode>
            <Name>CanAce Anterior Cervical Plating System</Name>
            <Description>Spinal Fixation System - Screws</Description>
            <Size>4.0mm / 4.5mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>346438</ARTG>
                <ARTG>346439</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER178</BillingCode>
            <Name>Scoliosis  &amp; Fracture System - LSZ3-Lamina Screw</Name>
            <Description>Signus Scoliosis  &amp; Fracture System - LSZ3-Lamina Screw</Description>
            <Size>5.0;7.5;10.0 mm </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>216747</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER187</BillingCode>
            <Name>SIGNUS Contact Thoracolumbar Plating System-Solid Screw</Name>
            <Description>SIGNUS Contact Thoracolumbar Plating System-Solid Screw</Description>
            <Size>Dia 6 mm, length 25-45 mm in 5 mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER209</BillingCode>
            <Name>SIGNUS  Cervical Plating Implant System-Bone Screw</Name>
            <Description>SIGNUS  Cervical Plating Implant System-Cervical Bone Screw, fixed or variable angle; self drilling or self tapping</Description>
            <Size>dia (2.7-4.3 mm)x length (12-22 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER278</BillingCode>
            <Name>Spineway Kili Lumbar Fusion Cage System-Screw</Name>
            <Description>Spineway Kili fusion cage system screw&#xD;
</Description>
            <Size>Diameter 4.5 mm, Length 20, 23mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>235415</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER312</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Occipital Screws</Name>
            <Description>Ulrich posterior OCT System (neon3)-Occipital screws, self tapping</Description>
            <Size>dia (5-5.5 mm) x length (6-16 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER351</BillingCode>
            <Name>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, cancellous</Name>
            <Description>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium,cancellous</Description>
            <Size>dia (4-4.5mm) x length (12-26mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>279702</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER459</BillingCode>
            <Name>LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Screw</Name>
            <Description>LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Screw, self tapping or self drilling; fixed or variable</Description>
            <Size>dia (3.5-4.0mm) x length (12-24mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>286127</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER513</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>E.2S Cervical Screw</Name>
            <Description>Titanium self-tapping cervical screws</Description>
            <Size>Diameter: 3.5 and 4mm&#xD;
Length 10, 12, 14, 16, 18, 20 and 22mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>171951</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER531</BillingCode>
            <Name>E.SPINE System</Name>
            <Description>TANIT SI Screw, non-sterile or sterile</Description>
            <Size>Diameter: 7mm  Length: 40mm - 120mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER548</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti hook bone screw</Name>
            <Description>Bone screw for hook</Description>
            <Size>10.5mm - 13.5mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER572</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Azure Anterior Cervical Plate System</Name>
            <Description>Bone Screws</Description>
            <Size>4.0 &amp; 4.5mm diameter  12, 14, 16, 18mm length</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER573</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Unity Lumbar Plate</Name>
            <Description>Unity Bone Screw</Description>
            <Size>6-7mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER574</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pillar SA</Name>
            <Description>Bone Screws</Description>
            <Size>5.0 - 5.5mm X  20-35mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER575</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF055</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Lonestar Cervical Stand Alone System Bone Screw</Name>
            <Description>Titanium Bone screw allowing intradiscal fixation to the vertebral body.</Description>
            <Size>3.6mm x 10/12/14/16/18mm Self drilling &amp; self tapping  4.0mm x 10/12/14/16/18mm Rescue self drilling &amp; Rescue self tapping</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER576</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF079</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cetra Bone Scews</Name>
            <Description>Self tapping and self drilling bone screws</Description>
            <Size>Diameter: 4mm-4.5mm  Length:10mm-20mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER622</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Blackstone Medical ACP Bone Screw</Name>
            <Description>Titanium Alloy Bone Screw</Description>
            <Size>4.1mm x 10mm - 18mm. 4.5mm x 10mm - 18mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER623</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF060</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Occipital Bone Screws and Rescue Screws</Name>
            <Description>Occipital Bone screws with non-anodized heads</Description>
            <Size>6mm – 14mm in 2mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER624</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF070</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SKYHAWK Bone Screws</Name>
            <Description>Primary and Rescue Screws</Description>
            <Size>Primary Screw: 5.5 mm diameter,  30mm- 60mm length (in 5mm increments)  Rescue Screw: 6.5 mm diameter, 30mm - 60mm length (in 5mm increments)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY032</BillingCode>
            <Name>Osimplant Bone Screw</Name>
            <Description>Bone Screws</Description>
            <Size>Lengths: 12 - 20 mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC011</BillingCode>
            <Name>Ally Bone Screw</Name>
            <Description>For use with DTRAX Cages</Description>
            <Size>One size</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>290978</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC012</BillingCode>
            <Name>GL-DTRAX Bone Screw</Name>
            <Description>Cortical screw</Description>
            <Size>One Size</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>290978</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW043</BillingCode>
            <Name>WEGO Spinal Systems</Name>
            <Description>Bone screws</Description>
            <Size>All sizes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC014</BillingCode>
            <Name>Origin Screw</Name>
            <Description>Origin Screw</Description>
            <Size>6-26mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>205325</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC018</BillingCode>
            <Name>KM Bone screw</Name>
            <Description>Bone Screw</Description>
            <Size>W:3.5-5.0mm  L:6-22mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>201492</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC025</BillingCode>
            <Name>Screw</Name>
            <Description>The Screw is used with the Perfect-C implant to obtain cortical fixation.</Description>
            <Size>Length 14 - 18mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>262490</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW393</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Bone Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW409</BillingCode>
            <Name>Aviator Anterior Cervical Plating System - Screw</Name>
            <Description>Anterior Cervical Plate System - Screw</Description>
            <Size>4 - 4.35mm diameter, 10 - 18mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>278368</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW513</BillingCode>
            <Name>Anchor-L Lumbar cage System, Bone Screw</Name>
            <Description>Bone Screw</Description>
            <Size>Dia 5mm- 6mm, Length 20mm- 30mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>278558</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW519</BillingCode>
            <Name>AVS Anchor C Cervical Cage System</Name>
            <Description>Screw for use with Anchor C Cervical Cage</Description>
            <Size>Diameter 3.5-4mm Length 8-14mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>315081</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW571</BillingCode>
            <Name>LITe Plate System - Screw</Name>
            <Description>Bone Screw</Description>
            <Size>Dia 5mm-5.5mm, Length 22mm-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>277947</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW679</BillingCode>
            <Name>Monterey AL, Screw </Name>
            <Description>Bone Screw </Description>
            <Size>Diameter 5mm   6mm </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>356926</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW778</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER491</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Yukon OCT Spinal System</Name>
            <Description>Occipital Screw</Description>
            <Size>(4.5-5.75)mm dia  x (6-16)mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW781</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER495</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ozark Cervical Plate System Screw</Name>
            <Description>Screw, fixed or variable angle</Description>
            <Size>(4-4.5)mm diameter x (10-26)mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB006</BillingCode>
            <Name>STACC Cervical Screw</Name>
            <Description>Cervical  Screw</Description>
            <Size>4mm x 14,16 and 18mm</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>188902</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution ACDF Plate Bone Screw</Name>
            <Description>Bone screw</Description>
            <Size>4.0mm diameter 10-20mm, 4.5mm diameter 10-20mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>248233</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution ACDF Cage Bone Screw</Name>
            <Description>Bone screw for fusion cages</Description>
            <Size>4.0 diameter, 12-16mm; 4.5 diameter, 12-16mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>248233</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution ALIF Cage Screw</Name>
            <Description>ThoracoLumbar Cage Bone Screw</Description>
            <Size>5.5mm Diameter, 20-35mm; 6.5mm Diameter, 20-35mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>248233</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Revolution ACDF Plate Screw</Name>
            <Description>Anterior Cervical Bone Screws</Description>
            <Size>Fixed and Variable Angle. Diameter 4 - 4.5mm. Length 10 - 20mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH539</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spinal Plate Screws</Name>
            <Description>Self-Drilling and Self-Tapping Plate Screws</Description>
            <Size>Diam - 4.0 - 4.5mm&#xD;
Length - 10 - 16mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>289731</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ512</BillingCode>
            <Name>Skyline Cervical Plate System</Name>
            <Description>Skyline anterior cervical screw, titanium</Description>
            <Size>Self drilling 3.8mm, 10-18mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ513</BillingCode>
            <Name>Skyline Cervical Plate System</Name>
            <Description>Skyline anterior cervical screw. Titanium</Description>
            <Size>Self tapping 3.8mm, 10-26mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ514</BillingCode>
            <Name>Skyline Cervical Plate System</Name>
            <Description>Skyline anterior cervical screw.  Titanium</Description>
            <Size>Self Tapping 4.3mm, 10-18mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ519</BillingCode>
            <Name>AEGIS ALP</Name>
            <Description>AEGIS ALP Bone Screws, Titanium</Description>
            <Size>24-36mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ603</BillingCode>
            <Name>McGuire Bone Screw</Name>
            <Description>Cancellous Bone Screw</Description>
            <Size>3.5mm x 8 - 60mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ690</BillingCode>
            <Name>Mountaineer OCT Spinal System - OC screw</Name>
            <Description>Occipital - titanium bone screw</Description>
            <Size>4.5 - 5.25 x 6 - 16</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif C</Name>
            <Description>Stalif Screws</Description>
            <Size>D: 4.0mm  L: 13 - 17mm</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP012</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centinel Spine</Name>
            <Description>Stalif Bone Screws</Description>
            <Size>D: 4.5 - 6.0mm  L: 25 - 40mm</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH053</BillingCode>
            <Name>Screw</Name>
            <Description>Occipital Screw</Description>
            <Size>6-12mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH083</BillingCode>
            <Name>Katia Bone Screw</Name>
            <Description>Cancellous Screw   Fixed or Variable Angle</Description>
            <Size>4.0 mm &amp; 4.5 mm   10 mm - 17 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH087</BillingCode>
            <Name>Ceplate Anterior Cervical System - Bone Screw </Name>
            <Description>Screws - Self-Tapping / Self-Drilling and Fixed / Variable Angle</Description>
            <Size>Diameter: 4.0mm - 4.5mm; Length 11mm - 17mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>366091</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB002</BillingCode>
            <Name>Independence Variable Angled Screw</Name>
            <Description>Variable Angled Bone Screw</Description>
            <Size>5.5mm x 20mm - 40mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190071</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB003</BillingCode>
            <Name>Independence Fixed Angled Screw</Name>
            <Description>Fixed Angled Bone Screw</Description>
            <Size>5.5mm x 20mm - 40mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190071</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB010</BillingCode>
            <Name>TRUSS® Thoracolumbar Variable Angle Screws</Name>
            <Description>Variable Angle screw</Description>
            <Size>5.5m and 6.5mm diameter x 22mm - 57mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB011</BillingCode>
            <Name>TRUSS® Thoracolumbar Fixed Angle Screws</Name>
            <Description>Fixed Angle screw</Description>
            <Size>5.5m and 6.5mm diameter x 22mm - 57mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB013</BillingCode>
            <Name>CITADEL® Anterior Variable Angled Bone Screws</Name>
            <Description>Variable Angle screw</Description>
            <Size>22m - 57mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190969</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB014</BillingCode>
            <Name>CITADEL® Anterior Fixed Angles Bone Screws</Name>
            <Description>Fixed Angle screw</Description>
            <Size>22mm - 57mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190969</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB016</BillingCode>
            <Name>VIP Anterior Cervical Fixed Angle Screws</Name>
            <Description>Anterior Cervical Fixed Angle Bone Screws</Description>
            <Size>4.6mm - 5.1mm Diameter, 12mm - 20mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190972</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB017</BillingCode>
            <Name>VIP Anterior Cervical Variable Angle Screws</Name>
            <Description>Anterior Cervical Variable Bone Screws</Description>
            <Size>4.6mm - 5.1mm Diameter, 12mm - 20mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190972</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB033</BillingCode>
            <Name>REVERE Bone Screw, Anterior Plate</Name>
            <Description>Bone Screw</Description>
            <Size>5.5mm - 7.5mm Diameter x 25mm - 50mm Length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB036</BillingCode>
            <Name>Coalition Variable Angled Screw</Name>
            <Description>Bone screw Variable angle</Description>
            <Size>3.6mm and 4.2mm diameter, 12mm - 20mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190040</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB037</BillingCode>
            <Name>Coalition Fixed Angled Screw</Name>
            <Description>Bone screw, Fixed Angle</Description>
            <Size>3.6mm and 4.2mm diameter, 12mm - 20 mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190040</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB041</BillingCode>
            <Name>XTEND Variable Angled Screws</Name>
            <Description>Variable Angled Bone Screws</Description>
            <Size>4.2, 4.6 and 5.1mm diameter x 10mm - 20mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB042</BillingCode>
            <Name>XTEND Fixed Angled Screws</Name>
            <Description>Fixed Angled Bone Screws</Description>
            <Size>4.2, 4.6 and 5.1mm diameter x 10mm - 20mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB052</BillingCode>
            <Name>ELLIPSE® Stabilization System Occipital Screw</Name>
            <Description>Bone Screw</Description>
            <Size>4.0mm to 4.5mm Diameter x 6mm - 16mm Length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB054</BillingCode>
            <Name>CORRIDOR Fixation System Screw Non Cannulated Screws</Name>
            <Description>Bone Screws</Description>
            <Size>3.5mm - 4.5mm diameter, 30mm - 60mm Length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190041</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB094</BillingCode>
            <Name>PLYMOUTH Thoracolumbar Plate System Screw</Name>
            <Description>Bone Screw</Description>
            <Size>5.5mm - 6.5mm&#xD;
22mm - 57mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB099</BillingCode>
            <Name>CANOPY Laminoplasty System Screw</Name>
            <Description>Bone and graft screw for Laminoplasty Plate</Description>
            <Size>2.2mm - 3.0mm &#xD;
4mm - 12mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>219536</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB107</BillingCode>
            <Name>InterContinental HA Screws</Name>
            <Description>HA Coated Bone Screws</Description>
            <Size>5.5mm x 30mm - 60mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB112</BillingCode>
            <Name>ASSURE® Anterior Plate System – Screws</Name>
            <Description>Standard - Self-drilling or Self Tapping &#xD;
Rigid – Self Drilling or Self Tapping</Description>
            <Size>Diameter - 4.0 -4.5mm&#xD;
Length – 10-20mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB139</BillingCode>
            <Name>Fortify® I-R Corpectomy Spacer System - Screws</Name>
            <Description>Bone Screws, fixed or variable angles, self-tapping or self-drilling</Description>
            <Size>4.2, 3.6, and 5.5mm diameter, 12-60mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB145</BillingCode>
            <Name>Coalition Anchor</Name>
            <Description>Titanium Anchor for Coalition Spacer</Description>
            <Size>12mm, 14mm and 15mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190040</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB160</BillingCode>
            <Name>QUARTEX Occiptal Screws</Name>
            <Description>Occipital Screws</Description>
            <Size>Diameter 4.2mm-4.6mm and Length 6mm-16mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB173</BillingCode>
            <Name>ELSA Bone Screw</Name>
            <Description>Variable Angle Bone Screw</Description>
            <Size>Diameter: 5.5mm&#xD;
Length: 30-60mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB185</BillingCode>
            <Name>Independence MIS Anchor</Name>
            <Description>Lumbar anchor for use with the Independence Spacer</Description>
            <Size>Diameter: 5.5mm  Length, 25mm, 27mm and 30mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190071</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB192</BillingCode>
            <Name>PROVIDENCE Variable Angle Screws</Name>
            <Description>Variable angled screws, self drilling and self tapping</Description>
            <Size>Length -10mm to 26mm  Diameter - 4.2mm to 4.6mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB193</BillingCode>
            <Name>PROVIDENCE Fixed Angle Screws</Name>
            <Description>Fixed angled screws, self-drilling and self-tappiing</Description>
            <Size>Length - 10mm to 26mm  Diameter - 4.2mm to 4.6mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH588</BillingCode>
            <Name>Cervical Spine Truss System - Stand Alone Screw</Name>
            <Description>Variable head locking screw</Description>
            <Size>(3.5-3.85) mm diam x (12-16) mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH706</BillingCode>
            <Name>Ultio Laminoplasty Screw</Name>
            <Description>Screw, self drilling, self tapping</Description>
            <Size>4-20mm length</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>275605</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH709</BillingCode>
            <Name>Integrated Anterior Lumbar Spine Truss System Screw</Name>
            <Description>Fixation Screw</Description>
            <Size>23-31mm lengths</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM402</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spider Cervical Plating System - Spider Screw</Name>
            <Description>Titanium, Self Tapping and Self Drilling</Description>
            <Size>4.0 - 4.25mm, lengths 12-16mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>170220</ARTG>
                <ARTG>160750</ARTG>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM412</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IRIX - C Screws</Name>
            <Description>Bone screws</Description>
            <Size>Diameter 3.5mm and 3.7mm; Length 12-21mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM421</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IRIX-A Screw</Name>
            <Description>Bone Screw</Description>
            <Size>Diameter 5.5 and 6.0mm, Length 25-40mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>238872</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM427</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK103</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Occipital Screws</Name>
            <Description>Occipital Screws</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM498</BillingCode>
            <Name>Sacral Screw</Name>
            <Description>Sacral Screw</Description>
            <Size>Diameter 6.5 &amp; 7.5mm  Length 30 - 70 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM528</BillingCode>
            <Name>Cervical Plate screws</Name>
            <Description>Cervical Plate screws</Description>
            <Size>4/4.5 mm diameter  12-20mm long</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>375813</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC296</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Occipital Screws</Description>
            <Size> 3.0 - 5.0 mm diameter, 4 - 30 mm length</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC310</BillingCode>
            <Name>Centerpiece</Name>
            <Description>TiMesh LP</Description>
            <Size>Screw</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC611</BillingCode>
            <Name>Vantage</Name>
            <Description>Vantage Plates and Screws; Thoracic Screw</Description>
            <Size>5.5-10.5 x 15-100mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC613</BillingCode>
            <Name>Vantage</Name>
            <Description>Vantage Plates and Screws; ATL Screw</Description>
            <Size>6.5 x 30-55mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC656</BillingCode>
            <Name>Pyramid</Name>
            <Description>Pyramid Bone Screws</Description>
            <Size>6.5mm Diameter, 20 -60mm length in 5mm increments</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC988</BillingCode>
            <Name>Sovereign Spinal System - Screws</Name>
            <Description>Sovereign Spinal System - Screws</Description>
            <Size>20 - 35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI057</BillingCode>
            <Name>Atlantis Anterior Cervical Plate System - Bone Screw</Name>
            <Description>Screws - Self-Tapping / Self-Drilling and Fixed / Variable Angle</Description>
            <Size>Diameter: 4.0mm - 4.5mm; Length 11mm - 17mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI175</BillingCode>
            <Name>Venture Screws</Name>
            <Description>Self drilling and self tapping screws (fixed and variable angle)</Description>
            <Size>4.0mm x 8mm - 21mm; 4.5mm x 8mm - 21mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI261</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Occipital Screws</Description>
            <Size>Diameter 4.5 - 5.0mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI321</BillingCode>
            <Name>Titan Spine Bone Screws</Name>
            <Description>Titan Spine Bone Screws-Endoskeleton TCS/TAS, standard</Description>
            <Size>dia (3.5-6.5mm) x length (13-35mm)</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>334300</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI462</BillingCode>
            <Name>PASS Spinal System Screw</Name>
            <Description>PASS Spinal System Screw</Description>
            <Size>6.5mm to 8.0mm diameter; 25 to 95mm length</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI477</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK092</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Occipital Plate Screws</Name>
            <Description>Occipital Plate Screws</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI498</BillingCode>
            <Name>ZEVO Anterior Cervical Plate System</Name>
            <Description>self-drilling/self-tapping screw</Description>
            <Size>Diameter: 4.5mm; Length 13mm - 15mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU123</BillingCode>
            <Name>MectaLIF Anterior Stand-Alone Screws</Name>
            <Description>Bone Screws</Description>
            <Size>Diameter: 5 &amp; 5.5mm  Length: 25, 30, 35 &amp; 40mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>222456</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU136</BillingCode>
            <Name>M.U.S.T Screws for Pedicle Hooks</Name>
            <Description>Bone Screws</Description>
            <Size>Ø 3,5; L 15 - 20 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>222456</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU167</BillingCode>
            <Name>MUST Mini Occipital Screws</Name>
            <Description>Occipital Bone Screws</Description>
            <Size>Ø 4 and 5 mm. L 6÷16 mm.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>222456</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV023</BillingCode>
            <Name>VuePoint Screw (occipital bone)</Name>
            <Description>Bone Screw</Description>
            <Size>4.5-5.0mm diameter, 6-14mm length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV031</BillingCode>
            <Name>Traverse Bolt</Name>
            <Description>The Traverse system, of which the Traverse bolt is a component, is indicated for use as an adjunct to fusion via a lateral or anterolateral surgical approach, above the bifurcation of the great vessels, in the treatment of thoracic and thoracolumbar (T1-L</Description>
            <Size>6.5mm x (25/30/35/40/45/50/55/60/65mm)
7.5mm x (25/30/35/40/45/50/55/60/65mm)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132467</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV034</BillingCode>
            <Name>Traverse Bone Screw</Name>
            <Description>The Traverse system, of which the Traverse bone screw is a component, is indicated for use as an adjunct to fusion via a lateral or anterolateral surgical approach, above the bifurcation of the great vessels, in the treatment of thoracic and thoracolumbar</Description>
            <Size>5.5mm x (25/30/35/40/45/50/55/60/65mm)
6.5mm x (25/30/35/40/45/50/55/60/65mm)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132467</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV039</BillingCode>
            <Name>Halo Bone Screw</Name>
            <Description>The Halo System, of which the Halo bone screw  is a component, is indicated for use via a lateral or anterolateral surgical approach above the bifurcation of the great vessels in the treatment of thoracic and thoracolumbar (T1-L5) spine instability or via</Description>
            <Size>5.5mm x (20/22/24/26/28/30/32/34mm)
6.5mm x (20/22/24/26/28/30/32/34mm)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV041</BillingCode>
            <Name>Helix Mini bone screw</Name>
            <Description>The Helix Mini system, of which the Helix Mini bone screw is a component, is intended for anterior screw fixation of the cervical spine. These implants have been designed to provide stabilisation as an adjunct to cervical fusion. Indications for the use o</Description>
            <Size>4.0mm x (11/13/15mm)
4.5mm x (11/13/15mm)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV044</BillingCode>
            <Name>Helix Bone Screw</Name>
            <Description>The Helix system, of which the Helix bone screw is a component, is intended for anterior screw fixation  of the cervical spine. These implants have been designed to provide stabilisation as an adjunct to cervical fusion. Indications for the use of this im</Description>
            <Size>4.0mm x (11/13/15/17/19mm)
4.5mm x (13/15/17/19mm)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV052</BillingCode>
            <Name>Leverage LFS (Bone Screw)</Name>
            <Description>The Leverage LFS, of which the bone screw is a component, is intended for use in the lower cervical and upper thoracic spine (C3 to T3) in laminoplasty procedures. Leverage LFS is used to hold allograft material in place in order to prevent the allograft </Description>
            <Size>2.6/3mm x 5-8mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV070</BillingCode>
            <Name>Helix-Revolution (screw)</Name>
            <Description>Bone Screw</Description>
            <Size>4 x 11-19mm; 4.5 x 11-19mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133466</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV072</BillingCode>
            <Name>Brigade standalone ALIF (screw)</Name>
            <Description>Bone screw</Description>
            <Size>4.5 x 20-35mm; 5.5 x 20-35mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV093</BillingCode>
            <Name>Helix-T (Bone Screw)</Name>
            <Description>Anterior cervical plate bone screw</Description>
            <Size>4/4.5x11-19mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV096</BillingCode>
            <Name>Brigade Bone Screw</Name>
            <Description>Anterior plate bone screw</Description>
            <Size>5.5/6.5 x 20-35mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV104</BillingCode>
            <Name>CoRoent Small Interlock (screw)</Name>
            <Description>The CoRoent Small Interlock System is a stand-alone anterior cervical interbody fusion system indicated for use in skeletally mature patients with degenerative disc disease (DDD) at one level from C2 - T1.</Description>
            <Size>10-20mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV107</BillingCode>
            <Name>CoRoent (Screw)</Name>
            <Description>Bone Screw</Description>
            <Size>10-70mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV162</BillingCode>
            <Name>ACP Screw - Variable Angle</Name>
            <Description>Variable Angle Bone Screw, self tapping and self drilling</Description>
            <Size>Diameter - 3.5mm - 4.0mm  Length - 11mm to 19mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV163</BillingCode>
            <Name>ACP Screw Fixed Angle</Name>
            <Description>Fixed Angle, self drilling and self tapping</Description>
            <Size>Diameter - 3.5mm to 4.0mm  Length - 11mm to 19mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV166</BillingCode>
            <Name>3DP Interfixated ALIF Bolt</Name>
            <Description>Bone Screw</Description>
            <Size>5.0 - 6.0mm X 15-25mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV169</BillingCode>
            <Name>Modulus ALIF Bolt</Name>
            <Description>Fixation bolt</Description>
            <Size>Diameter: 5-6mm  Length: 15-30mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI904</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Occipital Screws</Name>
            <Description>Occipital Screws</Description>
            <Size>4.5mm x 6-16mm, 5.25mm x 6-16mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW042</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BH108</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Anterior Cervical Plate System</Name>
            <Description>Titanium Cancellous Bone Screw</Description>
            <Size>4 - 20mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW043</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI950</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Timberline Lateral Fusion System</Name>
            <Description>Bone Screws</Description>
            <Size>30-60mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH618</BillingCode>
            <Name>HumanTech - Hero Cervical Plate System - Screws</Name>
            <Description>Cervical Plate Screws</Description>
            <Size>D: 4.0mm L: 12 - 18mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>316053</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB004</BillingCode>
            <Name>Bone Screws</Name>
            <Description>Bone Screws</Description>
            <Size>Diameter:2.0-4.35mm, Length: 6-18mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC003</BillingCode>
            <Name>WeCover Cervical System - Screw</Name>
            <Description>Plate System - Screws</Description>
            <Size>Self Drilling Screw Ø4.5 fixed angle 12mm - 22mm&#xD;
Self Drilling Screw Ø4.5 variable angle 12mm - 22mm&#xD;
Self Drilling Screw Ø4 fixed angle 12mm - 22mm&#xD;
Self Drilling Screw Ø4 variable angle 12mm - 22mm&#xD;
Self Tapping Screw Ø4.5 fixed angle 12mm - 22mm&#xD;
Self Tapping Screw Ø4 fixed angle 12mm - 22mm&#xD;
Self Tapping Screw Ø4 variable angle 12mm - 22mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>221268</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BF023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Redmond Screw</Name>
            <Description>Variable or constrained self-drilling/self-tapping/oversized screw</Description>
            <Size>Length: 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 20mm   Diameter: 4.0m (self-drilling and self-tapping); 4.5mm (oversized)</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centinel Spine</Name>
            <Description>Stalif Bone Screws</Description>
            <Size>D: 4.5 - 6.0mm  L: 25 - 40mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif C</Name>
            <Description>Stalif Screws</Description>
            <Size>D: 4.0mm  L: 13 - 17mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC035</BillingCode>
            <Name>Ulrich Anterior Cervical Plating System-Screws  </Name>
            <Description>Plate Screws - Self Tapping, Self Drilling, Rescue</Description>
            <Size>12-18mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>377912</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ014</BillingCode>
            <Name>Aquila Plate System</Name>
            <Description>Bone Screw</Description>
            <Size>10-20mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ048</BillingCode>
            <Name>Borealis Spine System</Name>
            <Description>Bone Screw</Description>
            <Size>10-20mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ051</BillingCode>
            <Name>Pegasus Plate System</Name>
            <Description>Bone Screw</Description>
            <Size>12-26mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ052</BillingCode>
            <Name>Aurora Screw</Name>
            <Description>Bone Screw</Description>
            <Size>24mm - 32mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI032</BillingCode>
            <Name>Fortilink®-SA Screw</Name>
            <Description>Self-drilling and self-tapping bone screws</Description>
            <Size>Diameter 4.5mm-5.5mm  Length 20-35mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI038</BillingCode>
            <Name>Shark CP Locking Plate Screws</Name>
            <Description>Self drilling screws, variable or fixed angle, titanium alloy. </Description>
            <Size>4 - 4.5mm diameter, 12-22mm length </Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>345367</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI041</BillingCode>
            <Name>Fortilink®-SC Screws</Name>
            <Description>Self drilling and self tapping bone screws</Description>
            <Size>Diameter: 3.4-3.9mm  Length: 12-16mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF162</BillingCode>
            <Name>Nik-Alias Screw</Name>
            <Description>Spine cage screw</Description>
            <Size>20-40mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>246581</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF169</BillingCode>
            <Name>Wasp ACDF Screw</Name>
            <Description>Wasp Cage - Screw</Description>
            <Size>4.5 and 5mm diameter</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>184460</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK223</BillingCode>
            <Name>Oasys-Occipito Cervico Thoracic System</Name>
            <Description>Cortical Screws</Description>
            <Size>Dia: 3.5mm x Length: 6mm - 24mm  Dia: 4.0mm x Length: 6mm - 54mm  Dia: 4.5mm x Length: 6mm - 16mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>279144</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST914</BillingCode>
            <Name>REFLEX  Anterior Cervical Plating System</Name>
            <Description>Screw</Description>
            <Size>Diameter 4 - 4.5mm lengths 10mm - 20mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>278368</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY149</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Schanz Screws</Description>
            <Size> 5-7mm dia </Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY187</BillingCode>
            <Name>Cervifix Posterior Cervical  System</Name>
            <Description>Screw</Description>
            <Size>Dia 3.2 - 4.5mm, Length 6 - 55mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY299</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Locking Screw</Description>
            <Size>10mm to 26mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY334</BillingCode>
            <Name>Arch Fixation System</Name>
            <Description>Screws, titanium</Description>
            <Size>2.0mm - 2.4mm screws, 4 to 12mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY362</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Pedicle Hook Screw</Description>
            <Size>Length 20 - 40mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY381</BillingCode>
            <Name>Axon Occipital Fusion System</Name>
            <Description>Occipital Screws 4.5mm / 5.0mm diameter
Titanium Alloy</Description>
            <Size>Length 4 - 18mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT004</BillingCode>
            <Name>SPICCA-SP2 Screws</Name>
            <Description>Titanium screws</Description>
            <Size>13mm - 21mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>320878</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT006</BillingCode>
            <Name>SASCA-2 Screws</Name>
            <Description>Titanium screws, including 3D printed screws.</Description>
            <Size>25mm - 40mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>320878</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT009</BillingCode>
            <Name>AXIS2 Screws</Name>
            <Description>Cervical screws - self-tapping/self-drilling, fixed and variable angle</Description>
            <Size>Diameter: 4.0mm, 4.5mm  Length: 12mm - 18mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>320878</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT020</BillingCode>
            <Name>Unity+ Screws</Name>
            <Description>Titanium bone screw</Description>
            <Size>Diameter: 5mm, 6mm; Length: 30mm - 50mm.</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>165</SubCategoryID>
            <GroupID>1464</GroupID>
            <ARTGs>
                <ARTG>320878</ARTG>
            </ARTGs>
            <MinimumBenefit>186</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB230</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Set Screw - titanium</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF008</BillingCode>
            <Name>Smartloc Spinal Fixation System / Set Screw</Name>
            <Description>Set screw for poyaxial pedicle screw</Description>
            <Size>8mm diameter, 5mm height</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>150778</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF017</BillingCode>
            <Name>Redmond Lumbar Cage System - Locking Cap</Name>
            <Description>Titanium locking cap</Description>
            <Size>Diameter: 3mm; Length: 4mm or 6mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH592</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Element</Name>
            <Description>Locking Element for Screws and Connectors</Description>
            <Size>std or 45 degree</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>288089</ARTG>
            </ARTGs>
            <Note>To be reimbursed only when used in patients with spinal tumours</Note>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW026</BillingCode>
            <Name>Libra Set Screw</Name>
            <Description>Set Screw - as part of Libra Pedicle Screw System</Description>
            <Size>One size only</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>355051</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE597</BillingCode>
            <Name>Sierra OCT Locking Cap</Name>
            <Description>Locking Cap and Set Screw</Description>
            <Size>1 size each</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE631</BillingCode>
            <Name>Malibu Spinal System Locking Cap</Name>
            <Description>Locking cap with integral set screw</Description>
            <Size>5.5mm and 6.35mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE661</BillingCode>
            <Name>Shoreline ACS Locking Cover</Name>
            <Description>Locking cover for fixation of bone screws</Description>
            <Size>5-12mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE663</BillingCode>
            <Name>Malibu Integrated Locking Cap and Set Screw</Name>
            <Description>Integrated Locking Cap and Set Screw</Description>
            <Size>1 size</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE666</BillingCode>
            <Name>Mariner Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>1 size</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE671</BillingCode>
            <Name>icotec Pedicle System Set Screw</Name>
            <Description>Set screw</Description>
            <Size>one size only</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>283853</ARTG>
                <ARTG>283854</ARTG>
            </ARTGs>
            <Note>To be reimbursed only when used in patients with spinal tumours</Note>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE762</BillingCode>
            <Name>NorthStar OCT</Name>
            <Description>NorthStar OCT Set Screw</Description>
            <Size>One Size</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR008</BillingCode>
            <Name>Life Spine Pedicle Screw System - Locking Cap</Name>
            <Description>Life Spine Screw System (Nautilus, Avatar) - Locking Caps</Description>
            <Size>One Size</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR035</BillingCode>
            <Name>Z-Medicle Pedicle Screw System - Locking Screw</Name>
            <Description>Z-Medicle Pedicle Screw System - Locking Screw</Description>
            <Size>One Size</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>343676</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR050</BillingCode>
            <Name>Ulrich Medical Pedicle Screw System - Locking Screw</Name>
            <Description>Ulrich Medical Pedicle Screw System - Locking Screw</Description>
            <Size>One Size</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>365230</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU002</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Set Screw</Name>
            <Description>Set screws for Perla spinal fixation system: set screws, extended set screws, hexagonal set screws</Description>
            <Size>One size only</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU019</BillingCode>
            <Name>Romeo 2/Romeo 2 MIS Posterior Thoraco-lumbar Fixation System - Set Screw</Name>
            <Description>Set screw</Description>
            <Size>One size only</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU042</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - setscrew </Name>
            <Description>Setscrew</Description>
            <Size>one size</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY107</BillingCode>
            <Name>Carbon Fibre Cages</Name>
            <Description>Stackable Cage Titanium Interface Screw Nuts</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>128255</ARTG>
                <ARTG>128257</ARTG>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY293</BillingCode>
            <Name>Crossover System (Titanium)</Name>
            <Description>Crossover Nut or Ball Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER141</BillingCode>
            <Name>Signus Pedicle Screw System-Set Screw</Name>
            <Description>Set Screw - as part of Signus Pedicle Screw System Construct</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER181</BillingCode>
            <Name>Scoliosis  &amp; Fracture System - LSZ3-Shear Nut</Name>
            <Description>SIGNUS Scoliosis  &amp; Fracture System - LSZ3-Shear Nut</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>216747</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER189</BillingCode>
            <Name>SIGNUS Contact Thoracolumbar Plating System-Locking Crown</Name>
            <Description>SIGNUS Contact Thoracolumbar Plating System-Locking Crown</Description>
            <Size>M12 x 0.75 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER224</BillingCode>
            <Name>SIGNUS Diplomat  Pedicle Screw System - Set Screw</Name>
            <Description>SIGNUS Diplomat  Pedicle Screw System - Set Screw</Description>
            <Size>dia 9.7mm x height 4.2mm or N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER232</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Locking Screw</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Locking Screw</Description>
            <Size>Height 3.7 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER287</BillingCode>
            <Name>Premia Spine Versalink Fixation System-Ring Nut/set screws</Name>
            <Description>Premia Spine Versalink Fixation System-Nut/set screws</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>267145</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER313</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Locking Screw</Name>
            <Description>Ulrich posterior OCT System (neon3)-Locking Screw, nut</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER335</BillingCode>
            <Name>Ulrich Pedicle Screw System-Locking screws</Name>
            <Description>Ulrich Pedicle Screw System (cosmicMIA, uCentum, flamenco)-Locking screws</Description>
            <Size>various</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER353</BillingCode>
            <Name>Ulrich Anterior Distraction Device System (ADDplus)-Locking Screw</Name>
            <Description>Ulrich Anterior Distraction Device System (ADDplus)-Locking Screw</Description>
            <Size>one size</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>279702</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER408</BillingCode>
            <Name>LnK MIS Spinal System/PathLoc-L  MIS Spinal System-Set Screw</Name>
            <Description>LnK MIS Spinal System/PathLoc-L MIS Spinal System-Set Screw</Description>
            <Size>dia 9.7mm x height 5.6mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>286124</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER437</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Set screw</Name>
            <Description>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Set screw</Description>
            <Size>Dia (6-7 mm) x Height (3.6-3.7 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>286122</ARTG>
                <ARTG>384816</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER449</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Set screws</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Set screws</Description>
            <Size>dia (8.7-9.7mm) x height (5.0-5.6mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER514</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>e.Spine locking screw</Name>
            <Description>Titanium locking screw for e.Spine hooks and e.Spine pedicular screws</Description>
            <Size>One size</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER529</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Set Screw</Name>
            <Description>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Crosslink/Accessory Set Screw</Description>
            <Size>M4, M5</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>286122</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER552</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti Lock Screw</Name>
            <Description>Lock Screw  </Description>
            <Size>Various sizes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER577</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spinal Fixation System</Name>
            <Description>Set Screw Spinal System</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER627</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF061</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Set Screw</Name>
            <Description>Universal set screw</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER628</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF071</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SKYHAWK Set Screw</Name>
            <Description>Set Screw for SKYHAWK Lateral Interbody Fusion System</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER664</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-set screws</Name>
            <Description>LnK AccelFix Spinal Fixation System set screws, star or hex type, Ti, sterile</Description>
            <Size>Diameter: 8.7-9.7 mm  Height:     5.0-5.6 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY003</BillingCode>
            <Name>Reform Locking Cap</Name>
            <Description>Locking Cap</Description>
            <Size>3.5mm to 5.5mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY012</BillingCode>
            <Name>Reform POCT Cap Screw</Name>
            <Description>Cap Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY035</BillingCode>
            <Name>Reform MIS Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>5.5</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW001</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Break off set screw </Description>
            <Size>5.5 mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW028</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Set screws </Description>
            <Size>All sizes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC017</BillingCode>
            <Name>KM Nut</Name>
            <Description>Nut</Description>
            <Size>Various sizes</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>201492</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC027</BillingCode>
            <Name>G2S Nut</Name>
            <Description>locking nut</Description>
            <Size>Nut</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>274075</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC032</BillingCode>
            <Name>SAXXO NUT</Name>
            <Description>NUT</Description>
            <Size>NUT 9.1 ,NUT 9.8 </Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>331780</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW751</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER213</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems Set Screws</Name>
            <Description>Set Screw</Description>
            <Size>Diameter: 5-9mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>293862</ARTG>
                <ARTG>159828</ARTG>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB003</BillingCode>
            <Name>Vertefix II Locking Screw</Name>
            <Description>Set/Locking Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>188902</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Setscrew</Name>
            <Description>The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine.</Description>
            <Size>standard</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BA Posterior Set Screw</Name>
            <Description>BA Posterior Set Screw</Description>
            <Size>Various</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>329318</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY039</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE538</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Claw Posterior Fixation System (Set Screw)</Name>
            <Description>Set Screw</Description>
            <Size>one size</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH351</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medyssey set screw</Name>
            <Description>Set screw</Description>
            <Size>9.5 - 10mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG012</BillingCode>
            <Name>VENTOTENE Set Screw</Name>
            <Description>Standard Cannulated</Description>
            <Size>9.8mm diameter</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>397231</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ524</BillingCode>
            <Name>VIPER Spine System</Name>
            <Description>Viper Single Innie Set Screw</Description>
            <Size>One size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ656</BillingCode>
            <Name>SI Set Screw - Expedium Anterior Spine System</Name>
            <Description>Single Innie Set Screw - Titanium</Description>
            <Size>one size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ915</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Si and Unitised Screw Set</Description>
            <Size>4.35 -7.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>145290</ARTG>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ916</BillingCode>
            <Name>Mountaineer Spinal System</Name>
            <Description>Inner screws and out nuts</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>128255</ARTG>
                <ARTG>128257</ARTG>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ942</BillingCode>
            <Name>Moss Miami Spinal System</Name>
            <Description>Inner and outer screw, nuts and set screws</Description>
            <Size>3 - 6.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ943</BillingCode>
            <Name>Isola Spine System</Name>
            <Description>Nuts, Set screws and locking screws</Description>
            <Size>3/8, 5/16 and 1/4 inch, 6.35-120mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
                <ARTG>128268</ARTG>
                <ARTG>148371</ARTG>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JV001</BillingCode>
            <Name>Everest</Name>
            <Description>Breakoff Set Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>JV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV067</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ Set Screw</Name>
            <Description>Sterile nut set screw or locking screw</Description>
            <Size>One Size</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV072</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Set Screw</Name>
            <Description>Set screw with cross connector kit</Description>
            <Size>One Size</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB013</BillingCode>
            <Name>AnyPlus and AnyPlus II Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>One size only  </Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>353891</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH060</BillingCode>
            <Name>Break off set screw and/or screw nut</Name>
            <Description>Break off set screw, screw nut</Description>
            <Size>5.5mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH092</BillingCode>
            <Name>Set Screw </Name>
            <Description>Set Screw </Description>
            <Size>Diameter : 9.5 mm &amp; 10 mm   Length : 4.5 mm - 9.3 mm </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>380418</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB023</BillingCode>
            <Name>REVERE Locking Cap</Name>
            <Description>Locking Cap</Description>
            <Size>4.5, 5.5 and 6.35mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB123</BillingCode>
            <Name>CREO MIS Posterior Stabilization System - Locking Cap</Name>
            <Description>Threaded Locking Cap</Description>
            <Size>9mm diameter</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB147</BillingCode>
            <Name>CAPITOL Locking Cap</Name>
            <Description>Non-threading locking cap</Description>
            <Size>One size only</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB154</BillingCode>
            <Name>QUARTEX Locking Cap</Name>
            <Description>Threaded locking cap</Description>
            <Size>One size only</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB190</BillingCode>
            <Name>CREO DLX Threaded Locking Cap</Name>
            <Description>Threaded Locking Cap</Description>
            <Size>One Size Only</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH452</BillingCode>
            <Name>DSS Breaking Nut</Name>
            <Description>The DSS Breaking Nut is a set screw that locks the DSS pedicle screw for final tightening. It is an integral part of the DSS pedicle screw system, is used every time and can not be used on its own.</Description>
            <Size>One size only</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>151022</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH456</BillingCode>
            <Name>DSS Fusion Coupler Set Screw</Name>
            <Description>The DSS Fusion Coupler set screw locks the telescoping fusion couplers rigidly in place. This set screw can only be used for this purpose, is used every case and can not be used for any other purpose.</Description>
            <Size>DIA700-04 for 20mm - 22mm fusion coupler
DIA70022-04 for 22mm - 25mm / 25mm - 31mm / 31mm - 43mm fusion couplers</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>151022</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH486</BillingCode>
            <Name>DSS HP Spinal System - Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>one size</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>186733</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH711</BillingCode>
            <Name>Athena Nut</Name>
            <Description>Buttress Locking Cap for poly axial tulip</Description>
            <Size>Standard - one size only</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>337150</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM405</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fortex Pedicle Screw Set Screw</Name>
            <Description>Pedicle Screw Set</Description>
            <Size>3.1mm height</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
                <ARTG>170220</ARTG>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM414</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Certex Spinal Implant System Cap</Name>
            <Description>Cap</Description>
            <Size>One Size Only</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM438</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK119</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Amendia Savannah T Pedicle Screw System-Set Screws</Name>
            <Description>Pedicle Screw System-Set Screws</Description>
            <Size>one size </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>281992</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM442</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK057</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella System Locking Cap</Name>
            <Description>Excella Pedicle Screw System Locking Cap</Description>
            <Size>one size</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM496</BillingCode>
            <Name>Nut for Screw or connector</Name>
            <Description>Nut for screw or connector</Description>
            <Size>one size for each type</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM509</BillingCode>
            <Name>Break off set-screw</Name>
            <Description>Break off set-screw</Description>
            <Size>No size</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>366793</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC394</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Set screw</Description>
            <Size>Each in one size</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC399</BillingCode>
            <Name>TSRH Spinal Implant System</Name>
            <Description>3D - Nut, Eyebolt locknot, locknut 1/2 inch, locking screws, double hex, flush break, universal breakoff</Description>
            <Size>Each in one size</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC504</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Breakoff Set Screw</Description>
            <Size>25 - 55mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC546</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Set screw</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC609</BillingCode>
            <Name>CD Horizon Spinal System</Name>
            <Description>Percutaneous Set Screw</Description>
            <Size>4.5 to 6.35mm dia</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC615</BillingCode>
            <Name>Vantage</Name>
            <Description>Vantage Plates and Screws; Lock Nut</Description>
            <Size>One Size Only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC667</BillingCode>
            <Name>SiLo</Name>
            <Description>Set Screw</Description>
            <Size>One Size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC674</BillingCode>
            <Name>CD HORIZON Spinal System - Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>3.5mm - 6.35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI262</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Set screw</Description>
            <Size>Standard, flat</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI459</BillingCode>
            <Name>PASS Polyaxial Spine System</Name>
            <Description>Breakaway Nut, Break off set screw, Revision Post and Nut Set Screw</Description>
            <Size>One size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI468</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK083</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Locking Nut</Name>
            <Description>Locking Nut</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN267</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Set screws and locking nut</Description>
            <Size>One size</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU107</BillingCode>
            <Name>M.U.S.T. Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>One Size</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU162</BillingCode>
            <Name>MUST MINI Screws</Name>
            <Description>Set Screw / Locking Screw</Description>
            <Size>Varius</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV022</BillingCode>
            <Name>VuePoint screw (inner set)</Name>
            <Description>Screw</Description>
            <Size>Tulip &amp; Laminar Hook; &#xD;
Offset &amp; Occipital Connector; &#xD;
Parallel Rod Connector; &#xD;
Inline Rod Connector; &#xD;
Cross Connector</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV032</BillingCode>
            <Name>Traverse Lock Nut</Name>
            <Description>The Traverse system, of which the Traverse lock nut  is a component, is indicated for use as an adjunct to fusion via a lateral or anterolateral surgical approach, above the bifurcation of the great vessels, in the treatment of thoracic and thoracolumbar </Description>
            <Size>One Size</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>132467</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV061</BillingCode>
            <Name>Armada (Lock Screw)</Name>
            <Description>Lock screw</Description>
            <Size>One Size</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV077</BillingCode>
            <Name>X-CORE (Lock Screw)</Name>
            <Description>Lock screw</Description>
            <Size>Small and Large</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV085</BillingCode>
            <Name>Precept (Lock Screw)</Name>
            <Description>Lock Screw</Description>
            <Size>one size</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV113</BillingCode>
            <Name>Reline (Lock Screw)</Name>
            <Description>Lock Screw</Description>
            <Size>Open or Closed</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI906</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Closure Top</Name>
            <Description>Closure Top and dome nut</Description>
            <Size>One Size</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI995</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Set Screw</Name>
            <Description>SET SCREW</Description>
            <Size>One size only</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH574</BillingCode>
            <Name>Samson - Expandable Vertebral Body Replacement - End Plate Screw</Name>
            <Description>End Plate Screw</Description>
            <Size>One Size</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>316057</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH581</BillingCode>
            <Name>Venus Spinal Fixation System - Nut/Set Screw/Locking Screw</Name>
            <Description>Venus - Nut/Set Screw/Locking Screw</Description>
            <Size>Various Sizes</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB038</BillingCode>
            <Name>DPS Spine System  Single Locking Nut</Name>
            <Description>Locking nut for pedicle screw.</Description>
            <Size>One size</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BF017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Redmond Lumbar Cage System - Locking Cap</Name>
            <Description>Titanium locking cap</Description>
            <Size>Diameter: 3mm; Length: 4mm or 6mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ024</BillingCode>
            <Name>Centaur Set Screw, Centaur Screw System</Name>
            <Description>Set Screw</Description>
            <Size>Small, Standard and Large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ040</BillingCode>
            <Name>Corvus Spinal System</Name>
            <Description>Setscrew and outer nuts</Description>
            <Size>various</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI011</BillingCode>
            <Name>Streamline TL/Streamline MIS - Set Screw</Name>
            <Description>Set Screw for Locking Streamline TL polyaxial and fixed pedicle screws, offset connectors and parallel connectors and Streamline MIS Cannulated Polyaxial Screws</Description>
            <Size>one size</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI035</BillingCode>
            <Name>HPS™ Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>345870</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI044</BillingCode>
            <Name>HPS™ 2.0 Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>345870</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF107</BillingCode>
            <Name>Freedom Set Screw</Name>
            <Description>Freedom Set Screw</Description>
            <Size>5.5mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF172</BillingCode>
            <Name>Freedom Posterior Set Screw</Name>
            <Description>Freedom Posterior Set Screw</Description>
            <Size>Various</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK112</BillingCode>
            <Name>XIA/Oasys Spine System</Name>
            <Description>Buttress thread locking nut</Description>
            <Size>3.5mm - 6mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>278581</ARTG>
                <ARTG>279144</ARTG>
                <ARTG>279159</ARTG>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ102</BillingCode>
            <Name>RESPONSE Spine System – Set Screw</Name>
            <Description>Set Screw</Description>
            <Size>Small, Large</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ122</BillingCode>
            <Name>RESPONSE Spine System - BandLoc Screw</Name>
            <Description>Set Screw</Description>
            <Size>Large</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ127</BillingCode>
            <Name>NEO Pedicle Screw System - Set Screw</Name>
            <Description>Titanium Alloy</Description>
            <Size>Diameter: 5.0mm - 7.0mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>289017</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY010</BillingCode>
            <Name>VentroFix</Name>
            <Description>Set screw</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY135</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>Locking Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY152</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Set Screw</Description>
            <Size>Standard</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY174</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Nut</Description>
            <Size>Standard, SS</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133919</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY186</BillingCode>
            <Name>Posterior Cervical System</Name>
            <Description>Nut</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133919</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY286</BillingCode>
            <Name>USS llio-Sacral Fixation system</Name>
            <Description>Locking Screw</Description>
            <Size>one size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY304</BillingCode>
            <Name>TeleFix Spinal System</Name>
            <Description>Posterior Locking Screw</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY308</BillingCode>
            <Name>Axon Spinal System</Name>
            <Description>Locking Set screw</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY383</BillingCode>
            <Name>Synmesh</Name>
            <Description>Locking Screw, Low Profile, For Synmesh End Rings</Description>
            <Size>Small, Large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY440</BillingCode>
            <Name>Synapse</Name>
            <Description>Locking Screw</Description>
            <Size>One size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY796</BillingCode>
            <Name>Vertebral Body Replacement System</Name>
            <Description>Endplate Screw</Description>
            <Size>One Size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT013</BillingCode>
            <Name>SOLFIX2 Set Screw</Name>
            <Description>Set screw</Description>
            <Size>One size</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB008</BillingCode>
            <Name>Lumfix Set Screw</Name>
            <Description>Std or Saddle </Description>
            <Size>9.9 mm outer diameter , 5.5 or 6mm rod  </Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1465</GroupID>
            <ARTGs>
                <ARTG>327225</ARTG>
            </ARTGs>
            <MinimumBenefit>148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE699</BillingCode>
            <Name>Sierra Occipital Clip</Name>
            <Description>Occipital Clip</Description>
            <Size>One Size</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1466</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW445</BillingCode>
            <Name>Oasys-Occipito Cervico Thoracic System (Saddle)</Name>
            <Description>Saddle Connector</Description>
            <Size>one size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1466</GroupID>
            <ARTGs>
                <ARTG>279144</ARTG>
            </ARTGs>
            <MinimumBenefit>192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB214</BillingCode>
            <Name>CREO® Side Loading Locking Sleeve</Name>
            <Description>Integrated nut and sleeve</Description>
            <Size>5.5-6.0mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1466</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI484</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK073</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PASS Pedicle Spine System Connector</Name>
            <Description>PASS Pedicle Spine System offset connector</Description>
            <Size>5.5 &amp; 6.0mm rod</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1466</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN260</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Cross connector head adapter</Description>
            <Size>One size</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1466</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY151</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Sleeve</Description>
            <Size>3.5 - 6mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1466</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY363</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Sleeve</Description>
            <Size>3.5 - 6mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1466</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>192</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE632</BillingCode>
            <Name>Zuma Spinal System Locking Cover</Name>
            <Description>Locking Cover</Description>
            <Size>10mm - 20mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>275780</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR038</BillingCode>
            <Name>Tesera Locking Plate</Name>
            <Description>Locking Plate for Tesera Cage Systems</Description>
            <Size>N/A</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>354092</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER578</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Unity Lumbar Plate</Name>
            <Description>Unity Cover Plate</Description>
            <Size>17-28mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER579</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF056</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Lonestar Cervical Stand Alone System Cover Plate</Name>
            <Description>The Cover Plate of the Lonestar Cervical Stand Alone System is designed to lock to the front of the cage to prevent screw back out.</Description>
            <Size>6-9mm  10-14mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW514</BillingCode>
            <Name>Anchor-L Lumbar Cage System, Locking Plate</Name>
            <Description>Final Locking plate</Description>
            <Size>One Size</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>278558</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH073</BillingCode>
            <Name>CARMEN Anterior Cervical Cover Plate ( One plate with three screws ) </Name>
            <Description>The CARMEN plate and bone screw components are intended for anterior inter-body screw fixation from C2-TI. The plate and bone screw components are indicated for use together with the Carmen Anterior Cage in the temporary stabilization of the anterior spine during the development of spinal fusions in patients with: 1) degenerative disc disease (as defined by neck pain of discogenic origin with degeneration of the disc confirmed by patient history and radio-graphic studies), 2) trauma (including fractures), 3) tumors, 4) deformity (defined as kyphosis, lordosis, or scoliosis), 5) pseudoarthrosis, and/or 6) failed previous fusions.</Description>
            <Size>Plate Size : Length : 18 mm - 20 mm;  Width : 13.6 mm - 14.2 mm     Bone Screw Size : Diameter : 3.5 mm ; 4.0 mm;  Length :  12 mm - 17 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW044</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI952</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Timberline Lateral Fusion System</Name>
            <Description>Cover Plate</Description>
            <Size>2 and 4 hole</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY701</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Cap</Description>
            <Size>One size</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1467</GroupID>
            <ARTGs>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>391</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER340</BillingCode>
            <Name>Ulrich Pedicle Screw System-Locking cap</Name>
            <Description>Ulrich Pedicle Screw System (uCentum/uBase)-Locking cap assembly (dual innie screw, nut, washer)</Description>
            <Size>one size</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ647</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Dual Innie Correction Key</Description>
            <Size>5.5-6.35</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB019</BillingCode>
            <Name>REVOLVE Stabilization Locking Cap</Name>
            <Description>Locking Cap</Description>
            <Size>One Size</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>190043</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB048</BillingCode>
            <Name>ELLIPSE Stabilization System, Locking Cap</Name>
            <Description>Locking Cap</Description>
            <Size>One Size</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB061</BillingCode>
            <Name>REVLOK Fenestrated Screw System Locking Cap</Name>
            <Description>Locking Cap</Description>
            <Size>One Size</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>196054</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB088</BillingCode>
            <Name>CREO Stabilization System Locking Cap</Name>
            <Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description>
            <Size>4.75 and 5.5</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <Note>The Prostheses List (PL) billing code does not cover the use of the device for vertebral body tethering (VBT) for the management of adolescent idiopathic scoliosis (AIS).</Note>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN276</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Multipoint System - Adapter Connector Plate and Screws</Description>
            <Size>Standard, Angled, Left, Right, Long; 6-16mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB039</BillingCode>
            <Name>DPS Spine System  Double Locking Cap and Nut</Name>
            <Description>Locking Cap and Nut</Description>
            <Size>One size only</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY448</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Locking Cap</Description>
            <Size>One Size</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1468</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>560</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE665</BillingCode>
            <Name>Mariner Pedicle Screw Modular Head</Name>
            <Description>Polyaxial, Extended, Deformity and Trauma Heads</Description>
            <Size>One size each</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU054</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - screw head</Name>
            <Description>Polyaxial screw heads, Reduction screw heads</Description>
            <Size>one size each</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER223</BillingCode>
            <Name>SIGNUS Diplomat Pedicle Screw System - Screw Head (Tulip)</Name>
            <Description>SIGNUS Diplomat Pedicle Screw System - Screw Head (Tulip)</Description>
            <Size>dia 12.5 mm x height 14.9-150 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER553</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti Polyaxial head</Name>
            <Description>Tulip Screw Head, standard,/reduction,modular</Description>
            <Size>Various sizes  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER580</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Firebird Phoenix screw heads</Name>
            <Description>Modular screw heads; various sizes including reduction heads</Description>
            <Size>Body Top Loading, NXG Body Top Loading, Top loaded Body-Slotted, Body Closed, Body Reduction - All one size only  Body Offset - 8mm, 11mm, 14mm  Short, standard and tall (open and closed)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY002</BillingCode>
            <Name>Reform Tulip Head</Name>
            <Description>Tulip Head</Description>
            <Size>12.5mm/17mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY036</BillingCode>
            <Name>Reform MIS Tulip</Name>
            <Description>Tulip</Description>
            <Size>5.5mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG013</BillingCode>
            <Name>VENTOTENE Modular Tulip</Name>
            <Description>Standard Polyaxial Short</Description>
            <Size>13.9mm diameter</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>397231</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB067</BillingCode>
            <Name>BEACON™ Stabilization System Clamp</Name>
            <Description>Clamp</Description>
            <Size>5.5mm and 6.35mm small, medium, large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>219169</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB068</BillingCode>
            <Name>BEACON™ Stabilizer System Connector</Name>
            <Description>Connector</Description>
            <Size>5.5mm and 6.35mm small, medium, large, offset</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>219169</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB101</BillingCode>
            <Name>CREO AMP™ Tulip</Name>
            <Description>Tulip Head</Description>
            <Size>4.75mm and 5.5mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB124</BillingCode>
            <Name>CREO MIS Posterior Stabilization System - Screw Head</Name>
            <Description>Modular Polyaxial Screw Head</Description>
            <Size>10mm and 30mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>196054</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH710</BillingCode>
            <Name>Athena Cup</Name>
            <Description>Modular Polyaxial tulip heads, available in standard, reduction and MIS reduction</Description>
            <Size>Standard, Reduction, MIS Reduction</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>337150</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC608</BillingCode>
            <Name>TSRH</Name>
            <Description>Connector</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC985</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Connectors</Description>
            <Size>Small, medium, large</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI263</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Occipital Screw Connectors</Description>
            <Size>Standard, offset, open angle</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV086</BillingCode>
            <Name>Precept (Tulip)</Name>
            <Description>Tulip screw</Description>
            <Size>5.5mm/6.25mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV140</BillingCode>
            <Name>Reline (Mod Tulip)</Name>
            <Description>Tulip Screw</Description>
            <Size>One size</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV141</BillingCode>
            <Name>Reline (Mod Reduction Tulip)</Name>
            <Description>Tulip Screw</Description>
            <Size>One size</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI911</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Cable Connector</Name>
            <Description>Cable Connector</Description>
            <Size>One Size</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY008</BillingCode>
            <Name>VentroFix</Name>
            <Description>Clamp</Description>
            <Size>Single, Double, Fracture, Left, Right</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY178</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Pedicle screw head</Description>
            <Size>5 - 6mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1469</GroupID>
            <ARTGs>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>686</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU028</BillingCode>
            <Name>Romeo 2  Posterior Thoraco-lumbar Fixation System - Transverse Rod</Name>
            <Description>Transverse rod</Description>
            <Size>Length: 20mm, 30mm, 40mm, 50mm, 60mm, 70mm, 80mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1470</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY146</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Cross Link Rod</Description>
            <Size>40-80mm length </Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1470</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY361</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Cross Link Rod</Description>
            <Size>40 - 80mm Length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1470</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY415</BillingCode>
            <Name>USS Micro-Crosslink</Name>
            <Description>Crosslink Clamp Rod</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1470</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER180</BillingCode>
            <Name>Scoliosis  &amp; Fracture System - LSZ3-Clip</Name>
            <Description>Signus Scoliosis  &amp; Fracture System - LSZ3-Clip</Description>
            <Size>N/A</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>216747</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB162</BillingCode>
            <Name>QUARTEX Occipital Clamp</Name>
            <Description>Occipital Clamps</Description>
            <Size>3.5mm to 4.0mm, short and long</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU160</BillingCode>
            <Name>MUST MINI Cross connector Clamp</Name>
            <Description>Cross connector Clamp</Description>
            <Size>one size only</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV161</BillingCode>
            <Name>Reline Small Stature Iliac Saddle</Name>
            <Description>Pelvic Saddle Hook</Description>
            <Size>5.0mm to 6.0mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY144</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Fracture Clamps</Description>
            <Size>Cranial, Standard, Low Profile</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY326</BillingCode>
            <Name>Spinal Plate/Plate System AO/ASIF Spinal Implants</Name>
            <Description>Internal fixator - cross link clamp</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY357</BillingCode>
            <Name>ECD - Expandable Corpectomy Device</Name>
            <Description>Locking clip, PEEK/Titanium</Description>
            <Size>Universal</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY359</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Fracture Clamps</Description>
            <Size>Cranial, Standard, Low Profile</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY382</BillingCode>
            <Name>Occipito-Cervical Fusion System</Name>
            <Description>Occipital Clamp Titanium Alloy</Description>
            <Size>1 or 2 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>293275</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY414</BillingCode>
            <Name>USS Micro-Crosslink</Name>
            <Description>Crosslink Clamp</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1471</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>353</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW750</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER174</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Nile Alternative Fixation System - Tether, Connector, Set Screws</Name>
            <Description>Woven Braid, polyester; Clamp, Titanium; Set Screw, Titanium</Description>
            <Size>(3-4)mm width, 60cm strap length, (50-110)mm leader, Size 20 </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>810</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI297</BillingCode>
            <Name>Translace Spinal Tethering System</Name>
            <Description>Tether, tether connector, set screws</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>312380</ARTG>
            </ARTGs>
            <MinimumBenefit>810</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI479</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK096</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Sublaminar cables and connectors</Name>
            <Description>Sublaminar cables and connectors</Description>
            <Size>all sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>312320</ARTG>
            </ARTGs>
            <MinimumBenefit>810</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>NAJA ligament correction system</Name>
            <Description>Braid and Connector</Description>
            <Size>5.5 and 6mm diameter, left side and right side.</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <ARTGs>
                <ARTG>273278</ARTG>
            </ARTGs>
            <MinimumBenefit>759</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY040</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE532</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Sublaminar Band</Name>
            <Description>Sublaminar Band for use with Jazz Claw Connector</Description>
            <Size>1 size</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>759</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY041</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE573</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Posterior Fixation System</Name>
            <Description>System of Polyester Braid, connector and locking screw</Description>
            <Size>4mm braid, 3.5-6mm connector</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>759</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY042</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE574</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Posterior Fixation System - Multipurpose Connector</Name>
            <Description>Polyester braid, connector and set screw</Description>
            <Size>5.5mm diameter</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>759</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB109</BillingCode>
            <Name>SILC™ PET Band</Name>
            <Description>PET Band</Description>
            <Size>4 -6mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>759</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV159</BillingCode>
            <Name>Versatie Band</Name>
            <Description>PET Band</Description>
            <Size>4.5mm - 5.5mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>759</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ123</BillingCode>
            <Name>RESPONSE Spine System - BandLoc, BandLoc Duo</Name>
            <Description>Clamp and Band Assembly</Description>
            <Size>Single, Dual Band</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>166</SubCategoryID>
            <GroupID>1816</GroupID>
            <ARTGs>
                <ARTG>292961</ARTG>
            </ARTGs>
            <MinimumBenefit>759</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER532</BillingCode>
            <Name>E.SPINE System</Name>
            <Description>TANIT SI Connector, sterile or non-sterile</Description>
            <Size>one size</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>930</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ792</BillingCode>
            <Name>Expedium 4.5 System Tandem Connectors</Name>
            <Description>Expedium extended growth Tandem Connectors</Description>
            <Size>40 - 80mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>930</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB369</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>In-Line Connector</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE633</BillingCode>
            <Name>Malibu Spinal System In-line Connector</Name>
            <Description>In-line Connector</Description>
            <Size>5.5mm and 6.35mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE713</BillingCode>
            <Name>Mariner Outrigger</Name>
            <Description>Mariner Outrigger Inline Connectors</Description>
            <Size>Axial, Closed  Closed, Axial with Rod (40-500mm)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE714</BillingCode>
            <Name>Mariner Outrigger</Name>
            <Description>Mariner Outrigger Variable Connectors</Description>
            <Size>8 &amp; 10mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR012</BillingCode>
            <Name>Life Spine Pedicle Screw System - Inline Connector</Name>
            <Description>Life Spine Pedicle Screw System - Inline Connector, Axial or Parallel</Description>
            <Size>Inline, Slimline, Domino or Wedding Band (3.5-5.5)mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU003</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Parallel Connector</Name>
            <Description>Parallel rod connectors</Description>
            <Size>Diameter: 3.5/3.5mm; 3.5/5.4mm; 3.5/5.5mm; 3.5/6mm  </Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU022</BillingCode>
            <Name>Romeo 2 Posterior Thoraco-lumbar Fixation System - Parallel Rod Connector, Axial Rod Connector</Name>
            <Description>Parallel rod connector, axial rod connector</Description>
            <Size>one size only</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU050</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - parallel connector</Name>
            <Description>Parallel connector</Description>
            <Size>Diameter: 5.5, 6mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY184</BillingCode>
            <Name>Monarch Spinal System</Name>
            <Description>Dual Rod Connectors End to End or Side by Side</Description>
            <Size>4.75 to 6.35mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER182</BillingCode>
            <Name>Scoliosis  &amp; Fracture System - LSZ3-Cross Bar</Name>
            <Description>SIGNUS Scoliosis  &amp; Fracture System - LSZ3-Cross Bar</Description>
            <Size>4.0x50 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>216747</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER227</BillingCode>
            <Name>SIGNUS Diplomat Pedicle Screw System - Parallel Connector</Name>
            <Description>SIGNUS Diplomat Pedicle Screw System - Parallel Connector</Description>
            <Size>5.5 mm x (4.5-6.0 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER228</BillingCode>
            <Name>SIGNUS Diplomat Pedicle Screw System - Sleeve</Name>
            <Description>SIGNUS Diplomat Pedicle Screw System - Sleeve</Description>
            <Size>Diameter 5.5 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER235</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Connector (in line) </Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Connector (in line; domino or axial)</Description>
            <Size>15mm x(15-16 mm); dia (7.5-8.5mm) x length (30-80 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER314</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Connector, axial/parallel</Name>
            <Description>Ulrich posterior OCT System (neon3)-Connector, axial/parallel</Description>
            <Size>one size</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER338</BillingCode>
            <Name>Ulrich Pedicle Screw System-inline connector</Name>
            <Description>Ulrich Pedicle Screw System (flamenco)-inline connectors, axial or parallel</Description>
            <Size>dia 5.5 mm to (5.5-6.0 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER452</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, in line</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, in line, parallel and domino, accommodates rods of 5.0, 5.5, 6.0 and 6.35 in diameter</Description>
            <Size>length (14-40mm) x width (8-16mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER515</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>e.Spine connector</Name>
            <Description>Titanium connector for rods of diameter 5.5 mm</Description>
            <Size>Straight (axial connexion), Open domino (parallel connexion), Closed domino (parallel connexion)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER526</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Connector</Name>
            <Description>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Axial Rod/Side Rod to Rod Connector, Right Side/Left Side Rod to Rod Connector</Description>
            <Size>height (8.0-12.8mm) x width (13.5-19.0mm); accomodates rod size 3.6-6.1mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>286122</ARTG>
                <ARTG>384816</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER546</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti In-line Connector</Name>
            <Description>Side by side / end to end connectors  </Description>
            <Size>Various sizes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER581</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF082</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthofix In-Line Connector</Name>
            <Description>Axial In-Line Connector with Rod</Description>
            <Size>One size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER629</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF066</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Rod Connectors</Name>
            <Description>Parallel Rod Connector, Axial Rod Connector and Lateral Offset Adaptor</Description>
            <Size>3.5mm by 5.5mm and 10mm offset (Lateral Adaptor)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER660</BillingCode>
            <Name>LnK AccelFix Spnal Fixation System-connector-in line</Name>
            <Description>LnK AccelFix Spnal Fixation System-connector-axial straight or domino</Description>
            <Size>To accommodate rod diameters of 5.2-6.5 mm  Length 30-40 mm or (14-16) x 16 mm </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>354819</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY005</BillingCode>
            <Name>Reform Dominoes</Name>
            <Description>Dominoes - Axial and Parallel</Description>
            <Size>Diameter 3.5mm to 6.0mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW032</BillingCode>
            <Name>Equinox Spinal Systems</Name>
            <Description>In Line Connectors</Description>
            <Size>3 mm to 6.5 mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW386</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Rod Clamp - Parallel, Axial</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
                <ARTG>279159</ARTG>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW722</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems</Name>
            <Description>Axial connectors, in-line, parallel, open and closed face</Description>
            <Size>3.5 – 6.5mm rods</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Connectors</Name>
            <Description>In-Line Connectors</Description>
            <Size>5.5mm to 6.35mm  5.5mm to 5.5mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV045</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BA Posterior Screw Domino Connector</Name>
            <Description>BA Posterior Screw Domino Connector</Description>
            <Size>Various Sizes</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>329318</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ635</BillingCode>
            <Name>Expedium Spine System – Dual Rod Connector</Name>
            <Description>Dual Rod Connector</Description>
            <Size>4.75, 5.5 &amp; 6.35mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ917</BillingCode>
            <Name>Mountaineer Spinal System</Name>
            <Description>Connectors</Description>
            <Size>3.5 to 6.35mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ920</BillingCode>
            <Name>Moss Miami Spinal System</Name>
            <Description>Axial Connector</Description>
            <Size>4/4mm to 5/7mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH049</BillingCode>
            <Name>Domino Rod Connector</Name>
            <Description>Rod connector</Description>
            <Size>S, M &amp; L</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH055</BillingCode>
            <Name>Connector</Name>
            <Description>Rod to Rod</Description>
            <Size>3.5mm to 5.5mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH093</BillingCode>
            <Name>Rod Connector </Name>
            <Description>Rod Connector </Description>
            <Size>Diameter : 5.5 mm - 5.5 mm / 5.5 mm - 6.0 mm / 6.0 mm - 6.0 mm   </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>380418</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB028</BillingCode>
            <Name>REVERE ADDITION In-line Connectors</Name>
            <Description>Connector, in-line</Description>
            <Size>4.5mm, 5.5mm and 6.35mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB056</BillingCode>
            <Name>REVERE ADDITION In-line Rod Connectors with Integral Rod</Name>
            <Description>IN-line Connector with integral rod</Description>
            <Size>5.5mm-6.5mm 160-200mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB073</BillingCode>
            <Name>ELLIPSE Stabilization System In-line Connector</Name>
            <Description>Connector</Description>
            <Size>3.5mm - 6.35mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB075</BillingCode>
            <Name>ELLIPSE® Stabilization System Lateral Connector</Name>
            <Description>Connector</Description>
            <Size>3.5mm to 10.0mm - 3.5mm - 6.5mm Rod</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB102</BillingCode>
            <Name>CREO AMP™ Sacral Plate</Name>
            <Description>Sacral Plate</Description>
            <Size>One size</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB108</BillingCode>
            <Name>SILC™ Clamp</Name>
            <Description>Inline connector</Description>
            <Size>4.5 -6.35mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB158</BillingCode>
            <Name>QUARTEX Inline Connectors</Name>
            <Description>In-line connectors</Description>
            <Size>4.0mm-4.0mm and 4.0mm-6.5mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB177</BillingCode>
            <Name>CREO ADDITION-Inline Connectors</Name>
            <Description>In-line Closed Connector</Description>
            <Size>5.5-6.35 to 5.5-6.35&#xD;
5.5-6.0 to 5.5-6.0</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB178</BillingCode>
            <Name>CREO ADDITION In-line Connectors with Integrated Rod</Name>
            <Description>In-line Closed Connector with Integrated Rod</Description>
            <Size>5.5 Rod, 5.5-6.35, 400mm&#xD;
6.0 Rod, 5.5-6.35, 400mm&#xD;
6.35 Rod, 5.5-6.35, 400mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM418</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Certex Spinal Implant System Connector</Name>
            <Description>Connector</Description>
            <Size>3.5mm x 22-26mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC407</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Domino</Description>
            <Size>3.2mm, 3.5mm, 4.5mm, 5,5mm, 6.35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC409</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Domino &amp; Axial Connector</Description>
            <Size>4.5mm, 5.5mm and 6.35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC542</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Connector</Description>
            <Size>Length 10 - 13mm; diameter 3.2 - 6.35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI264</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>In-line connector - Axial Domino</Description>
            <Size>Enables connection from 3.2 - 6.0mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI461</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK072</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PASS Pedicle Spine System Connectors</Name>
            <Description>PASS Pedicle Spine System Connectors</Description>
            <Size>5.5 &amp; 6.0 mm rods</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN265</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Axial and parallel connectors</Description>
            <Size>3.5-6.35mm </Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU149</BillingCode>
            <Name>M.U.S.T. Connectors</Name>
            <Description>Domino &amp; In-line Connectors</Description>
            <Size>5.5 mm and 6.35 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>222457</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU158</BillingCode>
            <Name>MUST MINI Rod To Rod Connector</Name>
            <Description>Rod To Rod Connector</Description>
            <Size>3.5-5.5</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV021</BillingCode>
            <Name>VuePoint inline connector</Name>
            <Description>In-line connector</Description>
            <Size>3.5mm x (3.5/4.5/6.5)mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV066</BillingCode>
            <Name>Armada</Name>
            <Description>In-line connector</Description>
            <Size>3.5/5.5/6.35 x 5.5mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV135</BillingCode>
            <Name>Reline (Rod to Rod Connector)</Name>
            <Description>Rod-to-Rod Connector</Description>
            <Size>To fit 4.5 - 6.5 mm rod diameter</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV160</BillingCode>
            <Name>VersaTie Clamp</Name>
            <Description>Inline connector</Description>
            <Size>5.0-6.0mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI910</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Closed Rod Connector</Name>
            <Description>Closed Rod Connector</Description>
            <Size>3.5 to 5.5mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI996</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine system - Rod Connectors</Name>
            <Description>Tandem rod connectors</Description>
            <Size>5.5/6.0mm &amp; 3.5mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH585</BillingCode>
            <Name>Venus Spinal System - In-line/Domino Connectors</Name>
            <Description>Venus Spinal System - In-line/Domino Connectors</Description>
            <Size>4.5 / 5.5mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ025</BillingCode>
            <Name>Centaur Screw System</Name>
            <Description>In Line Connectors</Description>
            <Size>5.5/6.35mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ036</BillingCode>
            <Name>Corvus Spinal System</Name>
            <Description>Connectors</Description>
            <Size>3.5mm - 6.35mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI015</BillingCode>
            <Name>Streamline TL- Parallel Connectors</Name>
            <Description>Parallel Connectors for rods of 5.5mm diameter (Titanium Alloy)</Description>
            <Size>One size of open parallel connector; one size of closed parallel connector</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF014</BillingCode>
            <Name>Centaur Screw System</Name>
            <Description>In Line Connectors</Description>
            <Size>5.5/6.35mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>166153</ARTG>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF106</BillingCode>
            <Name>Freedom Axial Connector</Name>
            <Description>Axial Connectors</Description>
            <Size>2 and 4 hole</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF181</BillingCode>
            <Name>Freedom Posterior Screw Domino Connector</Name>
            <Description>Freedom Posterior Screw Domino Connector</Description>
            <Size>Various Sizes</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ098</BillingCode>
            <Name>RESPONSE Spine System – Inline Connector</Name>
            <Description>Inline Connector</Description>
            <Size>40-80mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ193</BillingCode>
            <Name>NEO Pedicle Screw System - Inline Connector</Name>
            <Description>Parallel connector, Iliac connector</Description>
            <Size>40-70mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>289017</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY011</BillingCode>
            <Name>VentroFix</Name>
            <Description>Parallel connector</Description>
            <Size>6.0/6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY015</BillingCode>
            <Name>CerviFix Posterior Cervical System</Name>
            <Description>Parallel connector</Description>
            <Size>3.5/3.5, 3.5/5.0, 3.5/6.0</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY147</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Connectors</Description>
            <Size>Parallel, In-line, Transverse, SS, 15 - 25mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY442</BillingCode>
            <Name>Synapse</Name>
            <Description>Parallel Connector</Description>
            <Size>3.5/3.5-6.0mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UL001</BillingCode>
            <Name>Precision Axial Connector</Name>
            <Description>Axial Connectors</Description>
            <Size>2 and 4 hole</Size>
            <SupplierCode>UL</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>229115</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT015</BillingCode>
            <Name>SOLFIX2 Rod Connector</Name>
            <Description>Rod connectors: long and square</Description>
            <Size>One size of each</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB004</BillingCode>
            <Name>Lumfix Rod connector </Name>
            <Description>Domino (parallel) rod connectoro - open or closed </Description>
            <Size>(5.5 - 6.0)mm rod  x (5-5 -6.0)mm Rod </Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1472</GroupID>
            <ARTGs>
                <ARTG>327225</ARTG>
            </ARTGs>
            <MinimumBenefit>668</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB370</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Offset Connector</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE700</BillingCode>
            <Name>Sierra Connector</Name>
            <Description>Sierra OCT Lateral Connector</Description>
            <Size>One Size</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE712</BillingCode>
            <Name>Mariner Outrigger</Name>
            <Description>Mariner Outrigger Offset Connectors</Description>
            <Size>Parallel/Closed, Parallel/Side Loading, Parallel/Top Loading, Parallel/Closed/Side Loading, Parallel/Top/Side Loading, Parallel/Top/Offset, Side Loading with Rod  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE761</BillingCode>
            <Name>NorthStar OCT</Name>
            <Description>NorthStar OCT Offset Connector</Description>
            <Size>Parallel, Top Loading; Dual, Parallel, Top Loading; Parallel, Side Loading/Variable; Open Lateral Offset</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE794</BillingCode>
            <Name>Mariner Connectors</Name>
            <Description>Mariner Offset Connectors</Description>
            <Size>5.5mm  15mm-200mm Lengths  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP843</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Sacral Extender</Description>
            <Size>5.5mm x 5 - 20mm in length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR011</BillingCode>
            <Name>Life Spine Pedicle Screw System - Offset Connector</Name>
            <Description>Life Spine Pedicle Screw System - Offset Connector (Open or Closed)</Description>
            <Size>dia 5.5mm x length (20-40)mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR052</BillingCode>
            <Name>Ulrich Medical Pedicle Screw System - Connectors</Name>
            <Description>Ulrich Medical Pedicle Screw System - Connectors</Description>
            <Size>4.0mm-6.0mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>365230</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU004</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System -  Axial Connector, Lateral Connector</Name>
            <Description>Axial connectors, lateral connectors</Description>
            <Size>Axial - Diameter: 3.5/3.5mm  Lateral - small, large</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU027</BillingCode>
            <Name>Romeo 2 Posterior Thoraco-lumbar Fixation System - Iliac Connector</Name>
            <Description>Iliac connector</Description>
            <Size>Length: 15mm, 20mm, 30mm, 40mm, 50mm, 60mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU045</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - lateral connector, axial connector</Name>
            <Description>Lateral connector (open or closed), axial connector</Description>
            <Size>Lateral connector: Length: 15 - 60mm. Diameter: 5.5, 6mm  Axial connector: Diameter: 5.5, 6mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER226</BillingCode>
            <Name>SIGNUS Diplomat Pedicle Screw System - Offset Connector</Name>
            <Description>SIGNUS Diplomat Pedicle Screw System - Offset Connector</Description>
            <Size>dia 5.5 mm x length (15-30 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER237</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Connector lateral (offset), with locking screw</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Connector lateral (offset), with locking screw</Description>
            <Size>dia 5.5 mm x length (30-80) mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER315</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Connector, offset</Name>
            <Description>Ulrich posterior OCT System (neon3)-Connector, offset, square or parallel, left or right</Description>
            <Size>length (7-20 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER339</BillingCode>
            <Name>Ulrich Pedicle Screw System-Offset connector</Name>
            <Description>Ulrich Pedicle Screw System (uCentum, flamenco)-Offset connector</Description>
            <Size>for dia 6mm x length (15-60 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER453</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, offset</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, offset; open or closed; standard or knurled; standard or hex profile</Description>
            <Size>dia (6.2-6.5mm) x length (overall) (26-67mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER528</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Connector</Name>
            <Description>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Lateral Connector/Connector stopper, non-sterile or sterile</Description>
            <Size>rod dia 3.6 mm x offset length (10-20mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>286122</ARTG>
                <ARTG>384816</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER551</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti Offset Connector</Name>
            <Description>Offset Connector  </Description>
            <Size>dia 5.5-6.0mm  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER582</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF080</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthofix Offset Connectors</Name>
            <Description>Side/Top Loading, Side/Side Loading, Side/Front Loading, Front/Front Loading, Small Side/Front Loading</Description>
            <Size>Standard, 16mm and 18mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER583</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF081</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthofix Bypass Connector</Name>
            <Description>Offset Connector with Integrated Rod</Description>
            <Size>16mm - 34mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER630</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Firebird lateral offsets</Name>
            <Description>lateral offsets in lengths from 8mm-80mm. Titanium.</Description>
            <Size>15, 20, 25, 30, 35, 80mm; 8mm-35mm in 3mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER661</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-connector, offset</Name>
            <Description>AccelFix Spinal Fixation System offset connector, Ti, sterile, straight or angled, standard or hex, open or closed, with or without knurling</Description>
            <Size>Diameter: 5.5-6.5 mm  Length:    26-67 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW044</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Lateral Connectors</Description>
            <Size>20 mm to 65 mm long</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW391</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Connector - Axial, Dual, Offset</Description>
            <Size>4.5mm - 6mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
                <ARTG>279151</ARTG>
                <ARTG>279159</ARTG>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW392</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Sacral Block</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW721</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems</Name>
            <Description>Offset connectors, Open or Closed</Description>
            <Size>Length: 10mm - 100mm, Degree connector angle: -15 - +15</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>159828</ARTG>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV041</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BA Posterior Screw Lateral Offset Connector</Name>
            <Description>BA Posterior Screw Lateral Offset Connector</Description>
            <Size>10-25mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>329318</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH350</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medyssey Spinal Fixation System</Name>
            <Description>Crosslink</Description>
            <Size>41 - 66mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ607</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Lateral Connector, Open or Closed with/without rod</Description>
            <Size>4.5-6.35mm x 20 -500mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>145290</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ692</BillingCode>
            <Name>Mountaineer OCT Spinal System - Lateral Offset, Cable and J Hook Connector</Name>
            <Description>Lateral Offset, Cable and J Hook Connector</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ739</BillingCode>
            <Name>Expedium Spine system</Name>
            <Description>Open and closed Polyaxial connectors with or without end tab</Description>
            <Size>5.5 x 6.35 x 20-200mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH047</BillingCode>
            <Name>Connector</Name>
            <Description>Lateral Connector</Description>
            <Size>10-60mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH056</BillingCode>
            <Name>Rod Plate</Name>
            <Description>Plate</Description>
            <Size>3.5 mm to single occipital screw</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH058</BillingCode>
            <Name>Lateral Connector</Name>
            <Description>Closed</Description>
            <Size>10-20mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH074</BillingCode>
            <Name>Kumafix Connector with Nut </Name>
            <Description>Connector with Nut </Description>
            <Size>Connector Degree : 0;  7; 14   Left and Right    Nut Size : 6 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH094</BillingCode>
            <Name>Lateral Connector </Name>
            <Description>Lateral Connector </Description>
            <Size>Diameter ： 5.5 mm &amp; 6.0 mm   Length : 20 mm - 60 mm </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>380418</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB027</BillingCode>
            <Name>REVERE ADDITION Offset Connectors</Name>
            <Description>Connector, offset</Description>
            <Size>4.5, 5.5 and 6.35mm Diameter, 15-150mm Length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB029</BillingCode>
            <Name>REVERE ADDITION Offset Rod Connectors with Integral Rod</Name>
            <Description>Offset Connector with integral rod</Description>
            <Size>5.5mm - 6.5 mm, 20mm - 200mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB072</BillingCode>
            <Name>ELLIPSE Stabilization System Parallel Connector</Name>
            <Description>Connector</Description>
            <Size>3.5mm to 4.0 - 6.5mm Rod</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB074</BillingCode>
            <Name>ELLIPSE® Stabilization System Lateral Connector</Name>
            <Description>Connector</Description>
            <Size>Std, Short, medium, long</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB156</BillingCode>
            <Name>QUARTEX Parallel Connectors</Name>
            <Description>Parallel Connector</Description>
            <Size>4.0mm Rod to 4.0-6.5mm Rod</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB157</BillingCode>
            <Name>QUARTEX Lateral Connectors</Name>
            <Description>Lateral Connectors</Description>
            <Size>standard, short, long, extra long for 3.5mm and 4.0mm rods</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB176</BillingCode>
            <Name>CREO Offset Connectors</Name>
            <Description>Threaded Head Offset Connectors</Description>
            <Size>15mm-150mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB179</BillingCode>
            <Name>CREO ADDITION - Offset Connectors</Name>
            <Description>Offset connectors with various configurations</Description>
            <Size>5.5-6.35 to 5.5-6.35mm, 12mm Wide&#xD;
5.5-6.35 to 5.5-6.35mm, 9mm Wide&#xD;
5.5-6.35mm&#xD;
5.5mm Top Loading&#xD;
5.5-6.0mm Head to 5.5mm Top Loading&#xD;
5.5-6.0mm Head to 5.5-6.35mm Open, 12mm Wide&#xD;
5.5-6.0mm to 5.5-6.0mm, 12mm Wide</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB188</BillingCode>
            <Name>CREO DLX Offset Connectors</Name>
            <Description>Head, Closed and Open Offset Connectors</Description>
            <Size>15mm to 150mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM447</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK062</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella System Offset Connecter</Name>
            <Description>Excella Pedicle Screw System offset connector</Description>
            <Size>25 to 45 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM451</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK105</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Offset Connectors</Name>
            <Description>Offset Connectors</Description>
            <Size>Multiple to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM497</BillingCode>
            <Name>Sacral Plates</Name>
            <Description>Sacral Plates</Description>
            <Size>Left and Right 60° and 90°</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM500</BillingCode>
            <Name>Rod or Post Connector</Name>
            <Description>Rod or Post Connector and set screws</Description>
            <Size>Rod Connectors for 5.5 &amp; 6mm rods  Sacral Connectors for 5.5 &amp; 6mm rods  Post connector - one size  </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC668</BillingCode>
            <Name>CD HORIZON Spinal System - Lateral Connector</Name>
            <Description>Lateral Connector</Description>
            <Size>10mm - 100mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC676</BillingCode>
            <Name>SiLo</Name>
            <Description>Lateral Connector</Description>
            <Size>10-40mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI265</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Offset connector: Offset Domino, Lateral, Multi Axial Screw Extension</Description>
            <Size>Enables connection from 3.2 - 6.35mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI469</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK084</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Offset Connector</Name>
            <Description>Offset Connector</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN266</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Lateral offset and cable connectors</Description>
            <Size>One size</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU135</BillingCode>
            <Name>M.U.S.T Lateral Connectors</Name>
            <Description>Lateral Connectors</Description>
            <Size>20 - 150 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>222457</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU157</BillingCode>
            <Name>MUST MINI Lateral Connector</Name>
            <Description>Lateral Connector</Description>
            <Size>Diameter 3.5  Lenght 10 ÷ 30  mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV029</BillingCode>
            <Name>VuePoint offset connector</Name>
            <Description>Offset connector</Description>
            <Size>11mm, 25mm, 30mm, 45° Acute Angle - Offset Lateral Connector, &#xD;
3.5mm x (3.5/4.5/5.5/6.25mm) - Offset Rod-to-Rod connector, &#xD;
Eyelet Connector (Occipital) - One Size</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV049</BillingCode>
            <Name>Armada (Offset Connectors)</Name>
            <Description>Offset connector</Description>
            <Size>5.5mm x 20-120mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV114</BillingCode>
            <Name>Reline (Offset Connector)</Name>
            <Description>Offset Connector</Description>
            <Size>10-60mm length for 4.5-6.5 mm diameter rod, Ti and CoCr</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI907</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Lateral Offset Connector</Name>
            <Description>Offset Connector</Description>
            <Size>10mm and 25mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI997</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Iliac Lateral Connector</Name>
            <Description>Open and Closed Iliac Lateral Connector</Description>
            <Size>20mm - 50mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI998</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Tandem rod connectors</Name>
            <Description>Tandem rod connectors</Description>
            <Size>5.5/6.0mm &amp; 3.5mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH586</BillingCode>
            <Name>Venus Spinal System - Lateral Connector</Name>
            <Description>Venus Spinal System - Lateral Connector</Description>
            <Size>15-50mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ026</BillingCode>
            <Name>Centaur Lateral Connector, Centaur Screw System</Name>
            <Description>Cross Connector - Rod to Rod</Description>
            <Size>20-500mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ041</BillingCode>
            <Name>Corvus Spinal System</Name>
            <Description>Lateral Connectors</Description>
            <Size>20-50mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI014</BillingCode>
            <Name>Streamline TL - Offset Connectors</Name>
            <Description>Lateral Offset Connectors in lengths of 15-30mm (Titanium Alloy).</Description>
            <Size>15,20 &amp; 30 mm lengths available. Connects to a 5.5mm diameter rod</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF109</BillingCode>
            <Name>Freedom Domino Connector</Name>
            <Description>Parallel Axial Connectors</Description>
            <Size>2 and 4 hole</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF110</BillingCode>
            <Name>Freedom Offset Connector</Name>
            <Description>Offset Connectors</Description>
            <Size>15, 20, 25, 30, 35mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF173</BillingCode>
            <Name>Freedom Posterior Screw Lateral Offset Connector</Name>
            <Description>Freedom Posterior Screw Lateral Offset Connector</Description>
            <Size>10-25mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ099</BillingCode>
            <Name>RESPONSE Spine System – Offset Connector</Name>
            <Description>Closed, Open Lateral</Description>
            <Size>20-80mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY012</BillingCode>
            <Name>CerviFix Posterior Cervical System</Name>
            <Description>Clamp</Description>
            <Size>Left, Right, Medial, Lateral, Pedicle, Lamina</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY287</BillingCode>
            <Name>USS llio-Sacral Fixation system</Name>
            <Description>Transconnecting bar</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY288</BillingCode>
            <Name>USS llio-Sacral Fixation system</Name>
            <Description>Sacral clamp</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY310</BillingCode>
            <Name>Axon Spinal System</Name>
            <Description>transverse bar</Description>
            <Size>one size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY366</BillingCode>
            <Name>Axon Spinal System</Name>
            <Description>transverse bar</Description>
            <Size>one size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT011</BillingCode>
            <Name>SOLFIX2 Offset Connectors</Name>
            <Description>Offset connectors</Description>
            <Size>Short, long</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB003</BillingCode>
            <Name>Lumfix Rod Connector </Name>
            <Description>Lateral Rod connector, open or closed, straight or curved , monopolar or polyaxial </Description>
            <Size>5.5 or 6mm rod system,  (15 - 50)mm lleg length </Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1473</GroupID>
            <ARTGs>
                <ARTG>327225</ARTG>
            </ARTGs>
            <MinimumBenefit>705</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB228</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Cross Connector</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE634</BillingCode>
            <Name>Malibu Spinal System Lateral Connector</Name>
            <Description>Lateral Connector</Description>
            <Size>30mm - 60mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU024</BillingCode>
            <Name>Romeo 2 Posterior Thoraco-lumbar Fixation System - Straight Cross Connector</Name>
            <Description>Straight cross connector</Description>
            <Size>Length: 18mm, 21mm, 24mm, 27mm, 30mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU053</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - cross connector (fixed)</Name>
            <Description>Cross connector monobloc</Description>
            <Size>Length: 18, 21, 24, 27, 30mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU064</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Cross Connector</Name>
            <Description>Head-to-head cross connectors  </Description>
            <Size>Length: 20-25mm, 25-30mm, 30-35mm, 35-40mm, 40-45mm, 45-50mm  </Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY545</BillingCode>
            <Name>Monarch Spinal System</Name>
            <Description>Threaded Connector</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER140</BillingCode>
            <Name>Signus Pedical Screw System-Cross Link</Name>
            <Description>Cross Link-as part of Signus Pedicle Screw System Construct</Description>
            <Size>MP 0150-0038-38 mm; MP-0150-0042-42 mm;MP-0150-0050-50 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER236</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Connector (transverse rod to rod, </Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Connector (transverse rod to rod, </Description>
            <Size>15-20mm; 20-25mm; 20-30mm;25-30mm; 30-40 mm; 40-50mm; 40-55 mm; 55-70 mm; 70-85 mm;</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER450</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, transverse</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, crosslink rod to rod; fixed</Description>
            <Size>dia (5.2-6.5mm) x length (15-83mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER516</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>e.Spine Transverse Link</Name>
            <Description>Titanium spine transverse link</Description>
            <Size>Lengths 35, 46, 60, 70, 80 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER554</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti Cross Connector  </Name>
            <Description>Adjustable Cross Connector, compatible with dia 5.5 mm and 6.0 mm MOSS Rods  </Description>
            <Size>70mm - 110mm  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER665</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-Connector, lateral, fixed</Name>
            <Description>AccelFix Spinal Fixation System-Connector, lateral, fixed, Ti, sterile</Description>
            <Size>Diameter: 5.2-6.5 mm  Length: 16-83 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW021</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Plates</Description>
            <Size>All sizes &amp;lt;55 mm</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW754</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER200</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems – Fixed Cross Connector</Name>
            <Description>Fixed Cross Connector</Description>
            <Size>14-60mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW783</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER555</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Yukon Head to Head Connectors</Name>
            <Description>Head to Head transverse connector</Description>
            <Size>21-55mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY043</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE553</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Claw Posterior Fixation System - Connector</Name>
            <Description>Connector with dual locking screws for Jazz Claw Connector</Description>
            <Size>One size</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY044</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE586</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Frame T-Bar</Name>
            <Description>Fixed transverse rod-to-rod connector</Description>
            <Size>25mm, 30mm, 35mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ599</BillingCode>
            <Name>Mountaineer OCT Spinal System</Name>
            <Description>Transverse Connector Plate</Description>
            <Size>21 - 56mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>145364</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ652</BillingCode>
            <Name>Cross Connector - Expedium Anterior Spine System</Name>
            <Description>Drop and Lock One Piece Connector-Titanium</Description>
            <Size>13 to 20mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV064</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ Cross Connector System (transverse rod to rod fixed)</Name>
            <Description>STERISPINE™ Cross Connector System (tranverse rod to rod, fixed)</Description>
            <Size>20-36 mm  34-50 mm  48 -64 mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH054</BillingCode>
            <Name>Crosslink</Name>
            <Description>Crosslink Adjustable Connector</Description>
            <Size>28-52mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB051</BillingCode>
            <Name>ELLIPSE Occipito Cervico Thoracic Stabilization System</Name>
            <Description>T-Connector and Locking Nut</Description>
            <Size>21mm - 63mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB170</BillingCode>
            <Name>REVERE Anterior Staple System - Cross Connector</Name>
            <Description>Top Tightening Cross Connector</Description>
            <Size>13mm -20mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM445</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK060</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella System Connectors</Name>
            <Description>Excella Cross Connectors - Fixed</Description>
            <Size>20 to 35 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM459</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK011</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Capless LI  Pedicle screw system - X Link cross connector - Fixed</Name>
            <Description>Titanium, lowprofile transverse crossconnector</Description>
            <Size>low profile, multiple sizes, 25-35mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
                <ARTG>160750</ARTG>
                <ARTG>170220</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM499</BillingCode>
            <Name>Inline Connectors</Name>
            <Description>Inline Connectors</Description>
            <Size>7.5 to 17 mm </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI250</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Crosslink Plates - Fixed</Description>
            <Size>10 to 200mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI458</BillingCode>
            <Name>PASS Polyaxial Screw System Crosslinks</Name>
            <Description>PASS Polyaxial Screw System Crosslinks</Description>
            <Size>5.5mm: 22-48 x 34-62; small and medium </Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI474</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK089</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Crosslinks</Name>
            <Description>Crosslinks</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN261</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Head to head cross connectors</Description>
            <Size>20-70mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV020</BillingCode>
            <Name>VuePoint Fixed Cross Connector</Name>
            <Description>Fixed cross connector</Description>
            <Size>26mm-50mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV063</BillingCode>
            <Name>Armada (Fixed cross connector)</Name>
            <Description>Fixed cross connector</Description>
            <Size>5.5mm x 20-60mm
5.5mm, 5.5mm-6.35mm
5.5, 15mm-40mm x 200mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV100</BillingCode>
            <Name>Vuepoint (Adjustable Cross Connector)</Name>
            <Description>The VuePoint OCT System is intended to promote fusion of the cervical spine and occipito-thoracic junction (Occiput-T3), and is indicated for; 1: Degenerative disc disease (as defined by back pain of discogenic origin with degeneration of the disc confimred by patient history and radiographic studies), 2: Degenerative spondylolisthesis with objective evidence of neurologic impairment, 3: Fractur/Dislocation, 4: Spinal Stenosis, 5: Atlantaxial fracture with instability, 6; Occipitocervical dislocation, 7: Spinal tumor and/or 8: revision of previous cervical spine surgery</Description>
            <Size>One size only</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV111</BillingCode>
            <Name>Reline (Fixed Cross Connector)</Name>
            <Description>Fixed Cross Connector</Description>
            <Size>11-80mm length; to fit 4.5-6.5 mm rod diameter</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Fixed Cross Connector</Name>
            <Description>Fixed length cross connector, titanium</Description>
            <Size>21mm X 5.5mm - 31mm X 5.5mm &amp; 21mm Wide X 6.0mm - 31mm Wide X 6.0mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI908</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Rod to Rod Transverse Connector</Name>
            <Description>Rod to Rod Transverse Connector</Description>
            <Size>XS, S, M, L, XL</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB011</BillingCode>
            <Name>DPS Spine System - Transconnector Fixed</Name>
            <Description>Fixed transconnector for spinal fixation system.</Description>
            <Size>Diameter 5.5/6.0mm; Length 50 - 80mm.</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ039</BillingCode>
            <Name>Corvus Spine System</Name>
            <Description>Crosslink</Description>
            <Size>18-60mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI012</BillingCode>
            <Name>Streamline TL- Fixed Crosslink</Name>
            <Description>Fixed Transverse connector (Titanium Alloy)</Description>
            <Size>Lengths ranging from 16mm-40mm in 3mm increments</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF108</BillingCode>
            <Name>Freedom Crosslink Connector</Name>
            <Description>Crosslink Connectors</Description>
            <Size>Small, medium, large, x-large</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK227</BillingCode>
            <Name>Oasys-Occipito Cervico Thoracic System</Name>
            <Description>Connector - Transverse; Offset; Cross; Rod to Rod; Axial</Description>
            <Size>For rod diameters from 3.5mm to 6mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>279144</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK241</BillingCode>
            <Name>Xia Spinal System</Name>
            <Description>Titanium or Stainless Steel Cross Connector</Description>
            <Size>15-20mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4123</SubGroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
                <ARTG>279151</ARTG>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>389</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB229</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Cross, Domino, Axial, Lateral Connector</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF007</BillingCode>
            <Name>Smartloc Spinal Fixation System/Transverse Link</Name>
            <Description>Cross link for Smartloc Spinal Fixation System</Description>
            <Size>Telescopes to 70mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>150778</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE635</BillingCode>
            <Name>Malibu Spinal System CrossBar</Name>
            <Description>CrossBar</Description>
            <Size>5.5mm and 6.35mm diameter rods 23mm - 75mm length options</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE668</BillingCode>
            <Name>Mariner CrossBar</Name>
            <Description>Adjustable Cross link</Description>
            <Size>Small 33-41mm  Medium  39-52mm  Large 50-75mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE672</BillingCode>
            <Name>icotec Pedicle System Cross Link</Name>
            <Description>Adjustable cross link</Description>
            <Size>30-34mm  33-42mm  40-53mm  50-70mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>283853</ARTG>
                <ARTG>283854</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE677</BillingCode>
            <Name>Sierra CrossBar</Name>
            <Description>Sierra OCT CrossBar</Description>
            <Size>Small 21-26mm&#xD;
Medium 24-32mm&#xD;
Large 30-44mm&#xD;
X-Large 42-58mm &#xD;
S2S Small 24-29mm&#xD;
S2S Medium 27-35mm&#xD;
S2S Large 33-47mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE768</BillingCode>
            <Name>NorthStar OCT</Name>
            <Description>NorthStar OCT Crossbar</Description>
            <Size>3.5 &amp; 4mm  SM: 21-26mm  MD: 24-32mm  LG: 34-44mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP412</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Transverse Connector - Complete</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>142432</ARTG>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR009</BillingCode>
            <Name>Life Spine Pedicle Screw System - Transverse Connectors, Adjustable</Name>
            <Description>Life Spine Pedicle Screw System - Transverse Connectors, Adjustable. Arched or Straight</Description>
            <Size>Closed (25-90)mm x Open (32-100)mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR051</BillingCode>
            <Name>Ulrich Medical Pedicle Screw System - Crosslinks</Name>
            <Description>Ulrich Medical Pedicle Screw System - Crosslinks</Description>
            <Size>XXS-XL</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>365230</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU005</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Cross Connector</Name>
            <Description>Adjustable rod-to-rod cross connectors</Description>
            <Size>RTR - Length: 21-23mm, 23-26mm, 26-32mm, 32-44mm, 44-45mm  </Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU023</BillingCode>
            <Name>Romeo 2 Posterior Thoraco-lumbar Fixation System - Multiaxial Cross Connector</Name>
            <Description>Multiaxial cross connector, Multiaxial pre-bent cross connector</Description>
            <Size>Length: 33 - 36mm, 36-43mm, 43-55mm, 55-80mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU049</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - cross connector (adjustable)</Name>
            <Description>Multiaxial cross connector - straight or pre-bent</Description>
            <Size>Length: 30-31mm, 31-33mm, 33-36mm, 36-43mm, 43-55mm, 55-80 mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER316</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Connector, transverse</Name>
            <Description>Ulrich posterior OCT System (neon3)- Crosslink, adjustable, screw to screw and rod to rod</Description>
            <Size>length adjustable within range of 34-50 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER328</BillingCode>
            <Name>SIGNUS Diplomat Pedicle Screw System – Transverse Connector, adjustable</Name>
            <Description>SIGNUS Diplomat Pedicle Screw System – Cross Connector, adjustable</Description>
            <Size>small 35-45mm  medium 41-58mm  large 54-82mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER337</BillingCode>
            <Name>Ulrich Pedicle Screw System-Transverse connectors, adjustable</Name>
            <Description>Ulrich Pedicle Screw System (uCentum,flamenco)-crosslink connectors, adjustable, with or without hook</Description>
            <Size>closed (35-92) mm x open (43-107 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER451</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, transverse, adjustable</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Connector, transverse, adjustable</Description>
            <Size>closed 30-50mm; extended 34-74 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER527</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Crosslink</Name>
            <Description>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Crosslink Plate Type, Bar type, Hybrid Type, non-sterile or sterile</Description>
            <Size>closed 29-42 mm; extended 34-58 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>286122</ARTG>
                <ARTG>384816</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER584</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spinal Fixation System</Name>
            <Description>Multi Axial Cross Connector Assembly – Titanium/Lateral Offset</Description>
            <Size>5.5mm-80mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER632</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF065</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Cross Connectors</Name>
            <Description>Adjustable Cross Connector</Description>
            <Size>20mm – 50mm in 5mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER657</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti Cross Connector-adjustable    </Name>
            <Description>Biedermann Motech MOSS Spinal Fixation System-Ti Cross Connector-adjustable, compatible with dia 5.5 mm and 6.0 mm MOSS Rods   </Description>
            <Size>35-100 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER666</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-connector, lateral, adjustable</Name>
            <Description>AccelFix Spinal Fixation System-connector, lateral, adjustable</Description>
            <Size>Diameter: 5.2-6.5 mm  Lentgth: Adjustable from (28-35) mm to (52-83) mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY007</BillingCode>
            <Name>Reform Crosslinks</Name>
            <Description>Crosslinks Adjustable</Description>
            <Size>Length 20mm to 100mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY011</BillingCode>
            <Name>Reform POCT Cross Connector</Name>
            <Description>Cross Connector</Description>
            <Size>Diameter 3.5mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW050</BillingCode>
            <Name>WEGO Spinal Systems</Name>
            <Description>Connectors</Description>
            <Size>All Sizes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW390</BillingCode>
            <Name>XIA Spine System</Name>
            <Description>Cross Link</Description>
            <Size>Length 20mm - 99mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
                <ARTG>279151</ARTG>
                <ARTG>279159</ARTG>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW728</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems</Name>
            <Description>Transverse Connector</Description>
            <Size>3.5 – 5.5mm rod /rail diameter 14 - 93mm width</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>159828</ARTG>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB002</BillingCode>
            <Name>Vertefix ll Locking screw</Name>
            <Description>Transverse connector rod system</Description>
            <Size>One size only</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>188902</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Connector</Name>
            <Description>Adjustable</Description>
            <Size>XXSmalll to Large</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV043</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BA Posterior Screw Rod to Rod Connector</Name>
            <Description>Rod to Rod Connector</Description>
            <Size>25-66mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>329318</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BA Posterior Screw Head to Head Connector</Name>
            <Description>BA Posterior Screw Head to Head Connector</Description>
            <Size>25-66mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>329318</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ766</BillingCode>
            <Name>Expedium SFX Cross Connector System</Name>
            <Description>Fixed Length Cross Connector</Description>
            <Size>15mm - 36mm Length, 4.5, 5.5, 6.35mm rod diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ767</BillingCode>
            <Name>Expedium SFX Cross Connector System</Name>
            <Description>Variable Length Cross Connector</Description>
            <Size>26mm - 100 mm Length, 4.5, 5.5, 6.35mm rod diameter</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH061</BillingCode>
            <Name>Crosslink</Name>
            <Description>Crosslink Connector</Description>
            <Size>20-80mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH091</BillingCode>
            <Name>Crosslink </Name>
            <Description>Crosslink </Description>
            <Size>Diameter : 5.5 mm &amp; 6.0 mm   Length : 32 mm - 75 mm </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>380418</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB026</BillingCode>
            <Name>REVERE Cross Connectors</Name>
            <Description>Cross Connectors</Description>
            <Size>4.5mm 20mm-78mm&#xD;
5.5mm 29mm-91mm&#xD;
6.35mm 29-90mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB030</BillingCode>
            <Name>REVERE H-LINK</Name>
            <Description>Transverse Connector with integral Rods</Description>
            <Size>5.5mm - 6.35mm Rod with 38mm - 71mm transverse connector and 40 - 45mm rod</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB057</BillingCode>
            <Name>ELLIPSE Stabilization System, Top Loading T-Connector</Name>
            <Description>T-Connector</Description>
            <Size>21mm - 56mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB086</BillingCode>
            <Name>CREO Stabilization System Cross Connector</Name>
            <Description>The CREO Stabilization System implants are non-cervical spinal fixation intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description>
            <Size>4.75 and 5.5, 30-91mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB159</BillingCode>
            <Name>QUARTEX T-Connectors</Name>
            <Description>Rod to Rod and Head to Head T-Connectors</Description>
            <Size>21mm to 57mm - 27mm to 63mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB186</BillingCode>
            <Name>CREO DLX Cross Connector</Name>
            <Description>Adjustable Cross Connectors</Description>
            <Size>20mm-78mm to 22mm-91mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB216</BillingCode>
            <Name>CREO® Cross Connector</Name>
            <Description>Cross Connector</Description>
            <Size>20-78mm to 22-91mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH578</BillingCode>
            <Name>Pine Adjustable Cross Link</Name>
            <Description>Rod - Rod Connector</Description>
            <Size>30-80mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>274913</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM406</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Capless LI  Pedicle screw system - X Link cross connector - Variable</Name>
            <Description>Titanium, lowprofile transverse dual articulation crossconnector</Description>
            <Size>Low profile, Multiple sizes, 37-80mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
                <ARTG>170220</ARTG>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM419</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Certex Spinal Implant System Connector Adjustable</Name>
            <Description>Connector Adjustable</Description>
            <Size>3.5mm x 28-33mm to 42-58mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM446</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK061</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella System Connectors</Name>
            <Description>Pedicle Screw System Rod Connectors - Transverse adjustable</Description>
            <Size>Fits 5.5 or 6mm rods  Various sizes from 39 to 81 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC590</BillingCode>
            <Name>Vertex Reconstruction System</Name>
            <Description>Crosslink/Bar</Description>
            <Size>Extra small to  large</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI266</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Crosslink Connector</Description>
            <Size>Small, medium, large</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI291</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MI247</PriorBillingCode>
                <PriorBillingCode>MI249</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CD Horizon</Name>
            <Description>Crosslink Plates - Adjustable</Description>
            <Size>10 to 200mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI475</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK090</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Adjustable Crosslinks</Name>
            <Description>Adjustable Crosslinks</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN044</BillingCode>
            <Name>Crossover System (Titanium)</Name>
            <Description>Crossover connector</Description>
            <Size>Size 1 - 12, 18 - 107mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN259</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Rod to rod cross connectors</Description>
            <Size>20-64mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU124</BillingCode>
            <Name>M.U.S.T LINK - Cross Connector</Name>
            <Description>Cross Connector</Description>
            <Size>19-100mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>222457</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU159</BillingCode>
            <Name>MUST MINI  Cross Connector</Name>
            <Description>Cross Connector</Description>
            <Size>15-70 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV047</BillingCode>
            <Name>Armada</Name>
            <Description>Arch, adjustable transverse connector</Description>
            <Size>20-70mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV118</BillingCode>
            <Name>Reline (Adjustable Cross Connector)</Name>
            <Description>Adjustable Cross Connector</Description>
            <Size>20-100mm length; to fit 4.5-6mm rod diameter</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI909</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Head to Head Transverse Connector</Name>
            <Description>Transverse Connector Adjustable</Description>
            <Size>XS, S, M, L, XL</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI999</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Multi-Span Cross Connector</Name>
            <Description>Adjustable length cross connector, titanium</Description>
            <Size>33-36mm Wide X 5.5mm - 70-90mm Wide X 6.0mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB012</BillingCode>
            <Name>DPS Spine System - Transconnector Adjustable</Name>
            <Description>Adjustable transconnector for spinal fixation system.</Description>
            <Size>Diameter 5.5/6.0mm; Adjustable lengths: 34-39mm, 38-49mm, 48-68mm.</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ027</BillingCode>
            <Name>Centaur Cross Connector, Centaur Screw System</Name>
            <Description>Cross Connector - rod to rod - Adjustable</Description>
            <Size>10mm - 90mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI018</BillingCode>
            <Name>Streamline TL- Variable Crosslink</Name>
            <Description>Transverse rod to rod connector, Adjustable (Titanium Alloy)</Description>
            <Size>Small, medium,and large sizes, with lengths ranging from 37mm-85mm.</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF015</BillingCode>
            <Name>Centaur Cross Connector, Centaur Screw System</Name>
            <Description>Cross Connector - rod to rod - Adjustable</Description>
            <Size>10mm - 90mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>166153</ARTG>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF179</BillingCode>
            <Name>Freedom Posterior Screw Rod to Rod Connector</Name>
            <Description>Rod to Rod Connector</Description>
            <Size>25-66mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF180</BillingCode>
            <Name>Freedom Posterior Screw Head to Head Connector</Name>
            <Description>Freedom Posterior Screw Head to Head Connector</Description>
            <Size>25-66mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ096</BillingCode>
            <Name>RESPONSE Spine System – Cross Connector</Name>
            <Description>Cross Connector</Description>
            <Size>XS - XL&#xD;
20-80mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY250</BillingCode>
            <Name>Universal Spine System</Name>
            <Description>Low Profile Transconnector</Description>
            <Size>18-83mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY398</BillingCode>
            <Name>Axon Spinal System - Transconnector</Name>
            <Description>Axon Transconnector</Description>
            <Size>60mm - 75mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY569</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Matrix Snap-on Transconnector</Description>
            <Size>21mm - 90mm Length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT014</BillingCode>
            <Name>SOLFIX2 Cross Links</Name>
            <Description>Cross links</Description>
            <Size>29mm - 63mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB009</BillingCode>
            <Name>Lunfix Cross Connector</Name>
            <Description>Adjustable Cross Connector</Description>
            <Size>(20-80) minimum sie to (25-98)mm expanded size </Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>167</SubCategoryID>
            <GroupID>1474</GroupID>
            <SubGroupID>4124</SubGroupID>
            <ARTGs>
                <ARTG>327225</ARTG>
            </ARTGs>
            <MinimumBenefit>1175</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW758</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER211</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mesa Hooks</Name>
            <Description>Thoracic and Lumbar hooks</Description>
            <Size>Various blade and throat sizes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <Suffix>Integrated Locking Mechanism</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>913</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB002</BillingCode>
            <Name>Aesculap Hook System</Name>
            <Description>Pedicle, Lamina, Thoracic and Offset Hooks</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE598</BillingCode>
            <Name>Sierra OCT Hook</Name>
            <Description>Posterior Cervical Hook</Description>
            <Size>4.5 and 6.0mm Hooks</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE636</BillingCode>
            <Name>Malibu Spinal System Hooks</Name>
            <Description>Hook</Description>
            <Size>5.5mm x 5.5mm - 9.0mm x 9.5mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE767</BillingCode>
            <Name>NorthStar OCT</Name>
            <Description>NorthStar OCT Hook</Description>
            <Size>4.5 &amp; 6.0mm  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE790</BillingCode>
            <Name>Mariner Hooks</Name>
            <Description>Lamina, Pedicle, Angled &amp; Offset Hooks</Description>
            <Size>5.5-10.5 Heights  4.5-9.0 Widths  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR010</BillingCode>
            <Name>Life Spine Pedicle Screw System - Hooks</Name>
            <Description>Life Spine Pedicle Screw System - Hooks (Pedicle, Laminar, Offset Left/Right)</Description>
            <Size>Small, Medium &amp; Large in Standard, Wide, Narrow &amp; Reduced</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU006</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Hook</Name>
            <Description>Straight hooks, offset hooks (left/right)</Description>
            <Size>One size only</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU020</BillingCode>
            <Name>Romeo 2 Posterior Thoraco-lumbar Fixation System - Hook</Name>
            <Description>Laminar hook, pedicular hook, offset (left/right), angled (left/right)</Description>
            <Size>Small, large, extended</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU044</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - hook </Name>
            <Description>Hook laminar, hook angled, hook offset, hook pedicular</Description>
            <Size>various</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY438</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Hooks, Right, Left, Angled, Offset, Extended, Reduced Bladed</Description>
            <Size>4.25 - 12mm including narrow - wide</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER179</BillingCode>
            <Name>Scoliosis  &amp; Fracture System - LSZ3-Lamina Hook</Name>
            <Description>SIGNUS Scoliosis  &amp; Fracture System - LSZ3-Lamina Hook</Description>
            <Size>5.0;7.5;10.0 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>216747</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER234</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Hook</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Hook </Description>
            <Size>dia (14-22 mm)x length (10.2-27.15 mm)x (height (14.4 to 29.7mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER317</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Hooks</Name>
            <Description>Ulrich posterior OCT System (neon3)-Hooks, counter hooks, right/left, short/long</Description>
            <Size>short to long</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER336</BillingCode>
            <Name>Ulrich Pedicle Screw System-Hooks</Name>
            <Description>Ulrich Pedicle Screw System (uCentum, flamenco)-Hooks, pedicle,lamina, offset (left or right)</Description>
            <Size>width (5-9 mm) x length (5-11 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER517</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>e.Spine Hook</Name>
            <Description>Titanium Spine hook</Description>
            <Size>Transverse process. Pedicular, Lumbar laminar, Thoracic laminar, Right offset lumbar laminar, Left offset lumbar laminar and raised body lumbar laminar hook, Progressive blade (small, medium, large), Pedicle (small, medium, large), Reduced blade (small, medium, large), Large blade (small, medium, large), and Laminar (Left offset - Reduced, Right offset - Reduced)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER550</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Ti Hooks </Name>
            <Description>Pedicle Hook, Laminar Hook</Description>
            <Size>Various sizes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER633</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Blackstone - Posterior Hook</Name>
            <Description>Titanium</Description>
            <Size>Large/Angled/Offset/Left/Right/Narrow/Wide/ThoracicLaminar/Lumbar Laminar</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER634</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF064</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Cervical Hooks</Name>
            <Description>Cervical Hooks</Description>
            <Size>4.5mm and 6.0mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER667</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-hooks</Name>
            <Description>AccelFix Spinal Fixation System hooks standard, pedicle, angled or offset, Ti, sterile</Description>
            <Size>Diameter: 5.6-6.2 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY006</BillingCode>
            <Name>Reform Hooks</Name>
            <Description>Hooks and Reduction Hooks</Description>
            <Size>Various</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW019</BillingCode>
            <Name>WEGO Spinal Systems</Name>
            <Description>Hooks - various</Description>
            <Size>Small, medium, large</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW405</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Hooks</Description>
            <Size>Laminar and Pedicle Hooks</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>279150</ARTG>
                <ARTG>279159</ARTG>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW723</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems</Name>
            <Description>Lumbar Thoracic or Cervical Hooks; open or closed</Description>
            <Size>Various blade and throat sizes</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Hook</Name>
            <Description>The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine.</Description>
            <Size>Pedicle, wide blade, narrow blade, thoracic supralaminar, thoracic angled, lumbar infralaminar, extended body, offset.</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY045</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE539</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Claw Posterior Fixation System (Hook)</Name>
            <Description>Left and Right Hook</Description>
            <Size>Standard and large hook</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY046</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE570</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Claw Posterior Fixation System (Hook)</Name>
            <Description>Left and Right Hook</Description>
            <Size>Standard and large hook</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ595</BillingCode>
            <Name>Mountaineer OCT Spinal System</Name>
            <Description>CT Hook</Description>
            <Size>3.5mm - Small, Medium, Large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ761</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Slotted Hook</Description>
            <Size>One Size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH057</BillingCode>
            <Name>Hook</Name>
            <Description>Laminar</Description>
            <Size>5.5 mm &amp; 7.0 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB025</BillingCode>
            <Name>REVERE Hooks</Name>
            <Description>Hook - various</Description>
            <Size>small, medium, large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB049</BillingCode>
            <Name>ELLIPSE® Stabilization System Hooks</Name>
            <Description>Hooks</Description>
            <Size>5 - 7mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB085</BillingCode>
            <Name>CREO Stabilization System Hook</Name>
            <Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description>
            <Size>4.75 and 5.5; small, medium and large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB103</BillingCode>
            <Name>CREO AMP™ Lamina Clamp</Name>
            <Description>Lamina clamp</Description>
            <Size>Small, medium, large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB155</BillingCode>
            <Name>QUARTEX Hooks</Name>
            <Description>Left and Right Inline Hooks</Description>
            <Size>One size only</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB187</BillingCode>
            <Name>CREO DLX Hook</Name>
            <Description>Hooks-Thoracic, Laminar, Transverse Process and Pedicle</Description>
            <Size>Small,  Medium,  Large,  Right Large  Left Large  Right Medium  Left Medium  Offset Right  Offset Left  30 degree Offset Right  30 degree Offset Left</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM415</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK036</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Certex Spinal Implant System Hooks</Name>
            <Description>Hook</Description>
            <Size>4.5-6mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM450</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK065</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella System Hook</Name>
            <Description>Excella Pedicle Screw System Hook</Description>
            <Size>7 to 9mm x 6 to 9mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC406</BillingCode>
            <Name>CD HORIZON Spinal System - Hook</Name>
            <Description>Hook - various</Description>
            <Size>Extra Small - Large</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC591</BillingCode>
            <Name>Vertex Reconstructive System Laminar Hook</Name>
            <Description>Composition -  titanium alloy</Description>
            <Size>4.5 - 6.0mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI267</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Laminar Hook</Description>
            <Size>4.5 - 6.0mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI464</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK077</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PASS Spinal System</Name>
            <Description>System Hook</Description>
            <Size>all sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI473</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK088</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Laminar Hooks</Name>
            <Description>Laminar Hooks</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN280</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Hook Left, Right, Centre</Description>
            <Size>Short - Long</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU134</BillingCode>
            <Name>M.U.S.T. Hooks</Name>
            <Description>Hooks: Pedicle, Narrow, Extended Body, Wide Bladed, Offset L&amp;R, Angled L&amp;R</Description>
            <Size>Various sizes</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>222457</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU161</BillingCode>
            <Name>MUST MINI Hooks</Name>
            <Description>Hooks</Description>
            <Size>4.5-6.0 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV030</BillingCode>
            <Name>VuePoint hook (laminar)</Name>
            <Description>Hook (laminar)</Description>
            <Size>5.0mm, 6.0mm, 7.0mm, 8.0mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV058</BillingCode>
            <Name>Armada (Hook - Various)</Name>
            <Description>Hook</Description>
            <Size>Pedicle - Small/Medium, 5.5mm

Lamina - 6/8/10mm x 5.5mm

Angled - 5.5mm

Offset - 5.5mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV110</BillingCode>
            <Name>Reline (Hook)</Name>
            <Description>Hook</Description>
            <Size>4-12mm&#xD;
Lamina Narrorw, Lamina Wide, Lamina Down Narrow, Lamina Down Wide, Trans Process Narrow, Trans Process Wide, Lamina Up Narrow, Lamina Up Wide, Lamina Tall Narrow, Pedicle, Thoracic, Offset Left, Offset Right, Angle Left, Angle Right, Offset Angle Left, Offset Angle Right, Sidewinder Left, Sidewinder Right</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI912</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Hooks</Name>
            <Description>Virage Hooks</Description>
            <Size>6mm and 8mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH583</BillingCode>
            <Name>Venus - Spinal Fixation System - Hooks</Name>
            <Description>Venus Hooks</Description>
            <Size>4 - 9mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB013</BillingCode>
            <Name>DPS Spine System - Hook</Name>
            <Description>Hook for spinal fixation system.</Description>
            <Size>Laminar and Pedicle; Diameter 5.5/6.0mm, Width - Broad, narrow; Left and Right</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ028</BillingCode>
            <Name>Centaur Hook, Centaur Screw System</Name>
            <Description>Open hook</Description>
            <Size>various</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF012</BillingCode>
            <Name>Centaur Hook, Centaur Screw System</Name>
            <Description>Open hook</Description>
            <Size>various</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>166153</ARTG>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF182</BillingCode>
            <Name>Freedom Posterior Screw Hook</Name>
            <Description>Freedom Posterior Screw Hook</Description>
            <Size>Thick and Thin</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK222</BillingCode>
            <Name>Oasys-Occipito Cervico Thoracic System</Name>
            <Description>Hook</Description>
            <Size>Standard, Standard Short, Standard Tall, Offset Right, Offset Left</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>279144</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ097</BillingCode>
            <Name>RESPONSE Spine System – Hook</Name>
            <Description>Pedicle, Laminar, Thoracic</Description>
            <Size>Open - Closed &#xD;
Narrow- Wide &#xD;
Left – Right &#xD;
Offset 5-11mm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY013</BillingCode>
            <Name>CerviFix Posterior Cervical System</Name>
            <Description>Hook</Description>
            <Size>Small, Large, Left, Right</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY039</BillingCode>
            <Name>Spinal Plate/Plate System AO/ASIF Spinal Implants</Name>
            <Description>Spondylolysis hook screw (complete) small &amp; large</Description>
            <Size>Screw 45 - 60mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY325</BillingCode>
            <Name>Universal Spine System</Name>
            <Description>Hook</Description>
            <Size>Small, Medium, Large, Lamina, Thoracic, Pedicle</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY443</BillingCode>
            <Name>Synapse</Name>
            <Description>Lamina Hook, Top Loading</Description>
            <Size>right, left, straight, short, long</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>293275</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY568</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Pedicle and Lamina Hooks, straight, angled, off-set</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT010</BillingCode>
            <Name>SOLFIX2 Hook</Name>
            <Description>Pedicle, lamina and TP hooks</Description>
            <Size>Small, medium, large, pedicle marker, angle left, angle right, large groove, small groove, offset left, offset right</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>168</SubCategoryID>
            <GroupID>1475</GroupID>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE679</BillingCode>
            <Name>icotec Anterior Cervical Plate</Name>
            <Description>Cervical Plate</Description>
            <Size>18mm Width, 58mm - 94mm Length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>283853</ARTG>
            </ARTGs>
            <Note>To be provided only to patients with Spinal Tumours.</Note>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU014</BillingCode>
            <Name>Tryptik 2 Anterior Cervical Plate</Name>
            <Description>Anterior cervical plate</Description>
            <Size>Length: 55mm, 58mm, 61mm, 64mm, 68mm, 72mm, 76mm, 80mm, 84mm, 88mm, 92mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>166151</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER208</BillingCode>
            <Name>SIGNUS  Cervical Plating Implant System-Plate (&gt;55 mm)</Name>
            <Description>SIGNUS  Cervical Plating Implant System-Plate (&gt;55 mm)</Description>
            <Size>56-100 mm, in 3-5 mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER525</BillingCode>
            <Name>CastleLoc-P Anterior Cervical Plate, &gt;55mm</Name>
            <Description>CastleLoc-P Anterior Cervical Plate, &gt;55mm, 3-4 levels</Description>
            <Size>length 55-97 mm, width 17 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>286127</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER585</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Azure Anterior Cervical Plate System</Name>
            <Description>Anterior Cervical Plate &gt; 55mm</Description>
            <Size>56-120mm length</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER586</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Blackstone Medical ACP - 3 and 4 Level</Name>
            <Description>Titanium Alloy Anterior Cervical Plate - 3 and 4 Level</Description>
            <Size>56mm - 122mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER587</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF078</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cetra Anterior Cervical Plate &gt; 55mm</Name>
            <Description>Low profile anterior cervical plate</Description>
            <Size>56mm-94mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW407</BillingCode>
            <Name>Aviator Anterior Cervical Plating System - Plate longer than 55mm</Name>
            <Description>Anterior Cervical Plate - Integral Locking</Description>
            <Size>Three and four level greater than 55mm in length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>278368</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW737</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pyrenees Cervical Plate System</Name>
            <Description>Cervical Plate</Description>
            <Size>57mm to 110mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW746</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER052</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Blue Ridge Hybrid Cervical Plate System - Plate</Name>
            <Description>Low profile, anterior cervical plate. Locking,  titanium.</Description>
            <Size>56-92mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW762</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER240</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pyrenees Cervical Plate System-MonoPlate, Long</Name>
            <Description>Pyrenees Cervical Plate System-MonoPlate, Long</Description>
            <Size>Length 56-78 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW780</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER494</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ozark Plate Level 1-5 , &gt;55mm</Name>
            <Description>Plate Level 1-5 , &gt;55mm</Description>
            <Size>56-110 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH541</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spinal Plate - Cervical 55mm+</Name>
            <Description>Anterior Cervical Plate 55mm+</Description>
            <Size>56 - 92mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>289731</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ801</BillingCode>
            <Name>Skyline Cervical Plate System</Name>
            <Description>Skyline anterior cervical plate. Various size plates. Titanium</Description>
            <Size>56-105mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>148561</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB039</BillingCode>
            <Name>XTEND Anterior Cervical Plate &gt;55mm</Name>
            <Description>Anterior Cervical Plate &gt;55mm</Description>
            <Size>57mm - 104mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB111</BillingCode>
            <Name>ASSURE® Anterior Plate System – Plate</Name>
            <Description>Titanium Alloy Anterior Cervical Plate</Description>
            <Size>1.8 mm depth, 16mm width, 57-100mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB115</BillingCode>
            <Name>Unify Dynamic Anterior Cervical Plate System – Plate</Name>
            <Description>Titanium Alloy Dynamic Anterior Cervical Plate</Description>
            <Size>Depth - 2.8mm&#xD;
Width – 16.6mm&#xD;
Length – 58 -70 mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM408</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spider Cervical Plating System - Spider Plate</Name>
            <Description>Titanium, anterior cervical plate system</Description>
            <Size>56-77mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>160750</ARTG>
                <ARTG>159605</ARTG>
                <ARTG>170220</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC858</BillingCode>
            <Name>Atlantis Anterior Cervical Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>57.5mm - 110mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC859</BillingCode>
            <Name>Venture Anterior Cervical Plate</Name>
            <Description>Single or multi level plate, titanium alloy and Nitinol</Description>
            <Size>57.5mm - 150mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI162</BillingCode>
            <Name>ZEVO Anterior Cervical Plate System</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>57 - 108mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV069</BillingCode>
            <Name>Helix-Revolution (plate 56-110mm)</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>56-110mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>133466</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV092</BillingCode>
            <Name>Helix-T (Plate 56 - 110mm)</Name>
            <Description>Anterior cervical plate</Description>
            <Size>56-110mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV109</BillingCode>
            <Name>Archon (Plate 56-110mm)</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>56-110mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>209196</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW030</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxAn Anterior Cervical Plating System</Name>
            <Description>Titanium plate for anterior cervical spine</Description>
            <Size>&gt;55mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>287243</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB016</BillingCode>
            <Name>Anterior Cervical Plate System</Name>
            <Description>Anterior cervical plate. Various size plates, Titanium</Description>
            <Size>&gt;55mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ031</BillingCode>
            <Name>Aquila Plate System</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>2, 3 and 4 level cervical plates (55m - 109mm length)</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR084</BillingCode>
            <Name>Reflex Anterior Cervical Plate System</Name>
            <Description>Plate</Description>
            <Size>&gt;55mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>278368</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY458</BillingCode>
            <Name>Vectra T Anterior Spinal System</Name>
            <Description>Titanium</Description>
            <Size>&gt;55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY519</BillingCode>
            <Name>Vectra Anterior Spinal System</Name>
            <Description>Cervical Plate</Description>
            <Size>&gt;55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1475</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE680</BillingCode>
            <Name>icotec Anterior Cervical Plate</Name>
            <Description>Cervical Plate</Description>
            <Size>18mm width, 21mm - 55mm length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>283853</ARTG>
            </ARTGs>
            <Note>To be provided only to patients with Spinal Tumours</Note>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU013</BillingCode>
            <Name>Tryptik 2 Anterior Cervical Plate</Name>
            <Description>Anterior cervical plate</Description>
            <Size>Length: 20mm, 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm, 40mm, 43mm, 46mm, 49mm, 52mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>166151</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY524</BillingCode>
            <Name>Uniplate Spinal System</Name>
            <Description>Titanium Anterior Cervical Plate</Description>
            <Size>13-55mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>148371</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER207</BillingCode>
            <Name>SIGNUS  Cervical Plating Implant System-Plate</Name>
            <Description>SIGNUS Cervical Plating Implant System-Plate</Description>
            <Size>20-54 mm, in 2-3 mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER518</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>E.2S anterior cervical Plate</Name>
            <Description>Titanium anterior cervical plate</Description>
            <Size>15 lengths of plates from 24mm to 94mm&#xD;
24mm 4 holes&#xD;
26mm 4 holes&#xD;
29mm 4 holes&#xD;
32mm 4 holes&#xD;
35mm 6 holes&#xD;
39mm 6 holes&#xD;
43mm 6 holes&#xD;
49mm 6 holes&#xD;
55mm 6 holes&#xD;
60mm 8 holes&#xD;
66mm 8 holes&#xD;
69mm 8 holes&#xD;
77mm 10 holes&#xD;
89mm 10 holes&#xD;
94mm 12 holes</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>171951</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER524</BillingCode>
            <Name>CastleLoc-P Anterior Cervical Plate</Name>
            <Description>CastleLoc-P Anterior Cervical Plate, Plate level 1-3, ≤55 mm</Description>
            <Size>length 19-54 mm; width 17 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>286127</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER588</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Azure Anterior Cervical Plate</Name>
            <Description>Anterior Cervical Plate &lt;55mm</Description>
            <Size>18-54mm length</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER589</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Blackstone Medical ACP - Level 1 &amp; 2</Name>
            <Description>Titanium Alloy ACP L1-L2</Description>
            <Size>20mm - 54mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER590</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF077</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cetra Anterior Cervical Plate</Name>
            <Description>Low profile anterior cervical plate</Description>
            <Size>16mm-54mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY019</BillingCode>
            <Name>Slimplicity HP Plates</Name>
            <Description>Plates</Description>
            <Size>10mm - 105mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC013</BillingCode>
            <Name>Origin System</Name>
            <Description>Cervical Plate</Description>
            <Size>L:22-72mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>369730</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW408</BillingCode>
            <Name>Aviator Anterior Cervical Plating System - Plate</Name>
            <Description>Anterior Cervical Plate - Integral Locking</Description>
            <Size>One, two and three level up to 55mm in length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>278368</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW736</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pyrenees Cervical Plate System</Name>
            <Description>Cervical Plate</Description>
            <Size>18mm to 54mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW763</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER241</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pyrenees Cervical Plate System-Monoplate, Short</Name>
            <Description>Pyrenees MonoPlate, Short</Description>
            <Size>18-55mm length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW767</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER289</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pyrenees Segmental Plate</Name>
            <Description>Single level fusion plate with shelf.</Description>
            <Size>5-10mm shelf</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW779</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER493</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Ozark Plate Level 1-5, ≤55 mm</Name>
            <Description>Plate level 1 -5, ≤55 mm</Description>
            <Size>16-55 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution ACDF Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>1 level Plate (20mm-32mm), 2 level plate (34mm – 50mm)</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>247573</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Revolution ACDF Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>Double and Mini Plates, 18 - 50mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>273279</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH540</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spinal Plate - Cervical</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>20mm - 53mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>289731</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ800</BillingCode>
            <Name>Skyline Cervical Plate System</Name>
            <Description>Skyline anterior cervical plate. Various size plates, Titanium</Description>
            <Size>12-55mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>148561</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB015</BillingCode>
            <Name>VIP Anterior Cervical Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>13mm - 46mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>190972</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB038</BillingCode>
            <Name>XTEND Anterior Cervical Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>10mm - 54mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB040</BillingCode>
            <Name>XTEND Anterior Cervical Extender Plate</Name>
            <Description>Anterior Cervical Extender Plate</Description>
            <Size>10mm - 46mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB110</BillingCode>
            <Name>ASSURE® Anterior Cervical Plate System – Plate</Name>
            <Description>Titanium Alloy Anterior Cervical Plate</Description>
            <Size>1.8 mm depth, 16mm width, 14- 54mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB114</BillingCode>
            <Name>Unify Dynamic Anterior Cervical Plate System – Plate</Name>
            <Description>Titanium Alloy Dynamic Anterior Cervical Plate</Description>
            <Size>Depth - 2.8mm&#xD;
Width – 16.6mm&#xD;
Length – 10- 55 mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM407</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spider Cervical Plating System - Spider Plate</Name>
            <Description>Titanium, Anterior Cervical Plate System -</Description>
            <Size>22-54mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
                <ARTG>160750</ARTG>
                <ARTG>170220</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC346</BillingCode>
            <Name>Venture Anterior Cervical Plate</Name>
            <Description>Single or multi level plate, titanium alloy and Nitinol</Description>
            <Size>20mm - 50mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC418</BillingCode>
            <Name>Atlantis Anterior Cervical Plate</Name>
            <Description>Plate</Description>
            <Size>19.0mm -  47.5mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC419</BillingCode>
            <Name>Atlantis Anterior Cervical Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>50mm - 55mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC706</BillingCode>
            <Name>Venture Anterior Cervical Plate</Name>
            <Description>Single or multi level plate, titanium alloy and Nitinol</Description>
            <Size>52.5mm - 55mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC863</BillingCode>
            <Name>Zephir Anterior Cervical Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>22.5mm - 55mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI152</BillingCode>
            <Name>ZEVO Anterior Cervical Plate System</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>15mm - 55mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI157</BillingCode>
            <Name>Divergence Anterior Cervical Fusion Mini-plate System</Name>
            <Description>Divergence anterior cervical fusion mini-plate</Description>
            <Size>15.5mm - 22.5mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI480</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK106</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Intervertebral Fusion Staple</Name>
            <Description>Intervertebral Fusion Staple</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>295270</ARTG>
            </ARTGs>
            <Note>For single level ACDF (Anterior cervical discectomy and fusion) ONLY.</Note>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV068</BillingCode>
            <Name>Helix-Revolution (Plate 20-54mm)</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>20-54mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>133466</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV091</BillingCode>
            <Name>Helix-T (Plate 20-54mm)</Name>
            <Description>Anterior cervical plate</Description>
            <Size>20-54mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV108</BillingCode>
            <Name>Archon (Plate 18-55mm)</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>18-55mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>209196</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW031</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MaxAn Anterior Cervical Plating System</Name>
            <Description>Titanium plate for anterior cervical spine</Description>
            <Size>≤55mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>287243</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB003</BillingCode>
            <Name>Delta Plate</Name>
            <Description>Anterior cervical plate</Description>
            <Size>Length: 16-22mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB015</BillingCode>
            <Name>Anterior Cervical Plate System</Name>
            <Description>Anterior cervical plate. Various size plates, Titanium</Description>
            <Size>20-55mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC002</BillingCode>
            <Name>WeCover Cervical System - Plate</Name>
            <Description>Cervical Plate</Description>
            <Size>One Level Plate - 22,24,26,28,30,32, 34mm&#xD;
Two Level Plate - 36, 38, 40, 42, 44, 46, 48, 50mm&#xD;
Three Level Plate - 52mm&#xD;
Width of all plates are 18mm and the plate profile is 1.9mm.</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>221268</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ029</BillingCode>
            <Name>Pegasus Plate System, Pegasus Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>1 level plate (13mm-22mm), 2 level plate (28mm-40mm)</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ030</BillingCode>
            <Name>Aquila Plate System</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>1 level and 2 level plates (21 - 55mm Length)</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF158</BillingCode>
            <Name>Alias ACDF Plate</Name>
            <Description>Anterior Cervical Plate</Description>
            <Size>1 Level 12-30mm, 2 Level 30-44mm, 3 Level 42-66mm, 4 Level 64-76mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR085</BillingCode>
            <Name>Reflex Anterior Cervical Plate System</Name>
            <Description>Plate</Description>
            <Size>≤55mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>278368</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY459</BillingCode>
            <Name>Vectra T Anterior Spinal System</Name>
            <Description>Titanium</Description>
            <Size>≤55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY520</BillingCode>
            <Name>Vectra Anterior Spinal System</Name>
            <Description>Cervical Plate</Description>
            <Size>≤55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4125</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1297</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER186</BillingCode>
            <Name>SIGNUS Contact Thoracolumbar Plating System-Frame Plate</Name>
            <Description>Signus Contact Thoracolumbar Plating System-Frame Plate</Description>
            <Size>40-70 mm, in 5 mm increments (straight); 70-120 mm in 5 mm increments (10 deg angled)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>216749</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER591</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Unity Lumbar Plate</Name>
            <Description>Unity Plate</Description>
            <Size>17-28mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>195018</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER635</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF069</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SKYHAWK Lateral Plate</Name>
            <Description>Low profile Lateral Plate</Description>
            <Size>6mm, 8mm, 10mm, 12mm, 14mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW572</BillingCode>
            <Name>LITe Plate System - Plate</Name>
            <Description>Anterior and Lateral Lumbar Locking Plates</Description>
            <Size>Buttress1Size, Universal and Sacral Length 21mm-37mm, Lateral Length 16mm- 28mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>277947</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW733</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cayman Thoracolumbar Plate System / Plate</Name>
            <Description>Thoracolumbar Plate, Titanium</Description>
            <Size>21mm to 109mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>290395</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW776</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER489</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cayman United Plate</Name>
            <Description>Thoracolumbar Plate</Description>
            <Size>16-24</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>293886</ARTG>
            </ARTGs>
            <Note>“To be reimbursed only when used with posterior supplemental fixation with other implants.”</Note>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ518</BillingCode>
            <Name>AEGIS ALP</Name>
            <Description>Curved anterior lumbar plate</Description>
            <Size>4-25mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>148371</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB008</BillingCode>
            <Name>TRUSS® Thoracolumbar Plate with slider</Name>
            <Description>Thoracolumbar plate</Description>
            <Size>45mm-99.5mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB009</BillingCode>
            <Name>TRUSS® Thoracolumbar Plate</Name>
            <Description>Thoracolumbar plate</Description>
            <Size>22mm - 55mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB012</BillingCode>
            <Name>CITADEL® Anterior Lumbar Plate</Name>
            <Description>Anterior Lumbar plate</Description>
            <Size>20mm - 99mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>190969</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB095</BillingCode>
            <Name>PLYMOUTH Thoracolumbar Plate System Plate</Name>
            <Description>Thoracolumbar Plate</Description>
            <Size>15 - 24mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB106</BillingCode>
            <Name>InterContinental Plate</Name>
            <Description>Lateral Plate</Description>
            <Size>20mm x 8mm - 21mm.</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>190063</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC610</BillingCode>
            <Name>Vantage</Name>
            <Description>Vantage plates and Screws; Thoracic Plate</Description>
            <Size>3.5 - 8cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC612</BillingCode>
            <Name>Vantage</Name>
            <Description>Vantage Plates and Screws; ATL Plate</Description>
            <Size>4 - 10cm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC819</BillingCode>
            <Name>Pyramid +4</Name>
            <Description>Anterior Plate</Description>
            <Size>Height: 33mm - 45mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI171</BillingCode>
            <Name>Divergence-L Anterior/Oblique Lumbar Fusion System </Name>
            <Description>Lumbar Plates </Description>
            <Size>10-20mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI187</BillingCode>
            <Name>PIVOX Oblique Lateral Spinal System</Name>
            <Description>Plate</Description>
            <Size>Small, Large</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV105</BillingCode>
            <Name>Decade Lateral Plate System (plate)</Name>
            <Description>The NuVasive Decade Plate System is indicated for use in the treatment of lumbar and lumbarsacral (L1-S1) spine instability.</Description>
            <Size>2-4 Hole Static, 2-4 Hole Translating, Lengths 6-20</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>209200</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV155</BillingCode>
            <Name>XLIF Modular Plate</Name>
            <Description>Lateral plate</Description>
            <Size>Small (8mm), Medium (10mm), Large (12mm)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>209200</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV157</BillingCode>
            <Name>Halo Buttress Plate</Name>
            <Description>Titanium Buttress Plate</Description>
            <Size>21mm-25mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>209200</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF149</PriorBillingCode>
            </PriorBillingCodes>
            <Name>XM Plate</Name>
            <Description>Lumbar Fusion Plate</Description>
            <Size>17-27mm, in 2mm increments.</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ032</BillingCode>
            <Name>Aurora SPINE System</Name>
            <Description>Thoracolumbar plate</Description>
            <Size>15mm-51mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>217032</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF020</BillingCode>
            <Name>Aurora SPINE System</Name>
            <Description>Thoracolumbar plate</Description>
            <Size>15mm-51mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF149</BillingCode>
            <Name>XM Plate</Name>
            <Description>Lumbar Fusion Plate</Description>
            <Size>17-27mm, in 2mm increments.</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>208160</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY139</BillingCode>
            <Name>Spinal Plate/Plate System AO/ASIF Spinal Implants</Name>
            <Description>Anterior thoracolumbar plate - locking</Description>
            <Size>40mm - 109mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY290</BillingCode>
            <Name>Anterior Tension Band</Name>
            <Description>Plate</Description>
            <Size>30mm to 110mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY301</BillingCode>
            <Name>TeleFix Spinal System</Name>
            <Description>Rod/Plate construct</Description>
            <Size>40mm to 140mm in length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT019</BillingCode>
            <Name>Unity+ Plates</Name>
            <Description>Thoracolumbar plate</Description>
            <Size>Depth: 22mm;  Length: 8mm, 9mm, 11mm, 13mm, 15mm, 24mm, 27,5mm, 30.5mm.</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1476</GroupID>
            <SubGroupID>4126</SubGroupID>
            <ARTGs>
                <ARTG>320879</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB140</BillingCode>
            <Name>Aesculap Cervical System</Name>
            <Description>Titanium Alloy</Description>
            <Size>All Sizes &gt;55mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF010</BillingCode>
            <Name>WinLoc Cervical Plate System - plate</Name>
            <Description>Titanium anterior cervical plate</Description>
            <Size>3-Level: 58mm, 62mm, 66mm, 70mm, 74mm, 78mm, 82mm&#xD;
4-Level: 86mm, 90mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>218438</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE792</BillingCode>
            <Name>Admiral Cervical Plate</Name>
            <Description>Admiral Cervical Plate &gt;55mm</Description>
            <Size>57mm-100mm Lengths</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>275780</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR028</BillingCode>
            <Name>Choice Spine Cervical Plate 55+</Name>
            <Description>Anterior Cervical Fusion Plate</Description>
            <Size>Plate Lengths 57mm to 105mm (Three, Four and Five Level Plates)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>330080</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ084</BillingCode>
            <Name>CanAce Anterior Cervical Plating System</Name>
            <Description>Spinal Fixation System</Description>
            <Size>&gt;55mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>346438</ARTG>
                <ARTG>346439</ARTG>
                <ARTG>346450</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER167</BillingCode>
            <Name>Signus Anterior Cervical Plate - L3-L4</Name>
            <Description>Pre-contoured titanium plate, secured onto the spinal vertebrae by either fixed or variable angle colour coded screws.</Description>
            <Size>56mm - 100mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>122274</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER458</BillingCode>
            <Name>LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Plate, &gt;55mm</Name>
            <Description>LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Plate, &gt;55mm, 3-4 levels</Description>
            <Size>width 17mm x length (57-97 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>286127</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY029</BillingCode>
            <Name>Slim HP Plates</Name>
            <Description>Plates</Description>
            <Size>55 -105mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC023</BillingCode>
            <Name>Butterfly Plate</Name>
            <Description>Cervical Plate</Description>
            <Size>L:55-86mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>201492</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH082</BillingCode>
            <Name>Katia Anterior Cervical Plate - Long </Name>
            <Description>Anterior Cervical Plate &gt; 55 mm</Description>
            <Size>56 mm - 110 mm </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH086</BillingCode>
            <Name>Ceplate Anterior Cervical Plate</Name>
            <Description>Anterior Cervical Plate &gt;55mm</Description>
            <Size>57.5 mm - 110 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>366091</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB120</BillingCode>
            <Name>Assure-X Anterior Cervical Plate System - Plates &gt; 55mm</Name>
            <Description>Titanium Alloy Anterior Cervical Plate</Description>
            <Size>1.8mm profile, 16mm width, 57-100 mm in length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB195</BillingCode>
            <Name>PROVIDENCE Anterior Cervical Plates &gt; 55mm</Name>
            <Description>Low profile anterior cervical plates</Description>
            <Size>57mm to 104mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM529</BillingCode>
            <Name>Cervical Plate &gt;55mm</Name>
            <Description>Cervical Plate &gt;55mm</Description>
            <Size>&gt;55mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>375676</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU129</BillingCode>
            <Name>Mecta C Plates</Name>
            <Description>Cervical Plates</Description>
            <Size>L 3 to 4; 58 to 92 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>222455</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV165</BillingCode>
            <Name>ACP Plate &gt; 55mm</Name>
            <Description>Anterior cervical plate 3, 4 and 5 levels</Description>
            <Size>56mm to 110mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>209196</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH616</BillingCode>
            <Name>HumanTech - Hero Cervical Plate System, Plate Lge</Name>
            <Description>Cervical Plate Large</Description>
            <Size>L: 57 - 97mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>316053</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC034</BillingCode>
            <Name>Ulrich Anterior Cervical Plate &gt;55mm</Name>
            <Description>Ulrich Anterior Cervical Plating System - Plate 55mm+</Description>
            <Size>57-84mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>377912</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI037</BillingCode>
            <Name>Shark CP Locking Plate</Name>
            <Description>Plate, titanium alloy. </Description>
            <Size>greater than 55mm length </Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>345367</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY183</BillingCode>
            <Name>Posterior Cervical Plate System</Name>
            <Description>Plate</Description>
            <Size>22-33 holes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY454</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>Plate - Special Manuf.</Description>
            <Size>&gt;55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY456</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>Small Stature Plate</Description>
            <Size>&gt;55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY463</BillingCode>
            <Name>Posterior Cervical Plate System</Name>
            <Description>Cervical Spine Reconstruction Plate</Description>
            <Size>&gt;55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY465</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>VA Plate</Description>
            <Size>&gt;55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT008</BillingCode>
            <Name>AXIS2 Anterior Cervical Plate</Name>
            <Description>Anterior cervical plate</Description>
            <Size>57mm - 83mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <Suffix>&gt;55mm</Suffix>
            <ARTGs>
                <ARTG>320879</ARTG>
            </ARTGs>
            <MinimumBenefit>1238</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB374</BillingCode>
            <Name>Aesculap Cervical Systen</Name>
            <Description>Titanium Alloy</Description>
            <Size>All Sizes &lt; 55 mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF009</BillingCode>
            <Name>WinLoc Cervical Plate System - plate</Name>
            <Description>Titanium anterior cervical plate</Description>
            <Size>1-Level: 25mm, 27mm, 30mm, 33mm, 36mm&#xD;
2-Level: 39mm, 42mm, 45mm, 48mm, 51mm, 54mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>218438</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE659</BillingCode>
            <Name>Shoreline ACS TruProfile Cervical Plate</Name>
            <Description>Anterior cervical plating system</Description>
            <Size>Holes: 2, 3 and 4 &#xD;
Length: 5-12mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE791</BillingCode>
            <Name>Admiral Cervical Plate</Name>
            <Description>Admiral Cervical Plate &lt;55mm</Description>
            <Size>7mm-54mm Length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>275780</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR029</BillingCode>
            <Name>Choice Spine Cervical Plate</Name>
            <Description>Anterior Cervical Fusion Plate</Description>
            <Size>Plate Lenths 10mm to 54mm (One, Two &amp; Three Level Plates)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>330080</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ086</BillingCode>
            <Name>CanAce Anterior Cervical Plating System</Name>
            <Description>Spinal Fixation System</Description>
            <Size>≤55mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>346438</ARTG>
                <ARTG>346439</ARTG>
                <ARTG>346450</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER457</BillingCode>
            <Name>LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Plate</Name>
            <Description>LnK Anterior Cervical Plate System/CastleLoc-P Anterior Cervical Plate System-Plate, 1-3 levels</Description>
            <Size>width 17mm x length (13-54mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>286127</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC021</BillingCode>
            <Name>Butterfly Plate</Name>
            <Description>Cervical Plate</Description>
            <Size>L : 21-55mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>201492</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH084</BillingCode>
            <Name>Katia Anterior Cervical Plate </Name>
            <Description>Anterior Cervical Plate - Single or Multi level </Description>
            <Size>20 mm - 53.5 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH088</BillingCode>
            <Name>Ceplate Anterior Cervical Plate </Name>
            <Description>Anterior Cervical Plate - Single or Multi level plate </Description>
            <Size>22.5 mm - 55 mm </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>366091</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB119</BillingCode>
            <Name>Assure-X Anterior Cervical Plate System - Plates</Name>
            <Description>Titanium Alloy Anterior Cervical Plate</Description>
            <Size>1.8 mm profile, 16mm width, 10-54mm in length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB194</BillingCode>
            <Name>PROVIDENCE Anterior Cervical Plates</Name>
            <Description>Low profile anterior cervical plates</Description>
            <Size>10mm to 54mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>190070</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM530</BillingCode>
            <Name>Cervical Plate 55mm or less</Name>
            <Description>Cervical Plate 55mm or less</Description>
            <Size>55 mm and smaller</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>375676</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU130</BillingCode>
            <Name>Mecta C Plates</Name>
            <Description>Cervical Plates</Description>
            <Size>L 1 to 3; 20 to 55 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>222455</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV040</BillingCode>
            <Name>Helix Mini Plate</Name>
            <Description>Anterior cervical plate</Description>
            <Size>20mm-50mm (2mm increments)</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV164</BillingCode>
            <Name>ACP Plate</Name>
            <Description>Anterior Cervical Plates 1, 2, and 3 levels</Description>
            <Size>16mm to 54mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>209196</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH615</BillingCode>
            <Name>HumanTech - Hero Cervical Plate System - Plates</Name>
            <Description>Cervical Plate</Description>
            <Size>L: 21 - 53mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>316053</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC033</BillingCode>
            <Name>Ulrich Anterior Cervical Plate  </Name>
            <Description>Ulrich Anterior Cervical Plating System - Plate</Description>
            <Size>12mm - 54mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>377912</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI036</BillingCode>
            <Name>Shark CP Locking Plate </Name>
            <Description>Plate, titanium alloy</Description>
            <Size>55mm length  or less </Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>345367</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY365</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>VA Plate</Description>
            <Size>Length 23 - 109mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY455</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>Plate - Special Manuf.</Description>
            <Size>≤55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY457</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>Small Stature Plate</Description>
            <Size>≤55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY462</BillingCode>
            <Name>Posterior Cervical Plate System</Name>
            <Description>Cervical Spine Reconstruction Plate</Description>
            <Size>≤55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY464</BillingCode>
            <Name>Cervical Spine Locking Plate (CSLP) System</Name>
            <Description>VA Plate</Description>
            <Size>≤55</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT007</BillingCode>
            <Name>AXIS2 Anterior Cervical Plate</Name>
            <Description>Anterior cervical plate</Description>
            <Size>19.5mm - 53mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4127</SubGroupID>
            <ARTGs>
                <ARTG>320879</ARTG>
                <ARTG>320878</ARTG>
            </ARTGs>
            <MinimumBenefit>1180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE798</BillingCode>
            <Name>Meridian ALIF Plate</Name>
            <Description>Titanium ALIF Plate </Description>
            <Size>2 &amp; 4 Hole, Size 10mm-20mm </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4128</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU043</BillingCode>
            <Name>Juliet Ti LL plate</Name>
            <Description>Titanium lateral plate</Description>
            <Size>2 holes or 4 holes  Width: 13mm, 17mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4128</SubGroupID>
            <ARTGs>
                <ARTG>338461</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM526</BillingCode>
            <Name>Buttress Plates </Name>
            <Description>Buttress Plates used to stabilise the allograft or autograft at on level (L1-S1). </Description>
            <Size>Plates 20, 24, 28 mm  Screws 5.5 &amp; 6.5 mm diameter, 20 - 30mm long</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4128</SubGroupID>
            <ARTGs>
                <ARTG>375812</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV033</BillingCode>
            <Name>Traverse Plate</Name>
            <Description>Plate</Description>
            <Size>Fixed Plate - Size 15/20/25/30/35/40/45/50/55/60/65/70/80/90mm
Compression Plate - Size 45/50/55/60/65/70/75/80/85/95/105mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4128</SubGroupID>
            <ARTGs>
                <ARTG>132467</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV095</BillingCode>
            <Name>Brigade Anterior Plate</Name>
            <Description>Anterior plate</Description>
            <Size>26-42mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4128</SubGroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW045</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI951</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Timberline Lateral Fusion System</Name>
            <Description>Lateral Plate</Description>
            <Size>6-16mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4128</SubGroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>2039</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE599</BillingCode>
            <Name>Sierra Occipital Plate</Name>
            <Description>Occipital Plate</Description>
            <Size>25-35&#xD;
30-40&#xD;
35-45&#xD;
40-50</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE771</BillingCode>
            <Name>NorthStar OCT  </Name>
            <Description>NorthStar OCT Occipital Plate</Description>
            <Size>Small - Large</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU061</BillingCode>
            <Name>Perla Posterior Occipito-Cervico-Thoracic fixation system - occipital plate</Name>
            <Description>Occipital plate</Description>
            <Size>31 - 45 mm, Small, medium, large</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER322</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Plate</Name>
            <Description>Ulrich posterior OCT System (neon3)-Plate, occipital, midline for occipital and standard rod (4 mm).</Description>
            <Size>47,57 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER637</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF067</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Occipital Plate</Name>
            <Description>Occipital Plate</Description>
            <Size>20-30mm Rod Spacing  30- 40mm Rod Spacing  40-50mm Rod Spacing</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY038</BillingCode>
            <Name>Reform POCT Occipital Plate</Name>
            <Description>Occipital Plate</Description>
            <Size>25mm to 50mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW740</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems- Occipital Plate</Name>
            <Description>Occipital Plate for posterior occipital/cervical/thoracic fixation</Description>
            <Size>24-50mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ694</BillingCode>
            <Name>Mountaineer OCT Spinal System -Lateral washer plate</Name>
            <Description>Titanium Occipital - Lateral Washer Plate</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>148561</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ695</BillingCode>
            <Name>Mountaineer OCT Spinal System - OC Plate</Name>
            <Description>Titanium Occipital Plate</Description>
            <Size>31 - 45mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>148561</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB050</BillingCode>
            <Name>ELLIPSE® Stabilization System Occipital Plate</Name>
            <Description>Occipital Plate</Description>
            <Size>Small to Large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB161</BillingCode>
            <Name>QUARTEX Occipital Plate</Name>
            <Description>Occipital Plate</Description>
            <Size>Small to Large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM426</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK102</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Occipital Plate</Name>
            <Description>Occipital Plate</Description>
            <Size>Multiple sizes to suit patient anatomy</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC293</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Occipital Plate</Description>
            <Size>24 - 40 mm length</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI268</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Occipital Plate</Description>
            <Size>Small, standard</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI476</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK091</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Occipital plates</Name>
            <Description>Occipital plates</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU166</BillingCode>
            <Name>MUST Mini Occipital Plate</Name>
            <Description>Occipital Plate</Description>
            <Size>Small to Large. X, Y and T Shape.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV027</BillingCode>
            <Name>VuePoint Keel Plate (occipital)</Name>
            <Description>Plate (occipital)</Description>
            <Size>35/40/45mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW032</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI913</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Occiptial Plates</Name>
            <Description>Modular adjustable occipital plates</Description>
            <Size>small, medium, large</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK226</BillingCode>
            <Name>Oasys-Occipito Cervico Thoracic System</Name>
            <Description>Occipital Plate</Description>
            <Size>Mini, SML, MED, LGE, LGE Long, 100 deg, 130 deg</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>94635</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY380</BillingCode>
            <Name>Occipito-Cervical Fusion System</Name>
            <Description>Occipital Plate Medial / Lateral, Pure titanium</Description>
            <Size>50mm / 60mm width, 3 or 4 holes</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4129</SubGroupID>
            <ARTGs>
                <ARTG>293275</ARTG>
            </ARTGs>
            <MinimumBenefit>1897</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB174</BillingCode>
            <Name>Haven Dual Plates</Name>
            <Description>Dual Laminoplasty plates</Description>
            <Size>32mm - 39mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <Suffix>Bilateral laminoplasty plate</Suffix>
            <ARTGs>
                <ARTG>219536</ARTG>
            </ARTGs>
            <MinimumBenefit>837</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB092</BillingCode>
            <Name>CANOPY Laminoplasty System Plate</Name>
            <Description>Laminoplasty Plate</Description>
            <Size>5 - 13mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <ARTGs>
                <ARTG>219536</ARTG>
            </ARTGs>
            <MinimumBenefit>664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB149</BillingCode>
            <Name>Canopy Radiolucent Spacer</Name>
            <Description>Slide-on PEEK spacer with graft packing chamber</Description>
            <Size>5-13mm in 2mm increments</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <ARTGs>
                <ARTG>219536</ARTG>
            </ARTGs>
            <MinimumBenefit>664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH707</BillingCode>
            <Name>Ultio Laminoplasty Plate</Name>
            <Description>Plate</Description>
            <Size>Small - 25,7mm  Med - 27,1mm  Lge - 28,9mm  X-Large - 30,3mm  Standard support plate - 15,35mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <ARTGs>
                <ARTG>330538</ARTG>
            </ARTGs>
            <MinimumBenefit>664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI174</BillingCode>
            <Name>Centerpiece</Name>
            <Description>TiMesh LP</Description>
            <Size>Various</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV054</BillingCode>
            <Name>Leverage LFS (Traditional Plate)</Name>
            <Description>Laminoplasty plate</Description>
            <Size>8/9.5/11/12.5mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB046</BillingCode>
            <Name>Laminoplasty Mini Plate</Name>
            <Description>Laminoplasty Plate</Description>
            <Size>10/12/14mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY335</BillingCode>
            <Name>Arch Fixation System</Name>
            <Description>Pre contoured mini titanium plates</Description>
            <Size>4 to 16mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>169</SubCategoryID>
            <GroupID>1477</GroupID>
            <SubGroupID>4131</SubGroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>664</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE800</BillingCode>
            <Name>NorthStar Transition Rod</Name>
            <Description>Transition Rod</Description>
            <Size>3.5mm, 4.0mm – 5.5mm, 6.0mm Diameters  500mm Length  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR007</BillingCode>
            <Name>Life Spine Pedicle Screw System - Rod, Dual Diameter</Name>
            <Description>Life Spine Pedicle Screw System (Nautilus, Avatar) - Rod, Dual Diameter</Description>
            <Size>(3.5-5.5) Various Lengths</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU008</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Transition Rod</Name>
            <Description>Transition rods - Titanium or cobalt chromium</Description>
            <Size>Diameter: 3.5/5.4 to 6.0 mm  Length: 300mm, 600mm  </Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER341</BillingCode>
            <Name>Ulrich Pedicle Screw System-Rod, dual diameter</Name>
            <Description>Ulrich Pedicle Screw System (flamenco)-Rod, hybrid</Description>
            <Size>dia 5.5 mm /4.5 mm, length 400 mm;  dia 5.5 mm /6.0 mm, length 400 mm; dia 5.5 mm /6.25 mm, length 400 mm; dia 5.5 mm /6.25 mm, (threaded), length 400 mm; dia 4.0/6.0 mm, length 200 mm; dia 4.0/6.0 mm, length 400 mm  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER505</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/ CastleLoc-S Posterior Cervical Fixation System-Rod, dual dia</Name>
            <Description>LnK Posterior Cervical Fixation System/ CastleLoc-S Posterior Cervical Fixation System-Rod, dual diameter transitional rod, non-sterile or sterile</Description>
            <Size>3.5 mm transitioning to (4.5-6.0 mm) x overall rod length (300-550) mm)  Rod segment L1 can range between 100-200 mm and Rod segment 2 can range between 100-400 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>286122</ARTG>
                <ARTG>384816</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER556</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Multiple diameter rod  </Name>
            <Description>Dual Diameter Transition Rods, Ti or CoCr  </Description>
            <Size>Ø 3.0 - Ø6.0mm range in various sizes  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY030</BillingCode>
            <Name>Reform POCT Rod</Name>
            <Description>Transition Rod</Description>
            <Size>Lengths 250mm - 650mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW654</BillingCode>
            <Name>OASYS Spine System</Name>
            <Description>Transition Rods</Description>
            <Size>3.5mm transitioning to 4.5mm, 5.5mm and 6.0mm.  Ti Alloy and Vitallium</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>279144</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW655</BillingCode>
            <Name>Xia Spine System</Name>
            <Description>Transition Rods</Description>
            <Size>4.5 mm transitioning to 5.5mm and 6.0mm.   Titanium Alloy and Vitallium</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>279160</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW755</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER201</PriorBillingCode>
            </PriorBillingCodes>
            <Name>K2M Spinal Systems-Transitional Rod</Name>
            <Description>Transitional Rod</Description>
            <Size>3.5-(4.5 /5.5)mm x (300-600)mm length or 5.5/5.5mm x 495 rod/rail</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>159828</ARTG>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ596</BillingCode>
            <Name>Mountaineer Spinal System</Name>
            <Description>CT Dual Diameter Rod</Description>
            <Size>3.5 - 6.35mm x 420 - 600mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB045</BillingCode>
            <Name>ELLIPSE Stabilization System, Tapered Rod</Name>
            <Description>Dual Diameter Rod</Description>
            <Size>3.5mm ti 4.0mm - 6.5mm x 350mm - 500mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB091</BillingCode>
            <Name>CREO Stabilization Tapered Rod</Name>
            <Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description>
            <Size>4.75 and 5.5&#xD;
600mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB152</BillingCode>
            <Name>QUARTEX Tapered Rods</Name>
            <Description>Tapered rods which transition in diameter.</Description>
            <Size>Diameter 3.5mm &amp; 4.0mm transitioning up to 6.5mm &#xD;
Length 350mm -500mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM417</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Certex Spinal Implant System Transitional Rod</Name>
            <Description>Transitional Rod</Description>
            <Size>3.5mm - 5.5mm x100mm - 500mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI168</BillingCode>
            <Name>CD HORIZON SOLERA Spinal System </Name>
            <Description>Apex and Tapered Rods</Description>
            <Size>4.75mm to 6.3mm diameter</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI471</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK086</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dual diameter rod</Name>
            <Description>Dual diameter rod</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN264</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Dual diameter rods</Description>
            <Size>3.5-6.35mm diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU156</BillingCode>
            <Name>MUST MINI Transition Rod</Name>
            <Description>Transition Rod</Description>
            <Size>Diameter 3.5 / 5.5 &amp; 3.5 / 4.0&#xD;
Lenght 120 ÷ 600 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV026</BillingCode>
            <Name>VuePoint rod (transition)</Name>
            <Description>Transition Rod</Description>
            <Size>3.5mm to 5.5mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW033</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI916</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Rods</Name>
            <Description>Virage Dual Diameter Rods</Description>
            <Size>3.5/5.5mm x 450mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ038</BillingCode>
            <Name>Corvus Spinal System</Name>
            <Description>Dual Diameter Rod</Description>
            <Size>3.5mm-6.35mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY446</BillingCode>
            <Name>CerviFix Posterior Cervical System</Name>
            <Description>Rod: Tapered</Description>
            <Size>3.5/5.0 - 3.5/6.0 dual diameter, 300 -500mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Dual Diameter</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH593</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Rods, Curved</Name>
            <Description>curved and S shaped rods, carbon fiber reinforced polymer</Description>
            <Size>6.0mm x (30-300)mm length</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>288089</ARTG>
            </ARTGs>
            <Note>To be reimbursed only when used in patients with spinal tumours</Note>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW025</BillingCode>
            <Name>Libra Pedicle Screw System</Name>
            <Description>Rod - Pre-bent with or without thread available in Titanium or cobalt chromium</Description>
            <Size>Length 35mm - 120mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>355051</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY555</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Contoured Scoliosis Rod</Description>
            <Size>4.5 - 7.5 Diameter x - 320 - 455mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER285</BillingCode>
            <Name>Premia Spine Versalink Fixation System-Rods (shaped)</Name>
            <Description>Premia Spine Versalink Fixation System-Rods (shaped)</Description>
            <Size>offset and angle (0-30 degrees), length (40-90) mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>267145</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW765</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER243</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MESA Rail</Name>
            <Description>CoCr and Ti shaped beam rail rods</Description>
            <Size>Diameter: 4.5-5.5mm Length: 375-500mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB077</BillingCode>
            <Name>REVERE Rods Preshaped</Name>
            <Description>Pre-shaped Rods</Description>
            <Size>4.5, 5.5 - 6.35mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB180</BillingCode>
            <Name>CREO ADDITION Headed Rods</Name>
            <Description>Headed, shaped rods of various configurations</Description>
            <Size>Diameter - 5.5mm&#xD;
Length - 40mm - 230mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM495</BillingCode>
            <Name>Curved Rod</Name>
            <Description>Curved Rod</Description>
            <Size>Diameter 5.5 or 6 mm  Length 150 to 450 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM510</BillingCode>
            <Name>Curved Rods</Name>
            <Description>Curved Rods</Description>
            <Size>35 to 90 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>366793</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI454</BillingCode>
            <Name>UNiD™ Rods </Name>
            <Description>Curved rods that are preshaped to be patient specific</Description>
            <Size>diameter: 3.5/5.5-6.0mm length: 120 - 750mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>368750</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI478</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK095</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Curved Rods</Name>
            <Description>Curved Rods</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN114</BillingCode>
            <Name>EXPEDIUM Spinal System</Name>
            <Description>Pre-Shaped Rod</Description>
            <Size>4.5 - 7.5mm Diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>97391</ARTG>
                <ARTG>128257</ARTG>
                <ARTG>178040</ARTG>
                <ARTG>205380</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN293</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Offset rods</Description>
            <Size>3.5-5.5mm Diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV137</BillingCode>
            <Name>Reline System (Curved Rod)</Name>
            <Description>Curved Rod</Description>
            <Size>5.0- 6.0mm diameter, and 300- 500mm length, CoCr and Ti</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ156</BillingCode>
            <Name>Response Spine System - S Rod</Name>
            <Description>Pre-Contoured S-Rods, Shaped, CoCr, Ti</Description>
            <Size>5.5 &amp; 6.0mm diameter  350 - 500mm  Small, Med, Large</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY385</BillingCode>
            <Name>Speciality Rods</Name>
            <Description>Scoliosis / J/S Rod, Precontoured, Titanium / Stainless Steel</Description>
            <Size>5mm, 6mm diameter. Left / Right 50mm - 500mm length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>133401</ARTG>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT017</BillingCode>
            <Name>SOLFIX2 Pre-bent Rods</Name>
            <Description>Pre-bent (soft rods, minimally invasive rods)</Description>
            <Size>Diameter: 5.5mm, 6mm,  Length: 35mm - 500mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <Suffix>Shaped</Suffix>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>555</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB371</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Pre-bent Rods - Titanium Alloy</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB372</BillingCode>
            <Name>Aesculap Spinal System</Name>
            <Description>Straight Rods - Titanium Alloy</Description>
            <Size>All Sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>134538</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF005</BillingCode>
            <Name>Smartloc Spinal Fixation System / Fixation Rod</Name>
            <Description>Fixation Rod for Smartloc Spinal Fixation System</Description>
            <Size>40mm - 80mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>150778</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH594</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Rods</Name>
            <Description>Straight</Description>
            <Size>6mm x (32-300)mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>288089</ARTG>
            </ARTGs>
            <Note>To be reimbursed only when used in patients with spinal tumours</Note>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BW024</BillingCode>
            <Name>Libra Pedicle Screw System</Name>
            <Description>Rod - Standard with or without thread available in Titanium or cobalt chromium</Description>
            <Size>Length 35mm - 600mm</Size>
            <SupplierCode>BW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>355051</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE594</BillingCode>
            <Name>Newport MIS Rod</Name>
            <Description>MIS bulleted pre-contoured rod</Description>
            <Size>35-80 (5mm incr.)&#xD;
90-110 (10mm incr.)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE596</BillingCode>
            <Name>Sierra OCT Rod</Name>
            <Description>Sierra Pre-contoured OCT Rods</Description>
            <Size>3.5mm diameter &#xD;
20-80mm length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE637</BillingCode>
            <Name>Malibu Spinal System ESS CoNiCr Rods</Name>
            <Description>Rod CoNiCr Precontored</Description>
            <Size>5.5mm x 100mm - 600mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE638</BillingCode>
            <Name>Malibu Spinal System Rods</Name>
            <Description>Rod</Description>
            <Size>5.5mm x 30mm - 600mm  6.35mm x 100mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE667</BillingCode>
            <Name>Mariner Rod</Name>
            <Description>Pre-contoured and straight rods</Description>
            <Size>5.5 &amp; 6.0mm diameter   20mm - 600mm Length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE670</BillingCode>
            <Name>icotec Pedicle System Rod</Name>
            <Description>Pre-bent and straight rods</Description>
            <Size>5.5 mm to 6.0mm diameter   40-500 mm Length</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>283853</ARTG>
                <ARTG>283854</ARTG>
            </ARTGs>
            <Note>“To be reimbursed only when used in patients with spinal tumours.”</Note>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE705</BillingCode>
            <Name>Mariner MIS Rods</Name>
            <Description>Mariner MIS Rods</Description>
            <Size>5.5mm - 6.0mm Diameter.  20-450mm Length.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE772</BillingCode>
            <Name>NorthStar OCT</Name>
            <Description>NorthStar OCT Rod</Description>
            <Size>3.5, 4.0mm Diameter  30mm-500mm Lengths</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>275794</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP394</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Pre-Cut Rod</Description>
            <Size>5.5mm x 30 - 90mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP400</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Rod - Standard</Description>
            <Size>5.5mm x 12 - 48cm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR014</BillingCode>
            <Name>Life Spine Pedicle Screw System - Rods</Name>
            <Description>Life Spine Pedicle Screw System (Naultilus, Avatar) - Rods, Straight, Curved and Deformity, open or percutaneous (Ti or CoCr).</Description>
            <Size>dia. (5.5) x length (25-600)</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>321122</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR033</BillingCode>
            <Name>Z-Medical Pedicle Screw System - Rods</Name>
            <Description>Z-Medical Pedicle Screw System - Rods 5.5mm, Straight &amp; Curved (Open or Percutaneous)</Description>
            <Size>dia (5.5)mm x length (20-500)mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>343676</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR049</BillingCode>
            <Name>Ulrich Medical Pedicle Screw System - Rods</Name>
            <Description>Ulrich Medical Pedicle Screw System - Rods</Description>
            <Size>5.5/6.0 - 35mm-500mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>365230</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU007</BillingCode>
            <Name>Perla Posterior Cervico-Thoracic Fixation System - Rod</Name>
            <Description>Straight rods, pre-bent rods - Titanium or cobalt chromium</Description>
            <Size>Diameter: 3.5mm  Length: 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 100mm, 110mm, 120mm, 240mm, 350mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU021</BillingCode>
            <Name>Romeo 2/Romeo 2 MIS Posterior Thoraco-lumbar Fixation System - Rod, Percutaneous Rod</Name>
            <Description>Rod, percutaneous rod</Description>
            <Size>Rod -  Diameter 5.4mm  Length: pre-bent: 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 70mm, 80mm, 90mm; straight: 100mm, 120mm, 140mm, 160mm, 180mm, 200mm, 220mm, 240mm, 350mm, 500mm, 550mm  Percutaneous Rod -  Diameter: 5.4mm  Length:   pre-bent - 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm;   straight - 100mm, 110mm, 120mm, 130mm, 140mm, 150mm, 160mm, 170mm, 180mm, 190mm, 200mm, 210mm, 220mm, 230mm, 240mm, 250mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU048</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - rod </Name>
            <Description>Straight rods, pre-bent rods - Titanium or colbalt chromium</Description>
            <Size>Diameter:  5.5, 6mm. Length: 30 - 550mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU056</BillingCode>
            <Name>Perla Posterior Occipito-Cervico-Thoracic fixation system - adjustable occipital rod</Name>
            <Description>Adjustable occipital rod (titanium)</Description>
            <Size>Small, Medium</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU059</BillingCode>
            <Name>Perla TL Posterior thoraco-lumbar fixation system - percutaneous rod </Name>
            <Description>Percutaneous straight rods, pre-bent rods - Titanium</Description>
            <Size>Diameter:  5.5, 6mm. Length: 30 - 250mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU060</BillingCode>
            <Name>Perla Posterior Occipito-Cervico-Thoracic fixation system - occipital rod</Name>
            <Description>Occipital rod - Titanium or cobalt chromium</Description>
            <Size>3.5 x 220 - 90mm or 3.5 x 120 - 90 mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>338498</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY578</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Rods</Description>
            <Size>4.5 to 7.5 Diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
                <ARTG>178040</ARTG>
                <ARTG>205380</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER139</BillingCode>
            <Name>Signus Pedicles Screw System - Rod</Name>
            <Description>Titanium Rod- as part of the Signus Pedicle Screw System Construct</Description>
            <Size>6.0mm x 30mm - 100mm in 5mm increments 6.0mm x 108mm - 204mm in 12 mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER177</BillingCode>
            <Name>Scoliosis  &amp; Fracture System -LSZ3-Rod</Name>
            <Description>Signus Scoliosis  &amp; Fracture System -LSZ3Scoliosis &amp; Fracture System-LSZ3-Rod 5.5 x 500mm</Description>
            <Size>5.5x500 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>216747</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER225</BillingCode>
            <Name>SIGNUS DIPLOMAT Pedicle Screw System - Rod-Straight or Curved</Name>
            <Description>SIGNUS DIPLOMAT Pedicle Screw System - Rod-Straight or Curved</Description>
            <Size>dia 5.5 mm x length (30-150 mm)  dia 5.5 mm x length (150/200/250/300/500 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>216751</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER233</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Rod</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Rod</Description>
            <Size>dia (4.0-5.5 mm) x length (40-500 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER238</BillingCode>
            <Name>Spineway Mont Blanc Pedicle Screw System-Rod (tapered)</Name>
            <Description>Spineway Mont Blanc Pedicle Screw System-Rod (tapered)</Description>
            <Size>dia 5.5 mm x length (50-550 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>235417</ARTG>
                <ARTG>235418</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER284</BillingCode>
            <Name>Premia Spine Versalink Fixation System-Rods (straight or bent)</Name>
            <Description>Premia Spine Versalink Rods (straight or bent)</Description>
            <Size>dia 6 mm, length (40-180) mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>267145</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER286</BillingCode>
            <Name>Premia Spine Versalink Fixation System-Cross Bar</Name>
            <Description>Premia Spine Versalink Fixation System-Cross Bar</Description>
            <Size>one size</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>267145</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER319</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Rods</Name>
            <Description>Ulrich posterior OCT System (neon3)-Rods, Titanium or Co-CR, straight or curved</Description>
            <Size>dia 4 mm x length (20-400 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER334</BillingCode>
            <Name>Ulrich Pedicle Screw System-Rods</Name>
            <Description>Ulrich Pedicle Screw System (cosmicMIA, uCentum,flamenco)-Rods, straight, curved and scoliosis, open or percutaneous.</Description>
            <Size>dia (5.5-6.0 mm) x length (30-500 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER407</BillingCode>
            <Name>LnK MIS Spinal System/PathLoc-L MIS Spinal System-Rods</Name>
            <Description>LnK MIS Spinal System/PathLoc-L MIS Spinal System-Rods, bullet and hex shaped ends, straight or curved</Description>
            <Size>dia (5.5-6.0mm) x length (35-600mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>286124</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER436</BillingCode>
            <Name>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Rod</Name>
            <Description>LnK Posterior Cervical Fixation System/CastleLoc-S Posterior Cervical Fixation System-Rod,straight or pre-bent, non-sterile or sterile</Description>
            <Size>Dia 3.5mm x Length (20-240 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>286122</ARTG>
                <ARTG>384816</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER447</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Rods</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Rods; straight or curved; Titanium or CoCr alloy</Description>
            <Size>dia (5.0-6.35mm) x length (40-600mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER448</BillingCode>
            <Name>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Rods, shaped</Name>
            <Description>LnK Spinal Fixation System/OpenLoc-L Spinal Fixation System-Rods, shaped ends and single or double stopper features</Description>
            <Size>dia (5.0-6.35mm) x length (40-600mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>286123</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER519</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>e.Spine Rod</Name>
            <Description>Spine straight or pre-bend rods</Description>
            <Size>Diameter 5.5mm; Lengths:&#xD;
Titanium or CoCr Straight rods 40, 50, 60, 70, 80, 90, 110, 130, 160, 220, 440, 500, 600mm;&#xD;
Titanium Pre-bend rods: 40, 50, 60, 70, 80, 90mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>171952</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER549</BillingCode>
            <Name>Biedermann Motech MOSS Spinal Fixation System-Rod </Name>
            <Description>Rod, Ti or CoCr, straight or curved, bullet or hexagonal end </Description>
            <Size>Ø4.5mm -Ø6.0mm diameter, 30 - 600mm length, Ti and CoCr  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>337238</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER592</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF073</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Firebird Rods</Name>
            <Description>Firebird Rods - straight and pre-lordosed, titanium and CoCr</Description>
            <Size>35mm-600mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER593</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF083</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Orthofix Z Rod</Name>
            <Description>Pre-bent Z Rod</Description>
            <Size>Standard, 16mm, 18mm Offset  150mm X150mm, 150mm X 300mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER640</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF062</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Rods</Name>
            <Description>Titanium or Cobalt Chrome Rods and Transition Rods</Description>
            <Size>3.5mm diameter and 70mm, 120mm, and 200mm in length (Rods)  3.5mm – 5.5mm and 200/200mm, 200/300mm and 300/300mm in length (Transition Rods)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER641</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF063</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Centurion Occipital Rods</Name>
            <Description>Titanium or Cobalt Chrome Occipital Rod</Description>
            <Size>3.5mm, 110°, 120°, 135°</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER663</BillingCode>
            <Name>LnK AccelFix Spinal Fixation System-Rods</Name>
            <Description>AccelFix Spinal Fixation System Ti Rods, shaped ends, straight or curved, standard or MIS and single or double stopper features. sterile</Description>
            <Size>Diameter: 5.0-6.5 mm  Length:     40-612 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>384815</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EV028</BillingCode>
            <Name>Katana Rod</Name>
            <Description>The Katana Rod, part of the Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine. These are specialty rods for use in procedures such as the treatment for scoliosis.</Description>
            <Size>Titanium or CrCo straight rods.&#xD;
300 and 500mm</Size>
            <SupplierCode>EV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY004</BillingCode>
            <Name>Reform Rods</Name>
            <Description>Straight and Lordotic Curved Rods</Description>
            <Size>Length 20mm to 600mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>287905</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY010</BillingCode>
            <Name>Reform POCT Rod</Name>
            <Description>Rod - Straight and Curved</Description>
            <Size>Length 20mm to 350mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY037</BillingCode>
            <Name>Reform POCT </Name>
            <Description>Occipital Rod</Description>
            <Size>3.5mm Diameter</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>287906</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW031</BillingCode>
            <Name>WEGO Spinal Systems </Name>
            <Description>Rods</Description>
            <Size>All sizes</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC020</BillingCode>
            <Name>KM Rod</Name>
            <Description>Rod</Description>
            <Size>40-400mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>201492</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC028</BillingCode>
            <Name>G2S rods</Name>
            <Description>Rod</Description>
            <Size>L: 40-154mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>274075</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC031</BillingCode>
            <Name>SAXXO ROD</Name>
            <Description>ROD</Description>
            <Size>35-400mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>331780</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW389</BillingCode>
            <Name>Xia / Mantis Spine System</Name>
            <Description>Rod</Description>
            <Size>Diameter: 5.5mm - 6mm.  &#xD;
Length: 20mm - 600mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>139620</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW483</BillingCode>
            <Name>ES2 Spinal System, Rod</Name>
            <Description>Hex end rods</Description>
            <Size>5.5mm x 20 - 600mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>278581</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW727</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER018</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mesa/Denali/Everest Rod</Name>
            <Description>Straight and Contoured, CoCr, Ti Rods</Description>
            <Size>Length: 25mm - 600 mm; Diameter: 3.5mm - 6.5 mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW735</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Caspian OCT Spinal System - Rod</Name>
            <Description>cervico-thoracic posterior rigid fixation system - Rod</Description>
            <Size>Diameter: 3.5mm Length: 1.80mm - 240mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>159828</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB004</BillingCode>
            <Name>Vertefix II Alignment Rod</Name>
            <Description>Alignment Rod</Description>
            <Size>Diameters: 5.5 Length: 50, 75, 100, 125, 150, 200, 300mm</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>188902</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV007</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Rods</Name>
            <Description>Pre-Lordosed and Straight Rods - Ti and CoCr</Description>
            <Size>Curved and Straight Rods  Length: 25mm – 160mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>BA Posterior Screw Rod</Name>
            <Description>BA Posterior Screw Rod  Straight/PreBent  CrCo/Titanium</Description>
            <Size>Ø3.5 to 5.5  20-500mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>329318</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY047</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE527</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Jazz Posterior Fixation System Rod</Name>
            <Description>Straight, contoured and transition rods, titanium and cobalt chrome</Description>
            <Size>4mm - 6mm diameter, 70mm - 600mm length</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>200830</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH352</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Novel/Zenius Rods</Name>
            <Description>Rod</Description>
            <Size>5.5, 6.0, 6.5</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>148858</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG011</BillingCode>
            <Name>VENTOTENE Rods</Name>
            <Description>Straight and Pre-Bended</Description>
            <Size>5.5mm diameter  35-450mm length</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>397231</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ597</BillingCode>
            <Name>Mountaineer Spinal System</Name>
            <Description>CT Rod</Description>
            <Size>3.5mm x 60 - 400mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ644</BillingCode>
            <Name>Extra long rod - Expendium Anterior Spine System</Name>
            <Description>Rod - Titanium</Description>
            <Size>5.5mm x 450mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ648</BillingCode>
            <Name>Pre-cut rod - Expedium Anterior Spine System</Name>
            <Description>Rod - Titanium</Description>
            <Size>Diameter 5.5mm x lengths 45-150mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ693</BillingCode>
            <Name>Mountaineer OCT Spinal System - Pre-bent Rod</Name>
            <Description>Pre-bent Titanium Rod</Description>
            <Size>3.5 x 200 - 85mm or 3.5 x 120 - 85 mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ760</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Swedge Rod</Description>
            <Size>One Size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ809</BillingCode>
            <Name>Viper 2 Spine System - Cobalt Chrome Rods</Name>
            <Description>Cobalt Chrome Rod</Description>
            <Size>100-600mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV069</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ PS Sterile Connecting Rod</Name>
            <Description>Sterile rod available in straight and prebent versions.</Description>
            <Size>Pre bent rods-5.5mm   Lengths (mm): 30-100    Straight Rods-5.5mm  Lengths (mm): 100-380</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>273288</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB011</BillingCode>
            <Name>AnyPlus and AnyPlus II Rods</Name>
            <Description>Straight and Pre-bent Rods</Description>
            <Size>Diameter: 5.5mm  Length: 40-200mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>353891</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH044</BillingCode>
            <Name>Rod</Name>
            <Description>Rod</Description>
            <Size>30-500mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH051</BillingCode>
            <Name>Rod</Name>
            <Description>Rods</Description>
            <Size>80 - 240mm Length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH078</BillingCode>
            <Name>Kumafix Rod </Name>
            <Description>Rod </Description>
            <Size>Length : 30-500 mm </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH079</BillingCode>
            <Name>ZINA MIS Rod </Name>
            <Description>ZINA MIS Spine System - Rod  </Description>
            <Size>Diameter x Length ( mm )   5.5×30    5.5×35    5.5×40    5.5×45    5.5×50  5.5×55  5.5×60  5.5×65  5.5×70  5.5×75  5.5×80  5.5×85  5.5×90  5.5×95  5.5×100  5.5×110  5.5×120  5.5×130  5.5×140  5.5×150  5.5×160  5.5×170  5.5×180  5.5×190  5.5×200  5.5×210  5.5×220  5.5×230  5.5×240  5.5×250  5.5×300  5.5×350  5.5×400  5.5×450  5.5×500  </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>312520</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH090</BillingCode>
            <Name>Rod </Name>
            <Description>Rod </Description>
            <Size>Diameter ： 5.5 mm &amp; 6.0 mm  Length : 30 mm - 500 mm   </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>380418</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB020</BillingCode>
            <Name>REVOLVE Stabilization System Rods</Name>
            <Description>Rod</Description>
            <Size>5.5mm diameter 40mm - 300mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190043</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB046</BillingCode>
            <Name>ELLIPSE Stabilization System, Rod</Name>
            <Description>Rod</Description>
            <Size>3.5mm Diameter x 40mm - 240mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB076</BillingCode>
            <Name>REVERE Rods</Name>
            <Description>Rod, precurved and straight</Description>
            <Size>30mm-600mm in 4.5mm 5.5mm and 6.35mm diameter</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB087</BillingCode>
            <Name>CREO Stabilization System Rod</Name>
            <Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description>
            <Size>4.75 and 5.5 diameter&#xD;
15mm - 600mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB125</BillingCode>
            <Name>CREO MIS Posterior Stabilization System</Name>
            <Description>Titanium alloy and cobalt chrome straight and curved rods</Description>
            <Size>30-500mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB148</BillingCode>
            <Name>CAPITOL Curved Rod</Name>
            <Description>Pre-lordosed Rods</Description>
            <Size>3.5mm diameter 25-120mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB151</BillingCode>
            <Name>QUARTEX Rods</Name>
            <Description>Ttianium alloy and cobalt chrome alloy curved and straight rods</Description>
            <Size>3.5 and 4.0mm diameter, 25-500mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB182</BillingCode>
            <Name>CREO ADDITION - Z Rods</Name>
            <Description>Z pre-shaped rods</Description>
            <Size>Diameter 5.5-6.35mm&#xD;
12mm Offset&#xD;
100-200mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB189</BillingCode>
            <Name>CREO DLX Rods</Name>
            <Description>Curved, Straight and Hex-ended Rods</Description>
            <Size>Diameter: 6.35mm  Length: 20mm-600mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB212</BillingCode>
            <Name>CREO® Side Loading Rod</Name>
            <Description>Curved, straight and offset rods</Description>
            <Size>Length: 20mm- 600mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH485</BillingCode>
            <Name>Paradigm  Spinal System</Name>
            <Description>DSS/ HPS Rod, Titanium alloy</Description>
            <Size>5.5mm diameter rod  Length: 20mm to 300mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>186733</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH712</BillingCode>
            <Name>Athena Rod</Name>
            <Description>titanium alloy rods in both straight and curved </Description>
            <Size>Diameter 5.5mm  Lengths 25mm -700mm  </Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>337150</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM409</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Capless Li Pedicle screw system - rod</Name>
            <Description>Titanium rod. Straight and pre- bent</Description>
            <Size>Straight and pre- bent, multiple sizes, 40-300mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>170220</ARTG>
                <ARTG>160750</ARTG>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM416</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK037</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Certex Spinal Implant System Rod</Name>
            <Description>Rod</Description>
            <Size>3.5mm x 30-500mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM437</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK118</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Amendia Savannah-T Pedicle Screw System-Rods</Name>
            <Description>Pedicle Screw System-Rods, Straight and curved</Description>
            <Size>dia 5.5 mm x length (30-500 mm)</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>281992</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM443</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK058</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Excella Systems Rods</Name>
            <Description>Pedicle Screw System Rods, Straight and curved</Description>
            <Size>5.5 &amp; 6mm diameter  35 to 600mm length</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>295225</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM494</BillingCode>
            <Name>Straight Rod</Name>
            <Description>Straight Rod</Description>
            <Size>Diameter 5.5 or 6 mm  Length 35 - 505 mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>362890</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC396</BillingCode>
            <Name>TSRH Spinal Implant System</Name>
            <Description>3D - Rod</Description>
            <Size>Length 20-120mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC404</BillingCode>
            <Name>CD HORIZON Spinal System - Rod</Name>
            <Description>Rod</Description>
            <Size>20mm - 600mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC440</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Eclipse:  4.5mm Rod</Description>
            <Size>40 - 600mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC587</BillingCode>
            <Name>CD Horizon Spinal System</Name>
            <Description>Percutaneous Rod</Description>
            <Size>20mm to 600mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI248</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Rods</Description>
            <Size>20-600mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI269</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Pre - curved rod</Description>
            <Size>Length 25 - 200mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI270</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Straight Rod</Description>
            <Size>Length 120 - 600 mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI460</BillingCode>
            <Name>PASS Pedical Spine System Rod</Name>
            <Description>PASS Pedical Spine System Rod</Description>
            <Size>5.5 &amp; 6.0 mm diameter  Multiple lengths</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI470</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK085</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Straight rods</Name>
            <Description>Straight rods</Description>
            <Size>All sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN113</BillingCode>
            <Name>Mountaineer Spine System</Name>
            <Description>OC Adjustable Rod</Description>
            <Size>3.5mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>145010</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN169</BillingCode>
            <Name>VIPER Spinal System</Name>
            <Description>Spinal Rods</Description>
            <Size>30-480mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN268</BillingCode>
            <Name>SYMPHONY OCT System</Name>
            <Description>Straight, hinged, and pre-lordosed rods</Description>
            <Size>3.5-4.0mm diameter</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU108</BillingCode>
            <Name>M.U.S.T. Rods</Name>
            <Description>Straight, Pre-Bent and Pre-Contoured Rods</Description>
            <Size>5.5; length 35 - 600mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>196964</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU155</BillingCode>
            <Name>MUST MINI Rod</Name>
            <Description>Rod</Description>
            <Size>Diameter 3.5  Lenght 30 - 350 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>291175</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV025</BillingCode>
            <Name>VuePoint rod</Name>
            <Description>Rod</Description>
            <Size>60mm x 3.5mm, 120mm x 3.5mm, 240mm x 3.5mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV028</BillingCode>
            <Name>VuePoint rod (pre-bent)</Name>
            <Description>Pre-bent rod</Description>
            <Size>80-240mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>209198</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV060</BillingCode>
            <Name>Armada (Rod)</Name>
            <Description>Rod</Description>
            <Size>5.5mm x (25/30/35/40/45/50/55/60/65/70/75/80/85/90/100/120)

300/500mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV088</BillingCode>
            <Name>Precept (Rod)</Name>
            <Description>Rod</Description>
            <Size>15-600mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV116</BillingCode>
            <Name>Reline (Rod)</Name>
            <Description>Rod</Description>
            <Size>4.5-6mm diameter, and 15-600mm length, Ti and CoCr</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV136</BillingCode>
            <Name>Reline System (Tapered Rod)</Name>
            <Description>Tapered Rod</Description>
            <Size>5.0- 6.0mm diameter, and 300-500mm length, Ti and CoCr</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>209199</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW034</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitality Spine System - Rods</Name>
            <Description>Straight and contoured rods titanium and CoCR</Description>
            <Size>5.5 x 25mm - 5.5 x 510mm &amp; 6 x 25mm - 6 x 510mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>287242</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW035</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI914</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Rods</Name>
            <Description>Virage Rods</Description>
            <Size>3.5mm x 25-400mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH582</BillingCode>
            <Name>Venus Spinal Fixation System - Rods</Name>
            <Description>Venus - Rods</Description>
            <Size>D 4.0 - 5.5mm L 40-480mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB007</BillingCode>
            <Name>DPS Spine System - Rod</Name>
            <Description>Rods for posterior pedicle screw fixation system.</Description>
            <Size>Diameter 5/5.5/6mm; Length 40-500mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ033</BillingCode>
            <Name>Centaur Rod</Name>
            <Description>Standard</Description>
            <Size>30-480mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ037</BillingCode>
            <Name>Corvus Spinal System</Name>
            <Description>Rod</Description>
            <Size>20-250mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ050</BillingCode>
            <Name>Centaur Screw System</Name>
            <Description>Percutaneous Rods</Description>
            <Size>30mm-480mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI010</BillingCode>
            <Name>Streamline MIS- Rods</Name>
            <Description>Titanium Alloy straight and pre-bent Rods</Description>
            <Size>Titanium 5.5mm pre-bent rod lengths range from 35-80mm in 5mm increments and 90-200 in 10mm increments; straight rod lengths range from 35-80mm in 5mm increments and 90-200 250mm in 10mm increments, 300 &amp; 350mm.</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI017</BillingCode>
            <Name>Streamline TL/Quantum- Rods</Name>
            <Description>Titanium Alloy and Cobalt Chrome (CoCr) Spinal Rods</Description>
            <Size>Titanium 5.5mm pre-bent rod lengths range from 35-150mm in 5mm increments; Titanium 5.5mm straight rod lengths of 35mm, 40-110mm in 10mm increments, and with hex end in lengths of 120mm, 150mm, 200mm, 400mm and 600mm. CoCr 5.5mm straight rod with hex end in lengths of 200mm, 400mm, and 600mm.</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>233599</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI048</BillingCode>
            <Name>HPS™ Rod</Name>
            <Description>straight and pre-bent Rods</Description>
            <Size>20-300mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>345870</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF111</BillingCode>
            <Name>Freedom Systems Rods</Name>
            <Description>Freedom System Rods, Straight and Curved</Description>
            <Size>Diameter 5.5mm, Lengths 40-500mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF171</BillingCode>
            <Name>Freedom Posterior Screw Rod</Name>
            <Description>Freedom Posterior Screw Rod  Straight/PreBent  CrCo/Titanium</Description>
            <Size>Ø3.5 to 5.5  20-500mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>203838</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK224</BillingCode>
            <Name>Oasys-Occipito Cervico Thoracic System</Name>
            <Description>Rods - Ti-6A1-4V or Vitallium</Description>
            <Size>Diameter 3.5mm, Length 25mm-350mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>94635</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ101</BillingCode>
            <Name>RESPONSE Spine System – Rod</Name>
            <Description>CoCr, Ti</Description>
            <Size>500mm-600mm Length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>233454</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ126</BillingCode>
            <Name>NEO Pedicle Screw System - Rod</Name>
            <Description>Straight, Titanium Alloy, CoCr</Description>
            <Size>30mm - 500mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>289017</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ128</BillingCode>
            <Name>NEO Pedicle Screw System - Rod</Name>
            <Description>Shaped, Titanium Alloy</Description>
            <Size>30mm - 100mm length</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>289017</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY143</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Rods</Description>
            <Size>Length 40 - 500mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY444</BillingCode>
            <Name>CerviFix Posterior Cervical System</Name>
            <Description>Rod: Straight or pre bent</Description>
            <Size>3.5mm diameter, 120-250mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY564</BillingCode>
            <Name>Spinal Fixation System</Name>
            <Description>Matrix Rods</Description>
            <Size>20mm - 500mm length</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>293275</ARTG>
                <ARTG>293276</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT012</BillingCode>
            <Name>SOLFIX2 Rods</Name>
            <Description>Rods (straight soft rods, straight hard rods)</Description>
            <Size>Diameter: 5.5mm, 6mm,  Length: 35mm - 500mm</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>320880</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB005</BillingCode>
            <Name>Lumfix Rod</Name>
            <Description>Rod, Strasight, Curved  with or without end stop. Titanium or coCr</Description>
            <Size>(5.5 - 6.0)mm diameter x (35-500)mm length </Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1478</GroupID>
            <ARTGs>
                <ARTG>327225</ARTG>
            </ARTGs>
            <MinimumBenefit>373</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH457</BillingCode>
            <Name>DSS Fusion Coupler</Name>
            <Description>The DSS Fusion Coupler is a telescoping coupler that rigidly joins the DSS pedicle screws.</Description>
            <Size>20mm - 22mm
22mm - 25mm
25mm - 31mm
31mm - 43mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1479</GroupID>
            <ARTGs>
                <ARTG>151022</ARTG>
            </ARTGs>
            <MinimumBenefit>1145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Unit Rods</Name>
            <Description>Katana Unit Rods</Description>
            <Size>200 - 500mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4132</SubGroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB078</BillingCode>
            <Name>REVERE Rods, Dual Unit</Name>
            <Description>Scoliosis Rods</Description>
            <Size>5.5mm - 6.35mm 450mm - 500mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4132</SubGroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC537</BillingCode>
            <Name>Danek Unit Rod System</Name>
            <Description>Scoliosis Rods</Description>
            <Size>5.5mm to 6.35mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4132</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY384</BillingCode>
            <Name>Speciality Rods</Name>
            <Description>Unit Rod, Titanium / Stainless Steel</Description>
            <Size>5mm, 6mm diameter
250mm - 500mm length</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4132</SubGroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>1352</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER318</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Rods, occipital</Name>
            <Description>Ulrich posterior OCT System (neon3)-Rods, occipital, various shapes</Description>
            <Size>dia 4 mm x length (240-300 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4133</SubGroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>1711</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC019</BillingCode>
            <Name>KM Occipital Plate</Name>
            <Description>Occipital Plate Rod</Description>
            <Size>3-5mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4133</SubGroupID>
            <ARTGs>
                <ARTG>201492</ARTG>
            </ARTGs>
            <MinimumBenefit>1711</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB163</BillingCode>
            <Name>QUARTEX Occipital Jointed Rod</Name>
            <Description>Occipital Jointed Rods</Description>
            <Size>Left and Right, 4mm -Left and Right</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4133</SubGroupID>
            <ARTGs>
                <ARTG>190061</ARTG>
            </ARTGs>
            <MinimumBenefit>1711</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM428</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK104</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pre-Bent rods</Name>
            <Description>Pre-Bent rods</Description>
            <Size>3.5mm diameter rods</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4133</SubGroupID>
            <ARTGs>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>1711</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI271</BillingCode>
            <Name>Infinity Spinal System</Name>
            <Description>Occipital Hinged Rod</Description>
            <Size>Length 100 - 200mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4133</SubGroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1711</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV101</BillingCode>
            <Name>Vuepoint (Hinged Rod)</Name>
            <Description>The VuePoint OCT System is intended to promote fusion of the cervical spine and occipito-thoracic junction (Occiput-T3), and is indicated for; 1: Degenerative disc disease (as defined by back pain of discogenic origin with degeneration of the disc confimred by patient history and radiographic studies), 2: Degenerative spondylolisthesis with objective evidence of neurologic impairment, 3: Fractur/Dislocation, 4: Spinal Stenosis, 5: Atlantaxial fracture with instability, 6; Occipitocervical dislocation, 7: Spinal tumor and/or 8: revision of previous cervical spine surgery</Description>
            <Size>one size only</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4133</SubGroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1711</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW036</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI915</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Virage Occipital Rod</Name>
            <Description>Occipital Hinged Rod</Description>
            <Size>One size</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1480</GroupID>
            <SubGroupID>4133</SubGroupID>
            <ARTGs>
                <ARTG>111775</ARTG>
            </ARTGs>
            <MinimumBenefit>1711</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV147</BillingCode>
            <Name>MAGEC Spinal Bracing and Distraction System</Name>
            <Description>Magnetically controlled growing rods</Description>
            <Size>Actuator length: 70-90.mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>170</SubCategoryID>
            <GroupID>1826</GroupID>
            <ARTGs>
                <ARTG>231043</ARTG>
            </ARTGs>
            <MinimumBenefit>13696</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER320</BillingCode>
            <Name>Ulrich posterior OCT System (neon3)-Plate-rod</Name>
            <Description>Ulrich posterior OCT System (neon3)-Occipital plate, lateral, with rod</Description>
            <Size>One size</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>171</SubCategoryID>
            <GroupID>1481</GroupID>
            <ARTGs>
                <ARTG>279706</ARTG>
            </ARTGs>
            <MinimumBenefit>2343</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC543</BillingCode>
            <Name>Vertex Spinal System</Name>
            <Description>Plate/rod</Description>
            <Size>80 - 240mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>171</SubCategoryID>
            <GroupID>1481</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>2343</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY184</BillingCode>
            <Name>Posterior Cervical Plate System</Name>
            <Description>Plate - rod</Description>
            <Size>Special Manufacture - One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>171</SubCategoryID>
            <GroupID>1481</GroupID>
            <ARTGs>
                <ARTG>155808</ARTG>
            </ARTGs>
            <MinimumBenefit>2343</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY445</BillingCode>
            <Name>CerviFix Posterior Cervical System</Name>
            <Description>Occipital Plate Rod</Description>
            <Size>one size</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>171</SubCategoryID>
            <GroupID>1481</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>2343</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER594</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF072</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Blackstone Washers</Name>
            <Description>Titanium</Description>
            <Size>2mm, 3mm, 4mm, 5mm, 6mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>195012</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW024</BillingCode>
            <Name>WEGO Spinal Systems</Name>
            <Description>Washer</Description>
            <Size>Various</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW739</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ARI Anterior Staple System - Washer</Name>
            <Description>The ARI Anterior Staple System - washer</Description>
            <Size>One size only</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ649</BillingCode>
            <Name>Washer &amp; Single Hole Staple - Expedium Anterior Spine System</Name>
            <Description>Washer and Single Hole Staple - Titanium</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ770</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Washer</Description>
            <Size>Various</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ830</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Washers - slotted / angled</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>128256</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB032</BillingCode>
            <Name>REVERE Blocking Plate, Anterior Screw</Name>
            <Description>Blocking Plate</Description>
            <Size>One Size</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB168</BillingCode>
            <Name>REVERE Anterior Staple System - Washer</Name>
            <Description>Washers and Stackable Washers</Description>
            <Size>5.5mm - 8.5mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH451</BillingCode>
            <Name>DSS Spacer</Name>
            <Description>The DSS Spacer is an integral component of the DSS pedicle screw construct. It is used on the mono-axial DSS screw and is used each time a screw is placed. It can not be used on its own.</Description>
            <Size>One size only</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>151022</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH453</BillingCode>
            <Name>DSS Washer</Name>
            <Description>The DSS Washer is a washer that is an integral part of the DSS construct. The DSS construct can  not be used without the washer nor can the washer be used as a separate implant.</Description>
            <Size>One size only</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>151022</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM424</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK047</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Silex Washer</Name>
            <Description>Silex Washer</Description>
            <Size>13mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>228758</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM466</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Silex Sacroiliac Joint Fusion System</Name>
            <Description>Washers for the Silex Sacroiliac Joint Fusion System</Description>
            <Size>11, 13 &amp; 15mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>228758</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI463</BillingCode>
            <Name>PASS Spinal System</Name>
            <Description>Sacral Plate</Description>
            <Size>one size</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>295277</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH584</BillingCode>
            <Name>Venus - Spinal Fixation System - Washers</Name>
            <Description>Venus Washers</Description>
            <Size>STD, SP</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>316187</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ034</BillingCode>
            <Name>Centaur Screw System, Centaur Washer</Name>
            <Description>Washer</Description>
            <Size>1 size</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY150</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Washers</Description>
            <Size>Pointed, Flat, 4.2 - 7mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1482</GroupID>
            <ARTGs>
                <ARTG>133921</ARTG>
            </ARTGs>
            <MinimumBenefit>218</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN157</BillingCode>
            <Name>Viper Spinal System</Name>
            <Description>Polyaxial washer with barb</Description>
            <Size>13 to 19mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>178040</ARTG>
            </ARTGs>
            <MinimumBenefit>1148</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GW029</BillingCode>
            <Name>WEGO Spinal Systems</Name>
            <Description>Staple</Description>
            <Size>Various</Size>
            <SupplierCode>GW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>330363</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW738</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ARI Anterior Staple System - Staple</Name>
            <Description>A non-cervical anterolateral thoracolumbar screw stabilization as an adjunct to fusion.</Description>
            <Size>Single Hole Design and Dual Hole Design: 13mm, Left &amp; Right; 16mm, Left &amp; Right; 18mm, Left &amp; Right.</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW774</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER475</PriorBillingCode>
            </PriorBillingCodes>
            <Name>KEYS Anterior Staple</Name>
            <Description>Staple</Description>
            <Size>13-18mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>154442</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV019</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Katana Staple</Name>
            <Description>The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine.</Description>
            <Size>13-25mm, Caudal, Rostral, Single</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ643</BillingCode>
            <Name>Dual Hole Staple - Expendium Anterior Spine System</Name>
            <Description>Dual Hole Staple - Titanium</Description>
            <Size>Small to Xlarge - 4 sizes</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ657</BillingCode>
            <Name>Single Hole Staple - Expedium Anterior Spine System</Name>
            <Description>Single Hole Staple - Titanium</Description>
            <Size>One Size Only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ771</BillingCode>
            <Name>Expedium Spine System</Name>
            <Description>Staple</Description>
            <Size>Various</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>97391</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ829</BillingCode>
            <Name>Moss Miami (Titanium)</Name>
            <Description>Staple Washer</Description>
            <Size>One size only</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>128256</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB031</BillingCode>
            <Name>REVERE Integrated Staple Head Plate</Name>
            <Description>Integrated Staple Head Plate</Description>
            <Size>small, medium, large, x-large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB166</BillingCode>
            <Name>REVERE Anterior Dual Staple</Name>
            <Description>Dual Anterior Staple constructed of Titanium Alloy</Description>
            <Size>small, medium, large, x-large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB167</BillingCode>
            <Name>REVERE Anterior Single Staple</Name>
            <Description>Single anterior staple constructed of Titanium Alloy</Description>
            <Size>small, medium, large</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB181</BillingCode>
            <Name>REFLECT Staple</Name>
            <Description>Three prong threaded staple</Description>
            <Size>5.0 mm - 7.5 mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>190039</ARTG>
            </ARTGs>
            <Note>The Prostheses List (PL) billing code does not cover the use of the device for vertebral body tethering (VBT) for the management of adolescent idiopathic scoliosis (AIS).</Note>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC437</BillingCode>
            <Name>CD-Horizon</Name>
            <Description>Staples</Description>
            <Size>10 - 30mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC614</BillingCode>
            <Name>Vantage</Name>
            <Description>Vantage Plates and Screws; Staple (rostral/caudal)</Description>
            <Size>One Size Only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW037</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA050</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ROI-A Anchoring Plates</Name>
            <Description>A pair of titanium anchoring plates to serve as integral fixation within the ROI-A ALIF Cage</Description>
            <Size>Large - Plate length 27mm  Medium - Plate length 24mm  Small - Plate length 20mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>188175</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW038</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA051</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ROI-C Anchoring Plates</Name>
            <Description>A pair of titanium plates to serve as integral fixation within the ROI-C Cervical Cage</Description>
            <Size>Short  Long</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>188175</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ044</BillingCode>
            <Name>Centaur Screw System, Centaur Staple</Name>
            <Description>Staple</Description>
            <Size>small - extra large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK242</BillingCode>
            <Name>Xia Spinal System</Name>
            <Description>Titanium or Stainless Steel</Description>
            <Size>Single Hole Staple; Dual Hole Staples (Caudal/Rostral) - Small, Medium, Large</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>172</SubCategoryID>
            <GroupID>1483</GroupID>
            <ARTGs>
                <ARTG>94635</ARTG>
            </ARTGs>
            <MinimumBenefit>380</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC436</BillingCode>
            <Name>CD-Horizon</Name>
            <Description>C-ring</Description>
            <Size>One size only</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>173</SubCategoryID>
            <GroupID>1484</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>317</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY145</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Half Ring</Description>
            <Size>SS, Standard, Self-Holding</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>173</SubCategoryID>
            <GroupID>1484</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>317</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY360</BillingCode>
            <Name>Universal Spine System (USS)</Name>
            <Description>Half Ring</Description>
            <Size>SS, Standard, Self-Holding</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>173</SubCategoryID>
            <GroupID>1484</GroupID>
            <ARTGs>
                <ARTG>133401</ARTG>
            </ARTGs>
            <MinimumBenefit>317</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF022</BillingCode>
            <Name>Redmond Cervical Cage</Name>
            <Description>Stand-alone cervical interbody fusion cage with locking cap</Description>
            <Size>14mm L x 15mm W; 5mm - 12mm H&#xD;
15mm L x 15mm W; 5mm - 12mm H&#xD;
15mm L x 17mm W; 5mm - 12mm H</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE662</BillingCode>
            <Name>Shoreline ACS NoProfile Cage</Name>
            <Description>Cervical cage with no anterior profile</Description>
            <Size>Footprints: 16 x 14mm and 18 x 15mm&#xD;
Heights: 6 -12 mm&#xD;
7 Degrees Lordosis</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR031</BillingCode>
            <Name>Hygro-C Integrated ACDF </Name>
            <Description>Integrated ACDF Cage with screws for Integral Fixation</Description>
            <Size>14mm-16mm x 16mm-19mm x 4mm-9mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>330365</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR040</BillingCode>
            <Name>Tesera SC </Name>
            <Description>Integrated Fusion Cage</Description>
            <Size>Foot Print (16-19mm) Wide x (13.5 - 16mm) Deep x (5-12mm) Height,  2-12 Degrees Lordosis</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>354092</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU011</BillingCode>
            <Name>Scarlet AC-T Cervical Cage</Name>
            <Description>Cervical cage - anatomical, lordotic</Description>
            <Size>Height: 5mm, 6mm, 7mm, 8mm, 9mm, 10mm&#xD;
Footprint: 12 x 15mm (Small); 14 x 17mm (Large)</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU066</BillingCode>
            <Name>Tryptik MC cage/plate/screw</Name>
            <Description>Integrated titanium anterior fixation plate with screws and PEEK cage</Description>
            <Size>Cage: Height: 5mm, 6mm, 7mm.  Depth: 12mm, 14mm.    Screws: Dia.: 4 and 4.5 mm. Length: 12 to 18 mm.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER595</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF054</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Lonestar Cervical Stand Alone System Cage</Name>
            <Description>The Lonestar Cervical Stand Alone device is a stand-alone cervical cage system consisting of cages, screws and a anti-backout cover plate. The Lonestar is manufactured from PEEK and Titanium with Titanium Bone Screws.</Description>
            <Size>15mm W x 13mm L. Parallel &amp; &amp; degree lordotic. 6-14mm H in 1mm increments  15mm W x 15mm L. Parallel &amp; &amp; degree lordotic. 6-14mm H in 1mm increments  17mm W x 13mm L. Parallel &amp; &amp; degree lordotic. 6-14mm H in 1mm increments  17mm W x 15mm L. Parallel &amp; &amp; degree lordotic. 6-14mm H in 1mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EV013</BillingCode>
            <Name>Cato ACDF Standalone Cage</Name>
            <Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>Medium, Large – 6°, 9° and 12°, height 4-10mm</Size>
            <SupplierCode>EV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>248234</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY034</BillingCode>
            <Name>Dakota ACDF System</Name>
            <Description>Dakota ACDF System comprising of ACDF cage, ACDF plate, locking screw, bone screw</Description>
            <Size>5mm to 12mm heights</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>317596</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC024</BillingCode>
            <Name>Perfect-C</Name>
            <Description>The Perfect-C implant is a stand-alone anterior cervical interbody fusion device.</Description>
            <Size>Height - 5mm - 8mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>262490</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW518</BillingCode>
            <Name>AVS Anchor C Cervical Cage System</Name>
            <Description>Standalone Cervical Cage</Description>
            <Size>12 x 14mm, 14 x 16mm, height range ;  6mm-12 mm.) 0, 4 and 8 degree angulation</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>315081</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW747</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER137</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Chesapeake Cervical</Name>
            <Description>Cage with intergral fixation</Description>
            <Size>Height: 5mm - 15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>159146</ARTG>
                <ARTG>193652</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW771</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER472</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Chesapeake Cervical PEEK</Name>
            <Description>Cervical fusion cage with integrated fixation</Description>
            <Size>Heights 5-12mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>159146</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IB001</BillingCode>
            <Name>STACC Cervical Cage</Name>
            <Description>PEEK Stand alone interbody fusion cage</Description>
            <Size>5.5, 6.5, 7.5, 8.5 (Height) x 14mm (Width)</Size>
            <SupplierCode>IB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>188902</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV026</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Revolution Standalone ACDF cage</Name>
            <Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>Standard – 6 and 9 degrees, height 4-10mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>236042</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HRCc Cervical Locking Cage</Name>
            <Description>Cervical Locking Cage</Description>
            <Size>Size 4 to 9  Standard and Large</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>322672</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif C</Name>
            <Description>Interbody Fusion Cage - Domed</Description>
            <Size>5.5 - 9.5</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif C</Name>
            <Description>Interbody Fusion Cage - Tapered</Description>
            <Size>5.5 – 9.5</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif</Name>
            <Description>Cervical Interbody Fusion Cage - Lordotic(Tapered)/Anatomic(Domed)</Description>
            <Size>Depth 12 - 16mm, Height 5.5 - 11.5mm</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB065</BillingCode>
            <Name>COALITION Spacer</Name>
            <Description>ACDF Spacer</Description>
            <Size>12mm x 14mm, 14mm x 16mm and 15mm x 18mm ,5mm - 12mm height</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>190040</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB207</BillingCode>
            <Name>HEDRON IC</Name>
            <Description>3D Printed Integrated ACDF Plate-Spacer including screws</Description>
            <Size>Footprint: 12X14, 14X16, 15X18mm  Height: 5-12mm  Screws 3.6-4.2mm, 12-20mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>353400</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH587</BillingCode>
            <Name>Cervical Spine Truss System - Stand Alone Cage</Name>
            <Description>Cage and optional locking plate/locking screw</Description>
            <Size>cage 6 - 12mm height, screw locking plate 6-12mm height.</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM411</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IRIX - C Implants</Name>
            <Description>Cervical intergrated fusion system</Description>
            <Size>18 x 14mm and 16 x 13mm; Heights 5 - 12mm; Shape - Lordotic and parallel</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI154</BillingCode>
            <Name>Divergence Anterior Cervical Fusion Standalone System</Name>
            <Description>Divergence anterior cervical fusion Standalone interbody device</Description>
            <Size>5-10mm height</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI327</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER470</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Endoskeleton TCS</Name>
            <Description>Titanium Stand Alone ADCF Cage, sterile or non-sterile also with Nanolock™ surface technology, sterile</Description>
            <Size>12-16mm Length, 14-18mm Width, 5-12mm Heights</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>315580</ARTG>
                <ARTG>285244</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI482</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK152</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cervical Fusion Cage</Name>
            <Description>Cervical Fusion Cage</Description>
            <Size>Multiple sizes for patient anatomy</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>340293</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU177</BillingCode>
            <Name>Mecta-C Stand Alone System</Name>
            <Description>TiPEEK Anterior cervical cages + screws</Description>
            <Size>Height: from 5 mm to 12 mm in 1 mm increments  15 mm x 13 mm, 16 mm x 14 mm, 18 mm x 15 mm  7° lordosis</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>333435</ARTG>
                <ARTG>222456</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV103</BillingCode>
            <Name>CoRoent Small Interlock (cage)</Name>
            <Description>The CoRoent Small Interlock System is a stand-alone anterior cervical interbody fusion system indicated for use in skeletally mature patients with degenerative disc disease (DDD) at one level from C2-T1.</Description>
            <Size>Width 14-18mm x length 10-14mm x Height 5-16mm x Lordosis 0-20˚</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW039</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA052</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ROI-C Cervical Cage</Name>
            <Description>A cervical cage for anterior approaches to cervical spine</Description>
            <Size>Footprints 12x14, 12x15.5, 14x14, 14x15.5; 14x17mm; Heights 4.5mm to 10mm</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>188176</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB006</BillingCode>
            <Name>DCS System</Name>
            <Description>Anterior cervical interbody fusion system</Description>
            <Size>Cage Height: 5/6/7/8/9/10/11/12 mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>214788</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC005</BillingCode>
            <Name>Alias Cage</Name>
            <Description>PEEK Fusion Cage with Plasma coating</Description>
            <Size>5-9mm, 4, 8 and 12 degree, Flat and contoured options</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>268893</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC013</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BF022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Redmond Cervical Cage</Name>
            <Description>Stand-alone cervical interbody fusion cage with locking cap</Description>
            <Size>14mm L x 15mm W; 5mm - 12mm H  15mm L x 15mm W; 5mm - 12mm H  15mm L x 17mm W; 5mm - 12mm H</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif C</Name>
            <Description>Interbody Fusion Cage - Domed</Description>
            <Size>5.5 - 9.5</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif C</Name>
            <Description>Interbody Fusion Cage - Tapered</Description>
            <Size>5.5 – 9.5</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA031</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif</Name>
            <Description>Cervical Interbody Fusion Cage - Lordotic(Tapered)/Anatomic(Domed)</Description>
            <Size>Depth 12 - 16mm, Height 5.5 - 11.5mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ046</BillingCode>
            <Name>Borealis Spine System</Name>
            <Description>Cervical Cage IF</Description>
            <Size>Extra small - Extra Large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF104</BillingCode>
            <Name>Alias Cage</Name>
            <Description>Titanium or PEEK Fusion Cage with Plasma coating</Description>
            <Size>5-9mm, 4, 8 and 12 degree, Flat and countoured options</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY752</BillingCode>
            <Name>Zero-P</Name>
            <Description>Anterior Cervical Interbody Fusion System</Description>
            <Size>5-12mm Height</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT003</BillingCode>
            <Name>SPICCA-S2 Anterior Cervical Fusion Cage</Name>
            <Description>Anterior cervical fusion cage; PEEK, Titanium coated PEEK, or 3D printed Titanium.</Description>
            <Size>Footprints: 15mm x 14mm, 17.5mm x 15mm, 19.5mm x 17mm; Height: 4mm - 10mm; Lordosis: 7 or 12 degrees.</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5485</SubGroupID>
            <ARTGs>
                <ARTG>320878</ARTG>
                <ARTG>322720</ARTG>
            </ARTGs>
            <MinimumBenefit>4162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB346</BillingCode>
            <Name>Arcadius L Stand-Alone Interbody Device</Name>
            <Description>Titanium Coated PEEK ALIF CAGE</Description>
            <Size>4 degree, 9 degree &amp; 14 degree lordosis with width 35mm x Depth 25mm X Height 10/12/14/16/18/20mm.&#xD;
4 degree, 9 degree &amp; 14 degree lordosis with Width 40mm x Depth 29mm x Height 10/12/14/16/18/20mm.</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>122641</ARTG>
                <ARTG>221528</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF013</BillingCode>
            <Name>Redmond Lumbar Cage System - Fusion Cage</Name>
            <Description>PEEK titanium ALIF</Description>
            <Size>Height: 12, 14, 16, 18, 20mm&#xD;
Width: 28, 34, 36, 39, 43mm&#xD;
Length: 24, 27, 30, 32mm&#xD;
Angle: 6º, 12º, 18º</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE640</BillingCode>
            <Name>Zuma implant with integral plate</Name>
            <Description>PEEK Interbody cage with integral plate</Description>
            <Size>26mm x 24mm, 32mm x 25mm, 38mm x 26mm Height 10mm - 18mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>275780</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE652</BillingCode>
            <Name>Vu aPOD Prime NanoMetalene ALIF Cage</Name>
            <Description>PEEK titanium ALIF with NanoMetalene surface technology</Description>
            <Size>Height: 10,12,14,16, 18 and 20mm &#xD;
Lordosis : 10, 15, 20 and 30 degrees &#xD;
Footprints: 31 x 24mm, 35 x 27mm, 39 x 30mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR027</BillingCode>
            <Name>Hygro-L Stand-alone ALIF</Name>
            <Description>Integrated Titanium ALIF cage with Screws for Integral Fixation</Description>
            <Size>Length (32-38mm) x width (24.5-29mm); heights (12-24mm); lordotic angle (9-27) degrees</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>330365</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR037</BillingCode>
            <Name>Tesera SA</Name>
            <Description>Integrated Fusion Cage</Description>
            <Size>Foot Print (30-42mm)x(26-32mm); Height 11-21mm, Lordosis 7-28 Degrees</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>354092</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU037</BillingCode>
            <Name>Scarlet AL-T Secured Lumbar Cage</Name>
            <Description>Secured Lumbar Cage</Description>
            <Size>Small, Medium and Large Footprint&#xD;
Height 10-18mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER277</BillingCode>
            <Name>Spineway Kili Lumbar Fusion Cage System-Cage</Name>
            <Description>Spineway Kili lumbar fusion cage  </Description>
            <Size>Height (7-15mm) x Width (26-36mm) x Depth (21-29mm) x Angle (2-12 degrees)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>235415</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER538</BillingCode>
            <Name>Signus BIG ST – Lumbar Cage and fixation screws system</Name>
            <Description>ALIF Lumbar Cage and fixation screws</Description>
            <Size>10 – 20mm : 8 deg 12 deg 16deg &amp; 20deg</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER596</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF074</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PILLAR SA PTC</Name>
            <Description>ALIF cage constructed of PEEK Titanium composite (PTC) with cover plate</Description>
            <Size>Width - 33mm to 43mm  Depth/Length - 28mm  Height - 12mm to 20mm  Cover Plate - 33mm to 43mm  Lordosis - 7 to 12 degrees</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER597</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF075</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PILLAR SA</Name>
            <Description>ALIF Cage constructed of PEEK with titanium cover plate</Description>
            <Size>Width - 33mm to 43mm  Length/Depth - 28mm to 32mm  Height - 12mm to 20mm  Lordosis - 7 degrees to 12 degrees  Coverplate - 33mm-43mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EV036</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF157</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Tora Cage</Name>
            <Description>Anterior Lumbar Cage with integral fixation (PEEK, HA PEEK, Titanium, Porous Titanium)</Description>
            <Size>Angle 0 - 12 degrees, Length 40 - 60mm, Height 8 - 16mm</Size>
            <SupplierCode>EV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>248234</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY039</BillingCode>
            <Name>Dakota ALIF construct</Name>
            <Description>Anterior lumbar fusion device:  construct containing Dakota ALIF Cage, integrated faceplate and screw</Description>
            <Size>11mm to 19mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>317596</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW512</BillingCode>
            <Name>Anchor-L Lumbar Cage System, Anterior Lumbar Interbody Cage</Name>
            <Description>Anterior Lumbar Interbody Cage</Description>
            <Size>Footprints; 22x30mm, 25x35mm, 28x40mm  Heights 10-20mm (2mm incr.)  Lordosis 4°,8°,12°,16°</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>278558</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW678</BillingCode>
            <Name>Monterey AL, Cage with integral fixation </Name>
            <Description>ALIF cage with integral fixation</Description>
            <Size>10-24mm </Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>356926</ARTG>
            </ARTGs>
            <Note>This billing code is for Monterey AL Cage but only when it is used with screws to achieve integral fixation.’&#xD;
It was noted that when the cage is used without screws it should be listed on PL in the grouping 13.10.02.02 Spinal, Fusion cage, interbody, no integral fixation, ThoracoLumbar/Lumbar.</Note>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW743</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Chesapeake Spinal System</Name>
            <Description>Thoracolumbar Cage Peek/Ti</Description>
            <Size>Footprint: 24mm - 30mm x 30mm - 40mm  Height: 11mm - 21mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>159146</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY030</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution ALIF Cage</Name>
            <Description>ThoracoLumbar ALIF Cage</Description>
            <Size>Small (34x25mm) 8 - 18 degrees, 10 - 18mm  Medium (38x29mm) 8 - 18 degrees, 10 - 18mm  Medium Long (38x34mm) 8 - 18 degrees, 10 - 18mm  Large (42x30mm) 8 - 18 degrees, 10 - 18mm  X Large (42x34mm) 8 - 18 degrees, 10 - 22mm  XX Large (42x38mm) 13 degrees, 12 - 18mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>248234</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY031</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV016</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution TM2 Cage</Name>
            <Description>Thoraco Lumbar ALIF cage</Description>
            <Size>standard</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>248234</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY032</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV030</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution Altus ALIF Cage</Name>
            <Description>ThoracoLumbar ALIF Cage</Description>
            <Size>Small (34x25mm) 8 - 18 degrees, 10 - 18mm  Medium (38x30mm) 8 - 18 degrees, 10 -  18mm  Medium Long (38x34mm) 8 - 18 degrees, 10 -  18mm  Large (42x30mm) 8 - 18 degrees, 10 - 18mm  X Large (42x34mm) 8 - 18 degrees, 10 - 22mm  XX Large (42x38mm) 13 degrees, 12 - 18mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>236042</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA028</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif</Name>
            <Description>Lumbar/Thoracolumbar Interbody Fusion Cage</Description>
            <Size>W: 30-42mm H: 11-21mm Lordosis: 8-20°</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif Midline II Ti</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>30-42</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB001</BillingCode>
            <Name>Independence Spacer</Name>
            <Description>Spacer with integral plate</Description>
            <Size>small (24 X30mm), medium (26 X 34mm), large (29mm X 39mm) 8,15, 20, 25 and 30 deg 11mm – 25mm height</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>190071</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB171</BillingCode>
            <Name>ELSA Expandable Lateral Interbody Fusion Spacer</Name>
            <Description>Expandable lateral interbody fusion spacer with integrated fixation</Description>
            <Size>Height (unexpanded): 7-11mm&#xD;
Height (expanded): 14-20mm&#xD;
Length: 40-65mm&#xD;
Width: 20mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB175</BillingCode>
            <Name>ELSA ATP</Name>
            <Description>Anterior-to-Psoas Expandable Lumbar Spacer</Description>
            <Size>Width: 20mm&#xD;
Length - 40mm-65mm&#xD;
Unexpanded Height - 7-10mm&#xD;
Expanded Height - 14mm-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB206</BillingCode>
            <Name>HEDRON IA</Name>
            <Description>3D Printed Integrated ALIF Spacer including screws/anchor</Description>
            <Size>Spacer  Footprint: 24X30, 26X34, 29X39mm  Height: 11-21mm        Screws/Anchor: Diameter 5.5mm, Length 20-40mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>353398</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH715</BillingCode>
            <Name>Integrated Anterior Lumbar Spine Truss Cage</Name>
            <Description>Cage with integral fixation</Description>
            <Size>8-20mm heights</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM420</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK043</PriorBillingCode>
            </PriorBillingCodes>
            <Name>IRIX-A Implant</Name>
            <Description>Lumbar Integrated Fusion System.</Description>
            <Size>33mm x 26mm, 38mm x 28mm, 42mm x 30mm at 8 degrees and 12 degrees.</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>238872</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM512</BillingCode>
            <Name>Stand-Alone ALIF System including screws for integral fixation</Name>
            <Description>Stand-Alone ALIF System including screws for integral fixation</Description>
            <Size>10-20mm (H) x 30, 36, 40mm (W) x 8°, 14°, 20°, 30° </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>367230</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM514</BillingCode>
            <Name>ALIF Cage construct including screws and cover plate for integral fixation</Name>
            <Description>ALIF Cage construct including screws and cover plate for integral fixation</Description>
            <Size>Cage 10 - 20mm (H) x 20, 26, 40mm (W) x 8°, 14°, 20°, 30°  Screws 5.5mm, 20-30  Cover Plate Small, Large</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>367230</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC987</BillingCode>
            <Name>Sovereign Spinal System - Interbody Spacer</Name>
            <Description>Sovereign Spinal System - Interbody Spacer with Coverplate</Description>
            <Size>Small - 32mm x 23mm, Medium - 37mm x 27mm, Large - 42mm x 30mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI326</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER469</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Endoskeleton TAS</Name>
            <Description>Titanium  lumbar cage with integrated fixation, sterile or non-sterile also with  NanoLock™ surface technology, sterile  .</Description>
            <Size>10-17mm Height, 32-40mm x 21-27mm Width, 7˚-24˚ Angles</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>315580</ARTG>
                <ARTG>285244</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU121</BillingCode>
            <Name>MectaLIF Anterior Stand-Alone TiPEEK Cages.</Name>
            <Description>TiPEEK Anterior Interbody cage with integral plate.</Description>
            <Size>24mm x 31mm, 27mm x 35mm, 30mm x 35mm, 30mm x 40mm. Height 10-18 in 2mm increments.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>207288</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU122</BillingCode>
            <Name>MectaLIF Anterior Stand-Alone PEEK Cages</Name>
            <Description>PEEK Anterior Stand-Alone PEEK Cage</Description>
            <Size>24mm x 31mm, 27mm x 35mm, 30mm x 35mm and 30mm x 40mm. Height: 10-18mm in 2mm increments</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>207288</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV071</BillingCode>
            <Name>Brigade (implant)</Name>
            <Description>Interbody fusion implant</Description>
            <Size>4-20mm x 34-42mm x 24-32mm, 0-30 degrees</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV170</BillingCode>
            <Name>Modulus ALIF</Name>
            <Description>Integrated fixation lumbar fusion cage including bolts.</Description>
            <Size>Cage: 6-12mm X 34-42mm X 24-32mm  Bolt: Diameter 5-6mm, Length 15-30mm        </Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW040</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA053</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ROI-A ALIF Cage</Name>
            <Description>The ROI-A implant is an ALIF interbody/fusion cage manufactured from PEEK-Optima.  If the surgeon so chooses, additional stability can be added to the construct by inserting optional self-guided, locking anchoring plates into the cage and the adjacent vertebral bodies.</Description>
            <Size>Footprints 23x26mm, 30x33mm, 33x36m, 27x36mm, 30x39mm. Lordosis angles 2, 6, 10, 14 degrees. Heights 9-19mm. 1 cage per pack.</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>188176</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC004</BillingCode>
            <Name>Advantage Cage</Name>
            <Description>Plasma Coated PEEK Cage</Description>
            <Size>Small, medium, Medium Wide, Large, Extra Large</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>268893</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BF013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Redmond Lumbar Cage System - Fusion Cage</Name>
            <Description>PEEK titanium ALIF</Description>
            <Size>Height: 12, 14, 16, 18, 20mm  Width: 28, 34, 36, 39, 43mm  Length: 24, 27, 30, 32mm  Angle: 6º, 12º, 18º</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SF157</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Nik-Alias Cage</Name>
            <Description>Anterior Lumbar Cage with integral fixation (PEEK, HA PEEK, Titanium, Porous Titanium)</Description>
            <Size>Angle 0 - 12 degrees, Length 40 - 60mm, Height 8 - 16mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA028</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif</Name>
            <Description>Lumbar/Thoracolumbar Interbody Fusion Cage</Description>
            <Size>W: 30-42mm H: 11-21mm Lordosis: 8-20°</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA029</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Stalif Midline II Ti</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>30-42</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ045</BillingCode>
            <Name>Australis Spine System</Name>
            <Description>Thoracolumbar Cage IF</Description>
            <Size>extra small - extra large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF098</BillingCode>
            <Name>Advantage Cage</Name>
            <Description>PEEK Cage</Description>
            <Size>Small, medium, Medium Wide, Large, Extra Large</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF157</BillingCode>
            <Name>Nik-Alias Cage</Name>
            <Description>Anterior Lumbar Cage with integral fixation (PEEK, HA PEEK, Titanium, Porous Titanium)</Description>
            <Size>Angle 0 - 12 degrees, Length 40 - 60mm, Height 8 - 16mm</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY298</BillingCode>
            <Name>SynFix Spinal System</Name>
            <Description>Interbody fusion cage prefilled or unfilled</Description>
            <Size>5mm to 19mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY801</BillingCode>
            <Name>SynFix Spinal System</Name>
            <Description>Evolution, Interbody Fusion Spacer</Description>
            <Size>10.5mm - 19mm, small - large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT005</BillingCode>
            <Name>SASCA-2 ALIF Cage</Name>
            <Description>Anterior lumber interbody fusion screw cage; PEEK, Titanium coated PEEK, or 3D printed Titanium.</Description>
            <Size>Footprints: 37mm x 27mm, 41mm x 28mm; Height: 8mm - 18mm; Lordosis: 8, 15 or 20 degrees.</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1485</GroupID>
            <SubGroupID>5486</SubGroupID>
            <ARTGs>
                <ARTG>320878</ARTG>
                <ARTG>322720</ARTG>
            </ARTGs>
            <MinimumBenefit>5949</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB278</BillingCode>
            <Name>Aesculap Interbody Cage</Name>
            <Description>ACDF Interbody cage</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>122641</ARTG>
                <ARTG>273761</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF012</BillingCode>
            <Name>Vigor PEEK Cervical Disc Spacer</Name>
            <Description>PEEK cervical spine disc spacer</Description>
            <Size>Height: 5mm, 6mm, 7mm, 8mm, 9mm, 10mm&#xD;
Width: 12mm, 13mm, 14mm, 15mm, 16mm, 17mm&#xD;
Length: 12mm, 14mm, 16mm&#xD;
Angulation: 0°, 5°</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF018</BillingCode>
            <Name>Combo Cervical Cage</Name>
            <Description>Combination titanium PEEK cervical cage</Description>
            <Size>Height: 5, 6, 7, 8, 9, 10mm&#xD;
Width: 12, 13, 14, 15, 16, 17mm&#xD;
Length: 12, 14mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP004</BillingCode>
            <Name>PEEK Interbody system – Cervical</Name>
            <Description>ACIF Implants; Sterile and Non Sterile</Description>
            <Size>Diameter 14mm; 16mm: &#xD;
Height (5mm, - 12mm): &#xD;
Lordosis Angle 0 - 7.5 degrees: &#xD;
Curevd , Straight</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP008</BillingCode>
            <Name>TiPEEK Interbody system – Cervical</Name>
            <Description>ACIF Implants; Sterile&#xD;
Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®)</Description>
            <Size>Size: small, standard, large, extra large&#xD;
Width 12.5mm – 19mm&#xD;
Length 11.5mm – 16mm&#xD;
Height 5-12mm: &#xD;
Lordosis Angle 0 - 20°: &#xD;
Curved, Straight, Convex</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE561</BillingCode>
            <Name>icotec ACDF Cage</Name>
            <Description>Cervical Fusion Cage</Description>
            <Size>Width: 13mm, 16mm and 18mm, &#xD;
Height: 5mm - 10mm,&#xD;
Depth: 13mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>283852</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE592</BillingCode>
            <Name>Cambria Cervical Interbody Cage</Name>
            <Description>Cambria NanoMetalene Cervical Interbody Cage</Description>
            <Size>13x12mm, 15x13mm &amp;17x13mm footprints  5-12mm height</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE658</BillingCode>
            <Name>Shoreline ACS TruProfile Cage</Name>
            <Description>Cervical ACDF Cage</Description>
            <Size>Footprints: 14 x 13mm, 16 x 14mm, 18 x 15mm and 20 x 15mm  Lordosis: 7, 10 and 15 degrees  Heights: 5,6,7,8,9,10,11 and 12mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP514</BillingCode>
            <Name>Brantigan I/F Cage</Name>
            <Description>Cervical Brantigan Cage</Description>
            <Size>Standard/Large 4-10mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR025</BillingCode>
            <Name>Hygro-C ACDF Cage</Name>
            <Description>Hygro-C Titanium ACDF Cage</Description>
            <Size>Length (13.7mm) x Width (16.5-19.1mm) x Height (4-9mm); Lordotic angle 6 Degrees</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>330365</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU036</BillingCode>
            <Name>Tryptik Anterior Cervical Cage</Name>
            <Description>Tryptik Anterior Cervical Cages are manufactured from PEEK and are anatomically shaped to fit between vertebral bodies. </Description>
            <Size>Heights 5-12mm. Lordotic and Convex</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU051</BillingCode>
            <Name>Tryptik Ti cage</Name>
            <Description>Titanium anterior cervical cage</Description>
            <Size>Height: 4.5mm, 5mm, 6mm, 7mm,  8mm, 9mm, 10mm.  Width: 12mm, 14mm  Depth: 15mm, 12mm  Lordosis: convex and 7°.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>338461</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DZ087</BillingCode>
            <Name>CanPEEK-C Anterior Cervical Cage System</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>5mm - 10mm</Size>
            <SupplierCode>DZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>346450</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER151</BillingCode>
            <Name>Nubic</Name>
            <Description>Cervical Fusion Implant in interbody fusion of the Cervical Spine</Description>
            <Size>(4-12)x13x(14-17) mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER273</BillingCode>
            <Name>Spineway Ayers Rock Cervical Cage</Name>
            <Description>Spineway Ayers Rock cervical fusion cage&#xD;
</Description>
            <Size>Height (5-9mm) x Length (13-19mm) x Width (12-15mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>235415</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER327</BillingCode>
            <Name>Ulrich Anterior Cervical Cage</Name>
            <Description>Ulrich cerv-X Anterior Cervical Cage-PEEK, convex and lordotic</Description>
            <Size>height (4-10mm) x width (12-16mm) x length (12-14mm) x angle (0-5°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>279703</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER438</BillingCode>
            <Name>LnK Cervical Interbody Fusion Cage System/CastleLoc-C Cervical Interbody Fusion Cage System</Name>
            <Description>LnK Cervical Interbody Fusion Cage System/CastleLoc-C Cervical Interbody Fusion Cage System, PEEK</Description>
            <Size>width (14-20 mm) x length (12-15 mm) x height (5-10mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>286126</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER520</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cervical Interbody Cage E.C.C</Name>
            <Description>PEEK cervical interbody cage</Description>
            <Size>7 cage sizes:&#xD;
-3 possible heights: 5, 6 and 7mm&#xD;
-2 possible widths: 16 and 19mm&#xD;
-2 possible depths: 12 and 14mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>171933</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER537</BillingCode>
            <Name>Signus JASPIS</Name>
            <Description>Cervical porous titanium fusion cage </Description>
            <Size>width (14-18mm) x length (12-14 mm) x height (4-10 mm); lordosis (0-8°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER598</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Construx Mini PTC</Name>
            <Description>Anterior  cervical cage</Description>
            <Size>12x12mm, 15x12mm, 15x15mm, 5-14mm height, parallel or 5 degree lordotic</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER599</BillingCode>
            <Name>Construx Mini PEEK VBR System</Name>
            <Description>The Construx Mini is an anterior Cervical Interbody PEEK or Titanium Cage</Description>
            <Size>12mm x 12mm 5 degrees lordotic. 5mm-12mm in 1mm increments. 12mm x 12mm, Parallel. 5mm - 12mm in 1mm increments. 15mm x 12mm, 5/10/15 degrees lordotic. 5mm - 12mm in 1mm increments. 15mm x 12mm, Parallel. 5mm-12mm in 1mm increments        Width 12-17 mm; Length 12-15 mm, Height 5-12 mm, lordosis 0-15 degrees  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EV025</BillingCode>
            <Name>Eurospine ACDF Cage</Name>
            <Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>Flat or angled 6 - 9 degrees. &#xD;
Anterior width 17 - 19mm&#xD;
Posterior width 14 - 15mm&#xD;
Height 5 - 10mm</Size>
            <SupplierCode>EV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>273756</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY014</BillingCode>
            <Name>Tsunami Capri ACDF Cage</Name>
            <Description>ACDF Cage</Description>
            <Size>Angle 0 and 5 degrees  Height 4mm to 9mm  Length 12 to 18mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>323485</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY016</BillingCode>
            <Name>BMD Titanium ACIF Implant</Name>
            <Description>ACIF Cage</Description>
            <Size>Height 4mm height to 10mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>323561</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY018</BillingCode>
            <Name>Precision ShurFit ACDF</Name>
            <Description>Anterior Cervical Interbody Fusion System</Description>
            <Size>14 to 18mm wide  12 to 15mm deep  5 to 12mm height  5 and 10 Degree Lordotic Options</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>317596</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY023</BillingCode>
            <Name>Capri</Name>
            <Description>Cervical Fusion Cage</Description>
            <Size>4mm to 9mm height</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>323485</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY028</BillingCode>
            <Name>Osimplant BIA ACDF Implant</Name>
            <Description>ACDF Cage</Description>
            <Size>Small through large footprints</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>333220</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY033</BillingCode>
            <Name>Osimplant Cage</Name>
            <Description>Cervical Cage</Description>
            <Size>Small through large footprints</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>333220</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC006</BillingCode>
            <Name>Squale</Name>
            <Description>Cervical Cage</Description>
            <Size>4-10mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>159781</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC022</BillingCode>
            <Name>PM cage</Name>
            <Description>Cervical cage</Description>
            <Size>L :4-11mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>201493</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW636</BillingCode>
            <Name>Tritanium C</Name>
            <Description>Porous Titanium ACDF Cage</Description>
            <Size>H 5mm-9mm, Base 12mm x 14mm to 14mm x 17mm, 6deg to 10deg angle</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>297569</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW749</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER142</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aleutian Cervical Interbody System</Name>
            <Description>Cage, Convex, or Lordotic. PEEK</Description>
            <Size>Height: 5 -15mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>159146</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW769</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER455</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cascadia Cervical Interbody System</Name>
            <Description>Cascadia Interbody spacer, Porous Ti</Description>
            <Size>5-13mm heights</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>293886</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IT018</BillingCode>
            <Name>Fuse It</Name>
            <Description>Titanium alloy fusion cage - to use in situations such as anterior cervical fusion surgery</Description>
            <Size>6mm x 1cm, 8mm x 1cm, 10mm x 1cm, 12mm x 1cm, 6mm x 1cm, 8mm x 2cm, 10mm x 2cm, 12mm x 2cm</Size>
            <SupplierCode>IT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>235024</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY033</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution ACDF Cage</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>5-10mm   small, medium, large, extra large</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>248234</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY034</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Evolution ACDF Contoured Cage</Name>
            <Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>small, large - contoured</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>248234</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY035</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Fukiya ACDF Cage</Name>
            <Description>Fukiya Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>6-9 degrees, 5-10mm. Small, Medium, Large, Extra large</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>236042</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH543</PriorBillingCode>
            </PriorBillingCodes>
            <Name>C7 Cervical Cage</Name>
            <Description>Cervical Cage</Description>
            <Size>H 3-16mm L 12-16mm W 12-16mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>289247</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG006</BillingCode>
            <Name>Capri ACIF Cage</Name>
            <Description>Cervical Interbody Fusion Cage</Description>
            <Size>Angle 0, 5 and 10 degrees      Height 4mm to 9mm      Length 12, 14, 16, 18mm</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>370516</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV062</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ Cervical Cage</Name>
            <Description>Sterile Cervical Interbody Fusion Device</Description>
            <Size>H05- W.14.5 D12  H06- W.14.5 D12  H07- W.14.5 D12  H08- W.14.5 D12  H05- W.16 D14  H06- W.16 D14  H07- W.16 D14  H08- W.16 D14</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>273290</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH075</BillingCode>
            <Name>CARMEN Anterior Cervical Cage </Name>
            <Description>The CARMEN anterior cervical cage component is intended to be used for anterior cervical inter-body fusion procedures in skeletally mature patients with cervical disc disease at one level from the C2-C3 disc to the C7-T1 disc. Cervical disc disease is defined as intractable radiculopathy and/or myelopathy with herniated disc and/or osteophyte formation on posterior vertebral end-plates producing symptomatic nerve root and/or spinal cord compression confirmed by radio-graphic studies. This cage is to be used in patients who have had six weeks of non-operative treatment. The CARMEN cage must be used with supplemental fixation. The Carmen  cage is also required to be used with autogenous bone graft comprised of cancellous and/or corticocancellous bone graft and is to be implanted via an open, anterior approach</Description>
            <Size>Height       4 mm - 7 mm   Footprint :    12 mm x 14 mm ; 14 mm x 14 mm</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>312519</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH085</BillingCode>
            <Name>Caro Cervical Cage</Name>
            <Description>Cervical interbody cage, PEEK</Description>
            <Size> 4x14x12    4x14x14    5x14x12    5x14x14    6x14x12    6x14x14    7x14x12    7x14x14    8x14x12    8x14x14   </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>312519</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH095</BillingCode>
            <Name>Reach Cervical Interbody Cage </Name>
            <Description>Reach Cervical Interbody Cage </Description>
            <Size>Cage Height : 4 mm - 10 mm   Bone Screw Diameter : 3.5 mm &amp; 4.0 mm   Bone Screw Length : 8 mm - 18 mm   </Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>384821</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB034</BillingCode>
            <Name>Colonial Spacers</Name>
            <Description>Anterior Cervical Interbody Cage</Description>
            <Size>12 x 11 mm, 14 x 12mm, 16 x 14mm, 18 x 15mm and 0, 7, 12, 15 and 20 degree lordosis</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>191532</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB117</BillingCode>
            <Name>Colonial - TPS ACDF System</Name>
            <Description>ACDF spacer with Titanium Plasma Spray</Description>
            <Size>Height : 5-12mm, Width 12-18mm, Length: 11-15mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>191532</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB209</BillingCode>
            <Name>HEDRON™ C</Name>
            <Description>3D Printed ACDF Spacer</Description>
            <Size>Footprints: 12X14mm, 14X16mm, 15X18mm  Height 5-12mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>353400</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH530</BillingCode>
            <Name>Cervical Spine Truss System</Name>
            <Description>Cage</Description>
            <Size>5-16mm Height</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM400</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Zoe Cervical Cage</Name>
            <Description>The ZOE anterior cervical cage is an implant intended for the surgical treatment of the cervical vertebrae.  It is designed for stabilisation and arthrodesis between the cervical verterbrae by the anterior approach, to optimize bone fusion from C3 to C7 levels.</Description>
            <Size>Length: 12 - 14mm, Width: 14 - 16mm, Height: 4.5 - 10mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>195211</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM403</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Calix Interbody Spacer</Name>
            <Description>Cervical cage, PEEK</Description>
            <Size>Heights 5-12mm. Lordotic and Convex</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
                <ARTG>170220</ARTG>
                <ARTG>159605</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM501</BillingCode>
            <Name>ACDF Fusion Cage</Name>
            <Description>ACDF Fusion Cage</Description>
            <Size>6-12mm H x 12, 14, 16mm L x 14, 16, 19mm W</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>367230</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC413</BillingCode>
            <Name>Cornerstone Cage</Name>
            <Description>Sterile and Non-sterile</Description>
            <Size>4 - 14mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI156</BillingCode>
            <Name>Divergence Anterior Cervical Fusion Mini-plate System</Name>
            <Description>Divergence Anterior cervical fusion Mini-plate cage</Description>
            <Size>Height 5-11mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI328</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER461</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Endoskeleton TC</Name>
            <Description>Titanium coated anterior interbody fusion device for the lumbar spine, sterile or non-sterile, nanoLock (TM) surface technology</Description>
            <Size>12-16 x 14-18mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>315580</ARTG>
                <ARTG>285244</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI332</BillingCode>
            <Name>Cornerstone Cage Ti-Coated</Name>
            <Description>Cervical interbody cage with titanium coating</Description>
            <Size>14-18mm x Depth: 11-16mm x Height: 4-9mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN250</BillingCode>
            <Name>CONDUIT EIT Cervical Cage</Name>
            <Description>Cervical Cage with Titanium</Description>
            <Size>4-10mm heights</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN252</BillingCode>
            <Name>CONDUIT EIT SMART ACDF</Name>
            <Description>Cellular Titanium Cage with Graft Hole</Description>
            <Size>4-12mm height</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU102</BillingCode>
            <Name>Mecta-C</Name>
            <Description>Cervical Interbody Fusion Device made with PEEK</Description>
            <Size>Width: 12,14,and 15mm. Length: 14,16 and 18 mm. Height: from 4 to 9 mm. Flat Dome Shaped versions</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>191090</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV010</BillingCode>
            <Name>CoRoent</Name>
            <Description>Cervical Cage</Description>
            <Size>small</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV156</BillingCode>
            <Name>Modulus Cervical Interbody System</Name>
            <Description>Anterior Cervical Cage</Description>
            <Size>5-16mm x 15-19mm x 12-16mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV158</BillingCode>
            <Name>Cohere Cervical Interbody Fusion Device</Name>
            <Description>Spinal intervertebral fusion device manufactured from polyetheretherketone (PEEK)</Description>
            <Size>12-14mm X 14-16mm X 6-10mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH611</BillingCode>
            <Name>HumanTech - Anterior Cervical Interbody Fusion Cages</Name>
            <Description>Tristan - Anterior Cervical Interbody Fusion Cage</Description>
            <Size>L 12-19mm W: 14-16mm H: 4-10mm A:0-10 </Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>316185</ARTG>
                <ARTG>316186</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB001</BillingCode>
            <Name>Anterior Cervical PEEK Cage</Name>
            <Description>Interbody fusion cage</Description>
            <Size>Height: 5 -10 mm in 1 mm increments  Foot Print 13 x 16 mm / 13 x 19 mm / 12.5 x 15 mm / 11 mm x 14 mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>215887</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC001</BillingCode>
            <Name>WeTop Cervical Cage</Name>
            <Description>PEEK Cervical Cage</Description>
            <Size>12x12mm, 12x16mm, 14x18mm, 16x18mm, 16x20mm 18x20mm - all available in height ranges 4.5mm to 14mm</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>221267</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ017</BillingCode>
            <Name>VerteLoc Spine System</Name>
            <Description>Cervical Cage</Description>
            <Size>extra small - extra large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI031</BillingCode>
            <Name>Fortilink®-C</Name>
            <Description>Cervical interbody fusion device</Description>
            <Size>Width 12mm-20mm  Length 10mm-16mm  Height 5mm-12mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI042</BillingCode>
            <Name>Fortilink®-SC</Name>
            <Description>Cervical standalone fusion cage</Description>
            <Size>Width: 16-20mm  Length: 12-16mm  Height: 6-12mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF159</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ACDF Cage</Name>
            <Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>small, large – flat</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF175</BillingCode>
            <Name>Wasp ACDF Cage</Name>
            <Description>ACDF Cage (PEEK, PEEK/HA or Titanium)</Description>
            <Size>5-9mm, 4, 8 and 12 degree  </Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST712</BillingCode>
            <Name>Solis Cervical Cage</Name>
            <Description>PEEK Cervical Interbody Cage with or without fixation pegs</Description>
            <Size>Height 4mm to 12mm, Width 12mm – 16mm, Depth 12mm – 14mm, Angulation 0 – 4 degree</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>279146</ARTG>
                <ARTG>279147</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY273</BillingCode>
            <Name>Cervios IBF Cage</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>Height 5-10mm (1mm increments)</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY792</BillingCode>
            <Name>ACIS</Name>
            <Description>Anterior Cervical Interbody Spacer</Description>
            <Size>Small to large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY838</BillingCode>
            <Name>Bengal System</Name>
            <Description>Cervical Fusion Device</Description>
            <Size>4 to 16mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
                <ARTG>200396</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT002</BillingCode>
            <Name>SPICCA Anterior Cervical Fusion Cage</Name>
            <Description>Anterior cervical fusion cage; PEEK, Titanium coated PEEK, or 3D printed Titanium.</Description>
            <Size>Footprints: 15mm x 12mm, 15mm x 14mm, 17.5mm x 15mm, 19.5mm x 17mm; Height: 4mm - 10mm; Lordosis: 7 or 12 degrees.</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>322720</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ034</BillingCode>
            <Name>Valeo C+CSC</Name>
            <Description>Anterior Cervical Interbody Fusion Device</Description>
            <Size>Footprint: 16-17mm X 12-14mm&#xD;
Height: 5-12mm&#xD;
Lordosis: 0-6 degrees</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>287982</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ036</BillingCode>
            <Name>Valeo II C</Name>
            <Description>Anterior Cervical Interbody Fusion Device</Description>
            <Size>Footprint: 14-16mm x 12-14m&#xD;
Height: 5-14mm&#xD;
Lordosis 0-6 degrees</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4134</SubGroupID>
            <ARTGs>
                <ARTG>287982</ARTG>
            </ARTGs>
            <MinimumBenefit>2209</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF001</BillingCode>
            <Name>Vigor/X'Plo PEEK Interbody Fusion Cage</Name>
            <Description>Rotatable posterior lumbar interbody fusion cage</Description>
            <Size>Heights: 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 14mm, 16mm and Lengths: 24mm, 26mm, 32mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP007</BillingCode>
            <Name>PEEK Interbody System – Lumbar PLIF/TLIF (Paired)</Name>
            <Description>Sterile and Non sterile&#xD;
PLIF Implants&#xD;
TLIF Implants</Description>
            <Size>Width 8-12mm: &#xD;
Length 22-34mm: &#xD;
Height 7-17mm:  &#xD;
Lordosis Angle 0-8 degrees,</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE590</BillingCode>
            <Name>Ventura PLIF</Name>
            <Description>NanoMetalene Posterior Lumbar Interbody</Description>
            <Size>9&amp;11mm width  20&amp;24mm length  8-16mm height</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE716</BillingCode>
            <Name>REEF TO PLIF</Name>
            <Description>REEF TO NanoMetalene PLIF</Description>
            <Size>9 &amp; 11mm Widths  20 &amp; 24mm Lengths  7-18mm Heights  0-22 Degree Lordosis  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE783</BillingCode>
            <Name>FlareHawk Expandable PLIF Cage</Name>
            <Description>Expandable PEEK &amp; Titanium alloy lumbar interbody fusion device that enables significant graft delivery. FlareHawk is made up of an expandable shell and titanium shim.</Description>
            <Size>0,6,9,15 degree lordosis         Unexpanded: 7mm height x 9mm width      Expanded: 8mm - 14mm height x 14mm width;   25mm long</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>380419</ARTG>
                <ARTG>380420</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP510</BillingCode>
            <Name>Brantigan I/F Cage</Name>
            <Description>PLIF C/F Cage </Description>
            <Size>Straight / Wedge</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP515</BillingCode>
            <Name>I/F Ramp</Name>
            <Description>PLIF C/F Ramp</Description>
            <Size>7-15 x 9-17 x 21 - 25 mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP851</BillingCode>
            <Name>Surgical Titanium Mesh System</Name>
            <Description>Standard &amp; Trapezoidal</Description>
            <Size>10-16mm x 8-17mm Hgt</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR024</BillingCode>
            <Name>Hygro-L PLIF</Name>
            <Description>Titanium lumbar interbody fusion cage PLIF (paired)</Description>
            <Size>Length (22-26mm) x width (11.5mm); heights (7-14mm); lordotic angle (0-12) </Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>330365</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR045</BillingCode>
            <Name>Tesera P</Name>
            <Description>Titanium PLIF Cage</Description>
            <Size>Length (22-27mm) x Width (9mm) x Height (7-16mm); Lordotic angle (5-7) Degrees</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>354092</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU010</BillingCode>
            <Name>Juliet Ti PO</Name>
            <Description>Titanium lumbar cage</Description>
            <Size>Length: 24mm&#xD;
Height: 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm or 16mm&#xD;
Width: 8mm, 8.5mm, 9mm or 10.5mm&#xD;
Lordosis: 6º or 12º</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU030</BillingCode>
            <Name>Juliet Posterior Lumbar Interbody Cage</Name>
            <Description>PEEK cage built in anatomical slope.</Description>
            <Size>All 22mm length. 8, 10, 12 and 14mm heights. 0 or 5 degrees anatomical slope.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER149</BillingCode>
            <Name>Tetris / Tasmin Family of Lumbar fusion cages</Name>
            <Description>Titanium or peek, Interbody fusion device</Description>
            <Size>(6-24)mm x (20-28) mm x (9-11) mm; lordosis 0-22 degrees</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER246</BillingCode>
            <Name>Spineway Twin Peaks PLIF Fusion Cage-Paired</Name>
            <Description>Twin Peaks PLIF Fusion Cage-Paired, (standard or bullet shaped)</Description>
            <Size>height (7-14 mm) x length (20-25 mm) x lordosis (0-8 degrees)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>235415</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER358</BillingCode>
            <Name>Ulrich Fusion Cages-PLIF (paired)</Name>
            <Description>Ulrich Fusion Cages pezo/tezo-PLIF, paired, various, PEEK or Titanium</Description>
            <Size>height (7-14mm) x length (24-29mm) x angle (5-12°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>279703</ARTG>
                <ARTG>279705</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER440</BillingCode>
            <Name>LnK Lumbar Interbody Fusion Cage System-PLIF</Name>
            <Description>LnK Lumbar Interbody Fusion Cage System-PLIF cages, paired, PEEK, bullet shape, lordotic</Description>
            <Size>Length (25-28mm) x width 11mm x height (6-16 mm) x (angle (0-8 degrees)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>286125</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER521</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EU010</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Posterior Interbody Cage PIC</Name>
            <Description>PEEK posterior interbody cage</Description>
            <Size>6 thickness available: 8, 9, 10, 11, 12 and 13mm&#xD;
3 type of angulation: 0, 4, 8°&#xD;
2 lengths available: 20 and 25mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>171933</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER600</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF058</PriorBillingCode>
            </PriorBillingCodes>
            <Name>FORZA PTC</Name>
            <Description>PEEK/Titanium spacer with porous titanium endplates</Description>
            <Size>9mm X 23mm, Height 7mm-14mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER668</BillingCode>
            <Name>FORZA Spacer System-PLIF</Name>
            <Description>FORZA Ti straight or curved spacers, PLIF, paired in various sizes</Description>
            <Size>Profile: (9-11) mm x (23-27) mm  Height:6-14 mm  Lordosis: 0 and 8 degrees</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY024</BillingCode>
            <Name>Panarea</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>7mm to 16mm heights</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>323486</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC005</BillingCode>
            <Name>Swingo</Name>
            <Description>Lumbar Cage</Description>
            <Size>7-14mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>159781</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC015</BillingCode>
            <Name>SHARK CAGE</Name>
            <Description>Lumbar cage</Description>
            <Size>L:8-16mm</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>201493</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HC030</BillingCode>
            <Name>ISIS Cage</Name>
            <Description> ISIS Lumbar Cage</Description>
            <Size>Height:8-15mm  Width: 11mm  Length:24mm  Degrees: 0, 4 and 8</Size>
            <SupplierCode>HC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>280801</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW729</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER020</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aleutian PLIF</Name>
            <Description>Posterior lumbar spacer, PEEK</Description>
            <Size>(22-28)mm long x (8.5-10)mm wide x (4-17)mm high x (0-18) degree lordosis</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>159146</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH536</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dynamic Cage</Name>
            <Description>PLIF/TLIF Spinal Cage</Description>
            <Size>Angle 0° - 12°&#xD;
Height 7-16mm&#xD;
Length 22-32mm&#xD;
Width 8-11mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>289247</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH542</PriorBillingCode>
            </PriorBillingCodes>
            <Name>LP Cage</Name>
            <Description>LP - PLIF Peek Cage</Description>
            <Size>0°-8°, H 8-15mm L 22-27mm W 9-11mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>289247</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA007</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH537</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Medussa-PL Cage</Name>
            <Description>ThoracoLumbar/Lumbar Interbody Fusion Cage - PLIF, TLIF</Description>
            <Size>0°-8°, H 6-16mm L 25-38mm W 9-11mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>289247</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG003</BillingCode>
            <Name>Panarea</Name>
            <Description>ACP: Posterior Lumbar Cage 'PLIF'</Description>
            <Size>0, 5, 8, 14, 20 degree angle  24mm to 29mm width  7mm to 16mm height</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>370517</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ900</BillingCode>
            <Name>CONCORDE Spine System</Name>
            <Description>Interbody Fusion Device for paired insertion</Description>
            <Size>7-18mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>149723</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB009</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV071</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ Lumbar Cage- Paired</Name>
            <Description>Curved and Straight Fusion Cage- Oblique/TLIF/PLIF PEEK (straight/curved/bullet nosed)- Paired</Description>
            <Size>7 – 14mm in height, 10 – 12mm in width, 22 and 28mm in length</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH041</BillingCode>
            <Name>Halis Cages</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>6, 12 &amp; 18 Degrees Angle</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>312519</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB070</BillingCode>
            <Name>SUSTAIN spacer</Name>
            <Description>PLIF cage</Description>
            <Size>8mm-17mm height, 8mm-12mm width, 22mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>191531</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB127</BillingCode>
            <Name>Sustain - O TPS</Name>
            <Description>TPS coated PEEK radiolucent lumbar interbody fusion device</Description>
            <Size>Height 8-18mm,  Width 8-12mm, Length 22mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB133</BillingCode>
            <Name>Sustain-IR and Sustain-IR Narrow - Paired</Name>
            <Description>PEEK radiolucent interbody lumbar fusion device</Description>
            <Size>Height 7-17mm, Length 18-22mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB135</BillingCode>
            <Name>Caliber Expandable Lumbar Fusion Device - Paired</Name>
            <Description>Expandable titanium alloy and PEEK lumbar inter-body fusion device</Description>
            <Size>Unexpanded Height 7-12mm, Expanded Height 11-17mm, Width 10-12mm, Length 22mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>190042</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB142</BillingCode>
            <Name>RISE - paired</Name>
            <Description>Expandable Lumbar Fusion Device</Description>
            <Size>Width: 8mm, 10mm and 12mm &#xD;
Length: 22mm&#xD;
Height 7-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>214537</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB144</BillingCode>
            <Name>RISE IntraLIF - paired</Name>
            <Description>Intradiscal Lumbar Interbody Fusion Device</Description>
            <Size>8mm Width, 22mm Length 7-14mm Height</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>214537</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB198</BillingCode>
            <Name>SUSTAIN-RT</Name>
            <Description>Insert and rotate lumbar fusion device</Description>
            <Size>8-10mm X 22mm X 6-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB203</BillingCode>
            <Name>HEDRON P</Name>
            <Description>3D Printed Posterior Lumbar Interbody Spacer</Description>
            <Size>Width: 8-10mm  Length: 22mm  Height: 7-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>353398</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM404</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Calix Peek Lumbar System</Name>
            <Description>Peek lumbar interbody spacer for fusion of the lumbar spine using an anterior, posterior or transverse approach.</Description>
            <Size>36mm x 24mm x 8mm x 8 deg  36mm x 24mm x 10mm x 8 deg  36mm x 24mm x 12mm x 8 deg  36mm x 24mm x 14mm x 8 deg  36mm x 24mm x 16mm x 8 deg  36mm x 24mm x 18mm x 8 deg  36mm x 24mm x 20mm x 8 deg  36mm x 24mm x 8mm x 12 deg  36mm x 24mm x 10mm x 12 deg  36mm x 24mm x 12mm x 12 deg  36mm x 24mm x 14mm x 12 deg  36mm x 24mm x 16mm x 12 deg  36mm x 24mm x 18mm x 12 deg  36mm x 24mm x 20mm x 12 deg  28mm x 10mm x 6mm  28mm x 10mm x 7mm  28mm x 10mm x 8mm  28mm x 10mm x 9mm  28mm x 10mm x 10mm  28mm x 10mm x 11mm  28mm x 10mm x 12mm  28mm x 10mm x 13mm  28mm x 10mm x 14mm  28mm x 10mm x 15mm  28mm x 10mm x 16mm  22mm x 10mm x 6mm  22mm x 10mm x 7mm  22mm x 10mm x 8mm  22mm x 10mm x 9mm  22mm x 10mm x 10mm  22mm x 10mm x 11mm  22mm x 10mm x 12mm  22mm x 10mm x 13mm  22mm x 10mm x 14mm  22mm x 10mm x 15mm  22mm x 10mm x 16mm  26mm x 10mm x 6mm  26mm x 10mm x 8mm  26mm x 10mm x 10mm  26mm x 10mm x 12mm  26mm x 10mm x 14mm  26mm x 10mm x 6mm x 5o  26mm x 10mm x 8mm x 5o  26mm x 10mm x 10mm x 5o  26mm x 10mm x 12mm x 5o  26mm x 10mm x 14mm x 5o</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>159605</ARTG>
                <ARTG>170220</ARTG>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM440</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK123</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Amendia Zeus Fusion Cages-PLIF </Name>
            <Description>Amendia Zeus Fusion Cages-PLIF (paired), PEEK</Description>
            <Size>width (9-13 mm) x length (22-30 mm) x height (7-18 mm) x lordosis (0-8 degrees)</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>233730</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM515</BillingCode>
            <Name>PLIF Cage</Name>
            <Description>PLIF Cage - PEEK</Description>
            <Size>8, 10 or 12W x 8-16H x 22, 25, 28, 30 or 32L, 0° or 5° </Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>367230</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC456</BillingCode>
            <Name>Interfix </Name>
            <Description>Titanium Cage</Description>
            <Size>12 x 20mm - 24 x 50mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC457</BillingCode>
            <Name>LordoTec Cage (LT-Cage)</Name>
            <Description>Titanium,  PEEK</Description>
            <Size>18-28mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC577</BillingCode>
            <Name>R90 Spacer</Name>
            <Description>Spinal Implant (Peek)</Description>
            <Size>Height 7 - 16mm
Lordosis 6 - 18 degrees</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC976</BillingCode>
            <Name>Capstone Cage</Name>
            <Description>PLIF Vertebral Body Spacer</Description>
            <Size>Length: 22mm - 26mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI063</BillingCode>
            <Name>Capstone Control</Name>
            <Description>PLIF Vertebral Body Spacer</Description>
            <Size>Length: 22-26mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI066</BillingCode>
            <Name>Fuse Spinal system</Name>
            <Description>PLIF Vertebral Body Spacer</Description>
            <Size>Length: 24.5mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>200709</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI322</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER497</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Endoskeleton TO Interbody Fusion Device</Name>
            <Description>Titanium lumbar posterior interbody fusion cage, sterile or non-sterile, also with  NanoLock™ surface technology, sterile</Description>
            <Size>(22-31mm) x (8-16mm); 0-4 degrees</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>285244</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI329</BillingCode>
            <Name>Elevate Spinal System</Name>
            <Description>Expandable Lumbar Fusion Device - Paired</Description>
            <Size>Height: 7-16mm  Width: 10mm  Length: 23mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI396</BillingCode>
            <Name>Adaptix Cage</Name>
            <Description>PLIF Vertebral Body Spacer</Description>
            <Size>Length: 24-28 mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN236</BillingCode>
            <Name>OPAL</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>10-15mm, 9-10 x 24mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>231840</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN248</BillingCode>
            <Name>CONDUIT EIT PLIF Cage</Name>
            <Description>Lumbar Cage with Titanium</Description>
            <Size>7-16mm Heights</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN253</BillingCode>
            <Name>CONDUIT EIT SMART PLIF</Name>
            <Description>Cellular Titanium Cage with Graft Hole</Description>
            <Size>8-16mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU104</BillingCode>
            <Name>Mectalif Posterior</Name>
            <Description>Posterior Interbody Fusion Device made with PEEK</Description>
            <Size>Width: 9 and 11mm. Length: 22 and 25 mm. Height: from 7 to 15 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>180172</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV011</BillingCode>
            <Name>CoRoent</Name>
            <Description>PLIF cage - PEEK or Titanium</Description>
            <Size>Width 8-12mm x Length 20-40mm x Height 6-14mm x Lordosis 0-15°</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW046</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BH170</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Zyston Straight Interbody Spacer</Name>
            <Description>Posterior Lumbar Interbody Spacer, PEEK</Description>
            <Size>(7mm x 20mm) to (18mm x 30mm), Convex, Lordotic</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>287188</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH613</BillingCode>
            <Name>HumanTech - Adonis Spinal Fusion Cage System - PLIF</Name>
            <Description>Adonis Spinal Fusion Cage System - PLIF</Description>
            <Size>L 24-32mm   W: 9mm   H: 7-15mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>316185</ARTG>
                <ARTG>316186</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB002</BillingCode>
            <Name>Thoracic-lumbar PEEK cage</Name>
            <Description>Interbody fusion cage</Description>
            <Size>Height: 6 - 15mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>215887</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI029</BillingCode>
            <Name>Fortilink®-TS</Name>
            <Description>Posterior lumbar interbody fusion device</Description>
            <Size>Width: 10mm,  Length: 22mm  Height 8mm-17mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF102</BillingCode>
            <Name>Revolve Spacer</Name>
            <Description>Spinal Spacer</Description>
            <Size>9-17mm high, 21-27mm length, 12-22 degrees</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF152</BillingCode>
            <Name>Ayers PLIF cage</Name>
            <Description>PLIF Fusion Cage</Description>
            <Size>Curved and Straight Cages in multiple footprints with 3 angles.</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ST711</BillingCode>
            <Name>OIC Cage</Name>
            <Description>Interbody Cage</Description>
            <Size>W 8-11mm, H 6-16mm, L20-25mm, Angle 0, 4 and 8 degrees</Size>
            <SupplierCode>ST</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>205486</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY088</BillingCode>
            <Name>Plif Cage: Cage</Name>
            <Description>Contact fusion cage - bone compression screw for PLIF cage</Description>
            <Size>Width 8 - 11mm / height 9 - 15mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY274</BillingCode>
            <Name>Plivios IBF Cage</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>Height  7-17mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY340</BillingCode>
            <Name>PlivioPore</Name>
            <Description>Ti PLIF cage</Description>
            <Size>Height 7 - 17mm / width 7 - 13mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UL010</BillingCode>
            <Name>Revolution Spacer</Name>
            <Description>Spinal Spacer</Description>
            <Size>9-17mm high, 21-27mm length, 12-22 degrees</Size>
            <SupplierCode>UL</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>285840</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ037</BillingCode>
            <Name>Valeo II and Gen 1 PL/OL - paired</Name>
            <Description>PLIF lumbar interbody fusion device - paired</Description>
            <Size>Footprint: 9 x 21mm and 9 x 25mm&#xD;
Height: 7-18mm&#xD;
Lordosis: 0 -6 degrees</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <Suffix>Paired</Suffix>
            <ARTGs>
                <ARTG>287982</ARTG>
            </ARTGs>
            <MinimumBenefit>2490</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB070</BillingCode>
            <Name>Prospace Block</Name>
            <Description>Titanium</Description>
            <Size>9mm-11mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>101789</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB252</BillingCode>
            <Name>Aesculap Interbody Cage</Name>
            <Description>TLIF Interbody Cage</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>122641</ARTG>
                <ARTG>273761</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB365</BillingCode>
            <Name>Aesculap Interbody Cage</Name>
            <Description>PLIF Interbody Cage</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>122641</ARTG>
                <ARTG>273761</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF019</BillingCode>
            <Name>Latero Lumbar Cage</Name>
            <Description>PEEK lumbar cage</Description>
            <Size>Height: 10, 11, 12, 13, 14, 15, 16 or 18mm&#xD;
Width: 16, 18, 20 or 22mm&#xD;
Length: 30, 35, 40, 45, 50 or 55mm&#xD;
Angle: 9*</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>211536</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP001</BillingCode>
            <Name>Ti PEEK Interbody system – Lumbar PLIF/TLIF (single)</Name>
            <Description>Sterile                                                                &#xD;
PLIF Implants&#xD;
TLIF Implants&#xD;
Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®)</Description>
            <Size>Width 8-12mm: &#xD;
Length 22-34mm: &#xD;
Height 7-17mm:  &#xD;
Lordosis Angle 0-8 degrees</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP002</BillingCode>
            <Name>PEEK Interbody System – Lumbar ALIF</Name>
            <Description>Sterile and Non sterile&#xD;
ALIF Implants</Description>
            <Size>Width 24-28mm: &#xD;
Length 28-38mm: &#xD;
Height 8-17mm: &#xD;
Lordosis Angle 6 - 8 degrees</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP003</BillingCode>
            <Name>Ti PEEK Interbody System – Lumbar PLIF/TLIF (Paired)</Name>
            <Description>Sterile                                                                &#xD;
PLIF Implants&#xD;
TLIF Implants&#xD;
Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®)</Description>
            <Size>Width 8-12mm: &#xD;
Length 22-34mm: &#xD;
Height 7-17mm:  &#xD;
Lordosis Angle 0-8 degrees</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP005</BillingCode>
            <Name>PEEK Interbody system – Lumbar PLIF/TLIF (single)</Name>
            <Description>Sterile and Non sterile                                               &#xD;
PLIF Implants&#xD;
TLIF Implants</Description>
            <Size>Width 8-12mm: &#xD;
Length 22-34mm: &#xD;
Height 7-17mm:  &#xD;
Lordosis Angle 0-8 degrees</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP006</BillingCode>
            <Name>TiPEEK Interbody system Lumbar DLIF</Name>
            <Description>Sterile                                                                    DLIF Implants  Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima )</Description>
            <Size>Width 18-22mm:  Length 40-60mm:  Height 8-17mm:  Lordosis Angle 0 - 8 degrees</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP009</BillingCode>
            <Name>PEEK Interbody System – DLIF Lumbar</Name>
            <Description>Sterile and Non sterile &#xD;
DLIF Implants</Description>
            <Size>Width 18-22mm:&#xD;
Length 40-60mm:&#xD;
Height 8-17mm:&#xD;
Lordosis Angle 0 - 8 degrees</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BP010</BillingCode>
            <Name>TiPEEK Interbody system   Lumbar ALIF</Name>
            <Description>Sterile                                                                    ALIF Implants  Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima )</Description>
            <Size>Width 24-28mm:   Length 28-38mm:   Height 8-17mm:    Lordosis Angle 6-8 degrees,</Size>
            <SupplierCode>BP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273366</ARTG>
                <ARTG>273367</ARTG>
                <ARTG>273374</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE558</BillingCode>
            <Name>icotec ETurn Cage</Name>
            <Description>TLIF Cage</Description>
            <Size>32mm Length, 12 and 16mm width and 7-15mm height</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>283852</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE589</BillingCode>
            <Name>Hollywood TLIF</Name>
            <Description>NanoMetalene Transforaminal Lumbar Interbody</Description>
            <Size>11 x 27mm and 11 x 30mm width and length  7 - 14mm Height  8 degrees lordodis</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE591</BillingCode>
            <Name>Ventura TLIF</Name>
            <Description>Ventura Nanometalene TLIF</Description>
            <Size>9 &amp;11mm width  28 &amp; 32mm length  8-18mm height</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE686</BillingCode>
            <Name>Regatta</Name>
            <Description>Regatta Lateral Interbody System</Description>
            <Size>Height: 8 -16mm  Width: 18 and 23mm  Length: 40,45,50,55 and 60mm  Lordosis: 0, 10 and 15 degrees</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE711</BillingCode>
            <Name>REEF TO TLIF</Name>
            <Description>REEF TO NanoMetalene TLIF</Description>
            <Size>9&amp;11mm Widths  28, 32, 36mm Lengths  7-18mm Heights  0-22 Degree Lordosis</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE717</BillingCode>
            <Name>REEF TA</Name>
            <Description>REEF TA NanoMetalene TLIF</Description>
            <Size>9&amp;11mm Widths    28, 32, 36, 40mm Lengths    7-18mm Heights    0 - 20 Degrees Lordosis</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE784</BillingCode>
            <Name>FlareHawk Expandable TLIF Cage</Name>
            <Description>Expandable PEEK &amp; titanium alloy lumbar interbody fusion device that enables significant graft delivery. FlareHawk is made up of an expandable shell and titanium shim.</Description>
            <Size>0,6,9,15 degree lordosis        Unexpanded: 7mm height x 9mm width    Expanded: 8mm - 14mm height x 14mm width; 29mm long </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>380419</ARTG>
                <ARTG>380420</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE796</BillingCode>
            <Name>Meridian No Profile Cage with Locking Plate</Name>
            <Description>No Profile ALIF cage with titanium faceplate - two or three hole</Description>
            <Size>31x24, 35x27, 39x30      10-20mm Heights      10, 15, 20 &amp; 25 Degree Lordosis  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE797</BillingCode>
            <Name>Meridian TruProfile ALIF Cage</Name>
            <Description>Nanometalene ALIF cage for use with Meridian plate</Description>
            <Size>31x24, 35x27, 39x30     10-20mm Heights      10, 15, 20 &amp; 25 Degree Lordosis  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298002</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP511</BillingCode>
            <Name>Brantigan I/F Cage</Name>
            <Description>ALIF C/F Cage</Description>
            <Size>Small - Large, 21.5 - 29mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR023</BillingCode>
            <Name>Hygro-L PLIF/TLIF (single)</Name>
            <Description>Titanium lumbar interbody fusion cage PLIF/TLIF (single) </Description>
            <Size>length (30-36mm) x width (11.5-13.5mm) heights (7-14mm); lordosis (0-12) degrees</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>330365</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR046</BillingCode>
            <Name>Tesera T/ST</Name>
            <Description>Titanium TLIF Cage</Description>
            <Size>Length (28-34mm) x Width (10-11mm) x Height (7-16mm) Lordotic angle (0-7) Degrees</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>354092</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR047</BillingCode>
            <Name>Kyocera Lateral Lumbar Interbody System</Name>
            <Description>Lateral Lumbar Interbody Cage</Description>
            <Size>18-22mm W, 30-60mm L, 8-20mm H</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>354092</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU009</BillingCode>
            <Name>Juliet Ti TL, Juliet Ti OL</Name>
            <Description>Titanium lumbar cage</Description>
            <Size>TL - Length: 30mm or 34mm  Height: 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm or 16mm  Width: 10.5mm  Lordosis: 6º  OL - Length: 28mm, 32mm or 36mm  Height: 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm or 16 mm  Width: 8mm, 8.5mm, 9mm, 10mm or 10.5mm  Lordosis: 6º or 12º</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
                <ARTG>338461</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU016</BillingCode>
            <Name>Juliet LL Lateral Lumbar Cage</Name>
            <Description>Lateral lumbar - PEEK or titanium</Description>
            <Size>PEEK-&#xD;
Width: 21mm&#xD;
Length: 40mm, 45mm, 50mm, 55mm, 60mm&#xD;
Height: 8mm, 10mm, 12mm, 14mm, 16mm&#xD;
Lordotic angle: 6º&#xD;
Titanium-&#xD;
Width: 17mm, 21mm, 25mm&#xD;
Length: 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm&#xD;
Height: 6mm, 8mm, 10mm, 12mm, 14mm, 16mm&#xD;
Lordotic angle: 0º, 6º</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU031</BillingCode>
            <Name>Juliet Anterior Lumbar Cage</Name>
            <Description>PEEK cage with built in anatomical shape. The cage has built in stabilising Titanium spike to stabilise the implant in the disc space.</Description>
            <Size>All 26 mm length. 10, 12, 14 and 16mm height.  5 or 10 degree slope.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU034</BillingCode>
            <Name>Juliet TLIF Cage</Name>
            <Description>PEEK cage with built in anatomical angulations</Description>
            <Size>4 thicknesses - 8, 10, 12 and 14mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>166194</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU046</BillingCode>
            <Name>Juliet Ti LL cage</Name>
            <Description>Titanium lateral lumbar cage</Description>
            <Size>Height: 6mm, 8mm, 10mm, 12mm, 14mm, 16mm, 18mm, 20mm  Width: 17mm, 21mm  Length: 40mm, 45mm, 50mm, 55mm, 60mm  Lordosis: 0°, 8°, 15°, 25°</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>338461</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU062</BillingCode>
            <Name>Scarlet AL-T Hyperlordotic Secured Lumbar Cage</Name>
            <Description>Secured Lumbar Cage</Description>
            <Size>Small, Medium, Large footprint  Height: 13 to 26mm.  Lordosis: 20, 25 and 30°.</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>338461</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER150</BillingCode>
            <Name>Signus - Semial</Name>
            <Description>Composition - PEEK</Description>
            <Size>Height (ant) 7.80, 10.40, 13.20; Diameter 38, 43, 48; Height (post) 5.4, 8.0, 8.1, 10.8; Angle 5.00, 10.40</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>122274</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER162</BillingCode>
            <Name>Signus Mobis Lumbar TLIF Cage</Name>
            <Description>Peek-Optima Lumbar intervertebral TLIF cage</Description>
            <Size>6, 7, 8, 9, 10, 11, 12, 13, 14, 16, 18mm heights</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER190</BillingCode>
            <Name>Signus Mobis II TLIF Implant</Name>
            <Description>Signus Mobis II Thoracolumbar Fusion Cage-Peek or Ti</Description>
            <Size>Height (6-14 mm)xWidth 9 mm x Length 29 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER206</BillingCode>
            <Name>Signus TLIF Implant </Name>
            <Description>Signus TLIF Implant (Peek or Titanium)</Description>
            <Size>Height (6-18 mm) x Width 11 mm x Length (28-40) mm x 0 or 6 degree angle</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER229</BillingCode>
            <Name>SIGNUS Noval Interbody Fusion Cage </Name>
            <Description>SIGNUS Noval Interbody Fusion Cage </Description>
            <Size>height (8-18 mm) x width (40-48 mm)x lordosis (5-15 degrees)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER244</BillingCode>
            <Name>Spineway Twin Peaks TLIF Fusion Cage</Name>
            <Description>Twin Peaks TLIF Fusion Cage</Description>
            <Size>height (7-14 mm) x length (25-35 mm) x lordosis (4-9 degrees)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>235415</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER245</BillingCode>
            <Name>Spineway Twin Peaks PLIF Fusion Cage</Name>
            <Description>Twin Peaks PLIF Fusion Cage-oblique</Description>
            <Size>height (7-14 mm) x length (28-32 mm) </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>235415</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER356</BillingCode>
            <Name>Ulrich Fusion Cages-ALIF</Name>
            <Description>Ulrich Fusion Cages pezo/tezo-ALIF (various shapes), PEEK or Titanium</Description>
            <Size>height (8-26mm) x width (22-28mm) x length (28-34mm) x angle (0-12°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>279703</ARTG>
                <ARTG>279705</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER357</BillingCode>
            <Name>Ulrich Fusion Cages-TLIF</Name>
            <Description>Ulrich Fusion Cages pezo/tezo-TLIF (various shapes), PEEK or Titanium</Description>
            <Size>height (7-14mm) x width (11-16mm) x length (29-34mm) x angle 5°</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>279703</ARTG>
                <ARTG>279705</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER441</BillingCode>
            <Name>LnK Lumbar Interbody Fusion Cage System-TPLIF</Name>
            <Description>LnK Lumbar Interbody Fusion Cage System-TPLIF, PEEK</Description>
            <Size>length 32mm x width 11mm x height (6-16mm) x angle (0-8°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>286125</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER442</BillingCode>
            <Name>LnK Lumbar Interbody Fusion Cage System-TLIF</Name>
            <Description>LnK Lumbar Interbody Fusion Cage System-TLIF, PEEK, lordotic</Description>
            <Size>length (26-32mm) x width 11mm x height (7-16mm) x angle (0-8 degrees)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>286125</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER443</BillingCode>
            <Name>LnK Lumbar Interbody Fusion Cage System-ALIF</Name>
            <Description>LnK Lumbar Interbody Fusion Cage System-ALIF, PEEK, lordotic</Description>
            <Size>length (24-29mm) x width (32-38mm) x height (6-19mm) x angle (0-25°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>286125</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER444</BillingCode>
            <Name>LnK Lumbar Interbody Fusion Cage System/PathLoc-LC Lateral Cage System-DLIF</Name>
            <Description>LnK Lumbar Interbody Fusion Cage System/PathLoc-LC Lateral Cage System-DLIF, PEEK</Description>
            <Size>length (18-24mm) x width (40-65mm) x height (8-16mm) x angle (0-12°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>286125</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER569</BillingCode>
            <Name>SIGNUS VERTACONNECT expandable lumbar cage TLIF Implant</Name>
            <Description>SIGNUS expandable TLIF cage, Titanium alloy</Description>
            <Size>width (12 mm) x length (31 mm / 34 mm / 37 mm);     height:  posterior (8 mm /10mm / 12 mm),    anterior unexpanded (9 mm - 14 mm);  anterior expanded     (13 mm -19 mm)    angle:  anterior unexpanded (3°-7°),  anterior expanded  (11°-19°)           </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>129772</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER570</BillingCode>
            <Name>Biedermann Motech TELIX K Interbody Fusion Cage Implant System</Name>
            <Description>Biedermann Motech TELIX K Interbody Fusion Cage (TLIF), curved profile, Titanium  </Description>
            <Size>(7-17mm) x (28-36mm); lordosis 0/5°  </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>354050</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER601</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Forza PLIF</Name>
            <Description>PEEK PLIF cages in various sizes</Description>
            <Size>9x23/27mm  11x23/27mm  0 and 8 degree  6-16mm height in 1mm increments</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER602</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF047</PriorBillingCode>
            </PriorBillingCodes>
            <Name>FORZA TLIF</Name>
            <Description>PEEK TLIF cages in various sizes</Description>
            <Size>Width - 9mm to 11mm  Length - 27mm to 33mm  Height - 6mm to 16mm   0 - 8 degree</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER603</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF057</PriorBillingCode>
            </PriorBillingCodes>
            <Name>FORZA PTC</Name>
            <Description>PEEK/Titanium spacer with porous titanium endplates</Description>
            <Size>9mm X 27mm, Height 7mm-14mm  11mm X 27mm, Height 7mm-14mm  11mm X 31mm, Height 7mm-14mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER643</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OF068</PriorBillingCode>
            </PriorBillingCodes>
            <Name>SKYHAWK Interbody Fusion Device</Name>
            <Description>PEEK Interbody Fusion Device</Description>
            <Size>Width - 16mm, 18mm and 20mm, 22mm, 26mm  Length - 35mm, 40mm, 45mm, 50mm, 55mm, 60mm  Height - 8mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER646</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>HZ001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Forza XP Expandable Spacer System</Name>
            <Description>The Forza XP Expandable Spacer System is comprised of an assortment of non-sterile, single use, titanium alloy and polyetheretherketone (PEEK) polymer spacers with height expansion capability. The expandable interbody spacer is inserted into the lumbar disc space and expanded to fit the patient anatomy. The implants are offered in parallel, lordotic, and hyperlordotic configurations to help restore the natural curvature of the spine. The implants can be used in single placement or pairs with typical approaches being transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF). The implants feature a bulleted nose for ease of insertion and anti-migration ripples on both the inferior and superior surfaces to provide increased stability and help prevent anterior/posterior movement of the device.</Description>
            <Size>Length: 24 mm - 28 mm  Width: 10 mm - 12 mm  Starting height: 6.5 mm - 12.5 mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER669</BillingCode>
            <Name>FORZA Spacer System-TLIF</Name>
            <Description>FORZA Spacer System-TLIF, Ti, straight or curved</Description>
            <Size>Profile: (9-11) mm x (&gt;27-31) mm  Height: 6-14 mm  Lordosis: 0 or 8 degrees</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>206571</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY013</BillingCode>
            <Name>E4 TLIF Cage</Name>
            <Description>Interbody Cage</Description>
            <Size>6mm height to 16mm height</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY015</BillingCode>
            <Name>Tsunami Panarea b-OK Lumbar Cage</Name>
            <Description>Lumbar Interbody Cage</Description>
            <Size>7mm to 14mm height </Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323486</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY017</BillingCode>
            <Name>BMD Titanium TLIF Cage</Name>
            <Description>Lumbar Interbody Cage</Description>
            <Size>Height 7mm to 17mm </Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323520</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY021</BillingCode>
            <Name>Elba</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>7mm to 14mm heights</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323486</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY022</BillingCode>
            <Name>Salina</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>7mm to 14mm height</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323486</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY025</BillingCode>
            <Name>Stromboli</Name>
            <Description>Lumbar interbody fusion cage</Description>
            <Size>42mm to 58mm length</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323486</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY026</BillingCode>
            <Name>Alicudi</Name>
            <Description>Lumbar Interbody Fusion</Description>
            <Size>30mm to 38mm width</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323486</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY027</BillingCode>
            <Name>BMD Titanium ALIF Cage</Name>
            <Description>Lumbar Interbody Cage</Description>
            <Size>Heights: 9mm to 19mm</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323520</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EY031</BillingCode>
            <Name>BMD Titanium XLIF Cage</Name>
            <Description>Lumbar Interbody Fusion Cage</Description>
            <Size>9mm to 17mm Heights</Size>
            <SupplierCode>EY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>323520</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW406</BillingCode>
            <Name>Aria Spinal System / Peek DLIF Interbody Spacer</Name>
            <Description>PEEK DLIF Interbody Spacer</Description>
            <Size>H: 8-18mm L: 40-60mm W: 18-22mm 0-8 degree lordosis</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>298123</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW520</BillingCode>
            <Name>AVS Navigator</Name>
            <Description>Steerable TLIF Cage</Description>
            <Size>L 26-31mm, H6-15mm, 0 and 4 degree anglulation</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>278569</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW560</BillingCode>
            <Name>Tritanium PL Posterior Lumbar Cage</Name>
            <Description>Porous Titanium Alloy Interbody Cage</Description>
            <Size>6-16mm height, 23-32mm length, 9-11mm width, 0, 6 and 12 degrees</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>265560</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW649</BillingCode>
            <Name>Tritanium TL</Name>
            <Description>Steerable Posterior Lumbar Cage</Description>
            <Size>Footprints: 27mm x 10mm, 31mm x 10mm, 35mm x 10mm; Height 7mm to 14mm; Angulation 0, 6 and 12 degree</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>265560</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW680</BillingCode>
            <Name>Monterey AL, Cage </Name>
            <Description>ALIF Cage </Description>
            <Size>Height 8mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>356926</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW730</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aleutian Anterior</Name>
            <Description>Anterior/lateral lumbar interbody spacer</Description>
            <Size>(30-60)mm wide x (18-28)mm long x (8-21)mm height</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>159146</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW731</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aleutian TLIF</Name>
            <Description>Transforaminal lumbar interbody spacer</Description>
            <Size>(8.5-12)mm wide x (22-36)mm long x (4-17)mm height x (6-18) degree lordotic angle</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>193652</ARTG>
                <ARTG>159146</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW742</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER045</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Aleutian Lateral</Name>
            <Description>Lateral Interbody Spacer</Description>
            <Size>(16-22)mm width x (25-60)mm length x (6-20)mm height, (0-15) degreee  lordotic angle</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>159146</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW764</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER242</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cascadia Interbody Spacer</Name>
            <Description>Cascadia interbody spacer, porous Ti</Description>
            <Size>8.5 -14mm wide</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>293886</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW766</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER282</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cascadia Lateral</Name>
            <Description>Interbody spacer, Porous Ti</Description>
            <Size>8-20mm high</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>293886</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW782</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER506</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Cascadia AL Interbody System</Name>
            <Description>Porous Titanium ALIF cage</Description>
            <Size>Height: 9-21mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>193652</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY036</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Shuriken Cage</Name>
            <Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>7-13mm height; 30-35mm length; 6-18 degrees lordosis</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>236041</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IY037</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>EV023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Shinto PLIF Cage</Name>
            <Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description>
            <Size>Angle 8 - 22 degrees  Length 21 - 26mm   Height 5 - 13mm</Size>
            <SupplierCode>IY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>236042</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH538</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Taurus-P</Name>
            <Description>Taurus-P Fusion Cage</Description>
            <Size>0-8°, H7-16mm, L25-40mm, W9-12mm</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>289247</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG001</BillingCode>
            <Name>Elba</Name>
            <Description>ACT - Transforaminal Lumbar Interbody Fusion Cage 'TLIF'</Description>
            <Size>Height 7mm to 15mm</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>370517</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG002</BillingCode>
            <Name>Alicudi</Name>
            <Description>ACA - Anterior Lumbar Fusion Cage</Description>
            <Size>5, 8, 14, 20 degree angle  9mm to 15mm height  30mm to 38mm width</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>370517</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG004</BillingCode>
            <Name>Stromboli</Name>
            <Description>ACX - Direct Lateral Interbody Fusion Cage 'XLIF'</Description>
            <Size>0, 5, 8, 14 degree angle  42mm to 58mm length  7mm to 13mm height</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>370517</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JG005</BillingCode>
            <Name>Salina</Name>
            <Description>ACL - Lateral Oblique Cage</Description>
            <Size>5 degree angle  26mm to 33mm length  7mm to 14mm height</Size>
            <SupplierCode>JG</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>370517</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ569</BillingCode>
            <Name>Cougar Spine System</Name>
            <Description>Anterior/lateral Lumbar Interbody Fusion Cage, Carbon Fibre Reinforced Polymer (CFRP)</Description>
            <Size>Small - Large, 7 - 65mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KB010</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SV066</PriorBillingCode>
            </PriorBillingCodes>
            <Name>STERISPINE™ Lumbar Cage -Single</Name>
            <Description>Curved and Straight Fusion Cage- Oblique/TLIF/PLIF PEEK (straight/curved/bullet nosed)</Description>
            <Size>Straight:  Height 7-14mm  Width: 10-12mm  Length: 22-32mm  Curved   Height: 7-14mm  Length: 28-32mm</Size>
            <SupplierCode>KB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>273286</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH042</BillingCode>
            <Name>DICA Lumbar Cage</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>7 degrees</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>312519</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KH043</BillingCode>
            <Name>Lydia Cage</Name>
            <Description>Interbody Fusion Cage</Description>
            <Size>8 &amp; 15 degrees angle, 8-12mm height and 20-24mm length</Size>
            <SupplierCode>KH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>312519</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB004</BillingCode>
            <Name>TransContinental Spacer</Name>
            <Description>PEEK Interbody cages</Description>
            <Size>X-small, small, medium, large, x-large 0 deg, 6 deg and 10 degree 7 - 17mm Height</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB005</BillingCode>
            <Name>TransContinental M Spacer</Name>
            <Description>PEEK Interbody cages</Description>
            <Size>0 degree, 6 degree, 20 degree and 25 degree, Height: 8mm - 21mm . Length: 35mm-60mm, Width: 20mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB006</BillingCode>
            <Name>Signature Spacer</Name>
            <Description>PEEK Interbody spacer</Description>
            <Size>small, medium, large. 7mm - 17mm Height</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>190020</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB007</BillingCode>
            <Name>Continental Spacer</Name>
            <Description>PEEK Interbody spacer</Description>
            <Size>x-small, small, medium, large. 0deg, 8deg, 15deg. 9mm - 21mm Height</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>190020</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB071</BillingCode>
            <Name>SUSTAIN Spacer</Name>
            <Description>TLIF Cage</Description>
            <Size>8mm-17mm height, 8mm-12mm width, 26-30mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191534</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB118</BillingCode>
            <Name>Continental TPS Spacer</Name>
            <Description>ALIF PEEK spacer with Titanium Plasma Spray</Description>
            <Size>Width 25-39mm, Length 20-28mm, Height 9-21mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB126</BillingCode>
            <Name>Sustain - O TPS</Name>
            <Description>TPS coated PEEK radiolucent lumbar interbody fusion device</Description>
            <Size>Height-8mm-18mm,  Width 8mm - 12mm, Length - 26mm-30mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB128</BillingCode>
            <Name>Signature-R, Signature-R TPS &amp; Signature-Ti  TLIF System</Name>
            <Description>PEEK or TPS Coated PEEK or Titanium lumbar interbody fusion device</Description>
            <Size>Small - 10 x 28mm with heights from 7-17mm&#xD;
Large - 11 x 33mm with heights from 7-17mm&#xD;
PEEK TPS - 10-11mm x 32-37mm with heights from 7-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB132</BillingCode>
            <Name>Sustain-IR and Sustain-IR Narrow</Name>
            <Description>PEEK radiolucent interbody lumbar fusion device</Description>
            <Size>Height 7-17mm, Length 26-30mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB134</BillingCode>
            <Name>Calber Expandable Lumbar Fusion Device</Name>
            <Description>Expandable titanium alloy and PEEK lumbar interbody fusion device</Description>
            <Size>Un-expanded Height -7-12mm, Expanded Height 11-17mm, Width 10-12mm, Length 26-30mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>190042</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB136</BillingCode>
            <Name>TransContinental TPS</Name>
            <Description>Lateral Lumbar Interbody Fusion (LLIF) Device</Description>
            <Size>Length - 40-60mm in 5mm increments&#xD;
Height - 7-17mm&#xD;
Width - 18mm &amp; 22mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB141</BillingCode>
            <Name>RISE</Name>
            <Description>Expandable Lumbar Fusion Device</Description>
            <Size>Width:10mm, Length: 26mm, 30mm&#xD;
Width:12mm, Length: 26mm and 30mm&#xD;
&#xD;
Heights 7-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>214537</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB143</BillingCode>
            <Name>Rise IntraLIF</Name>
            <Description>Intradiscal Lumbar Interbody Fusion Device</Description>
            <Size>Width 8mm, Length 26mm, 30mm and 34mm&#xD;
Height 7-14mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>214537</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB150</BillingCode>
            <Name>Caliber -L</Name>
            <Description>Expandable Lateral Lumbar Interbody Fusion Device</Description>
            <Size>Width -16mm, Length 25-40mm in 5mm increments&#xD;
Width -18mm, Length 40-60mm in 5mm increments&#xD;
Width -22mm, 40 - 60mm in 5mm increments &#xD;
Heights - 7-10mm, 8-11mm, 9-13mm, 10-13mm, 10mm-14mm, 11-15mm, 11-16mm, 12-16mm, 12-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>190042</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB169</BillingCode>
            <Name>RISE-L Lateral Lumbar Interbody Fusion Device</Name>
            <Description>Expandable titanium lumbar interbody fusion device</Description>
            <Size>Width 18-22mm, Length 40-60mm, Height 7-10mm (unexpanded) - 14-17mm (expanded)</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>214537</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB172</BillingCode>
            <Name>Altera Articulating Expandable TLIF</Name>
            <Description>Articulating Expandable Titanium TLIF Spacer</Description>
            <Size>Length: 26-36mm&#xD;
Height (non-expanded):8-12mm&#xD;
Height (expanded): 12-16mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>214537</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB200</BillingCode>
            <Name>SUSTAIN-RT</Name>
            <Description>Insert and rotate lumbar fusion device</Description>
            <Size>8-10mm x 26-30mm x 6-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191535</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB201</BillingCode>
            <Name>SUSTAIN Large</Name>
            <Description>Anterior Lumbar Interbody Fusion Device in PEEK and Titanium</Description>
            <Size>Footprint: 25 X 31mm  Height 9-21mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>191533</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB202</BillingCode>
            <Name>HEDRON L</Name>
            <Description>3D Printed Lateral Spacer</Description>
            <Size>Width: 18-22mm  Lengths: 40-60mm  Heights: 7-15mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>353398</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB204</BillingCode>
            <Name>HEDRON P</Name>
            <Description>3D Printed Posterior Lumbar Interbody Spacer</Description>
            <Size>Width: 10-12mm  Length: 26-30mm  Height: 7-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>353398</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB205</BillingCode>
            <Name>HEDRON T</Name>
            <Description>3D Printed TLIF Spacer</Description>
            <Size>Width: 10-11mm  Length: 28-33mm  Height: 7-17mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>353398</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB208</BillingCode>
            <Name>HEDRON A </Name>
            <Description>3D Printed ALIF Spacer</Description>
            <Size>Footprint: 22X 29mm, 24X 35mm, 28X39mm  Height 9-21mm  </Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>353398</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH529</BillingCode>
            <Name>ALIF Spine Truss System</Name>
            <Description>Cage</Description>
            <Size>8-20mm height</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH543</BillingCode>
            <Name>Posterior Spine Truss System Interbody Fusion Device</Name>
            <Description>TLIF Cage</Description>
            <Size>(9-12)mm x (22-40)mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH546</BillingCode>
            <Name>Lateral Spine Truss System</Name>
            <Description>Interbody spacer, Porous Ti</Description>
            <Size>8-16mm high</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>252733</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM439</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK122</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Amendia Zeus Fusion Cages-TLIF</Name>
            <Description>Zeus Fusion Cages-TLIF, PEEK (straight-versatile/curved/bullet nosed)</Description>
            <Size>width (9-13 mm) x length (20-36 mm) x height (7-16 mm)</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>233730</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM485</BillingCode>
            <Name>GoLIF Cage</Name>
            <Description>Lumbar interbody fusion cage</Description>
            <Size>22mm - 26mm (length)  8-15mm (height)</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>364210</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM502</BillingCode>
            <Name>TLIF Cage</Name>
            <Description>TLIF Cage - Titanium</Description>
            <Size>10, 12W x 7-16H x 28, 33L x 5°, 10°, 12.5°</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>367230</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM511</BillingCode>
            <Name>LLIF Cage</Name>
            <Description>LLIF Cage - PEEK</Description>
            <Size>18, 22, 26W x 8, 10, 12, 14H x 40, 45, 50, 55L x  0°, 8°, 12°</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>367230</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM513</BillingCode>
            <Name>TLIF Cage</Name>
            <Description>TLIF Cage</Description>
            <Size>10, 12mm (W) x 7 - 16mm (H) x 28, 33mm (L) x 5°, 10°, 12.5°</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>367230</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC673</BillingCode>
            <Name>Verte-Stack</Name>
            <Description>Perimeter Cage</Description>
            <Size>Extra Small, Small, Medium, Large, Extra Large</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC685</BillingCode>
            <Name>Verte-Stack Crescent</Name>
            <Description>PEEK</Description>
            <Size>Height 6 - 18mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC974</BillingCode>
            <Name>Capstone Cage</Name>
            <Description>TLIF Vertebral Body Spacer</Description>
            <Size>Length: 32mm - 36mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC975</BillingCode>
            <Name>Capstone Cage</Name>
            <Description>DLIF Vertebral Body Spacer</Description>
            <Size>Length: 40mm - 60mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI062</BillingCode>
            <Name>Capstone Control</Name>
            <Description>TLIF vertebral Body Spacer</Description>
            <Size>Length: 27-32mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI064</BillingCode>
            <Name>Crescent Spinal System</Name>
            <Description>Titanium</Description>
            <Size>height: 7-16mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI065</BillingCode>
            <Name>Clydesdale Spinal System</Name>
            <Description>Lateral vertebral body spacer (PEEK &amp; PTC)</Description>
            <Size>Length: 40mm - 60mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI172</BillingCode>
            <Name>Divergence-L Anterior/Oblique Lumbar Fusion System </Name>
            <Description>Interbody cage</Description>
            <Size>10-20mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI186</BillingCode>
            <Name>PIVOX Oblique Lateral Spinal System</Name>
            <Description>Interbody Cage</Description>
            <Size>20-27mm width</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI273</BillingCode>
            <Name>AVILA</Name>
            <Description>Oblique or Anterior Cage</Description>
            <Size>Small, Medium, Large</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI284</BillingCode>
            <Name>ARTiC Spinal System</Name>
            <Description>Titanium Fusion Cage</Description>
            <Size>Height: 8-15mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI323</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER462</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Endoskeleton TL</Name>
            <Description>Titanium Lateral Interbody fusion cage, sterile or non-sterile also with NanoLock™ surface technology, sterile</Description>
            <Size>Length: 40-60mm, Width 18-26mm, Height 8-16mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>285244</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI324</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER463</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Endoskeleton TA</Name>
            <Description>Titanium anterior interbody fusion device for the lumbar spine, sterile or non-sterile, also with Nano Lock™ surface technology, sterile</Description>
            <Size>32-40 x 21-27mm    Width 32-40mm, Length 21-27mm, Height 10-17mm, 20,25,30,35,40,45,50,55,60,65mm, 0˚ &amp; 7˚angles</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>285244</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI325</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER498</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Endoskeleton TT Interbody Fusion Device</Name>
            <Description>Titanium posterior interbody fusion cage, parallel or lordotic, sterile or non-sterile, also with NanoLock™ surface technology, sterile</Description>
            <Size>Height 7-14mm; 30-35mm x11mm, 0˚ or 4˚ angles</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>285244</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI331</BillingCode>
            <Name>Elevate Expandable Interbody Device</Name>
            <Description>Expandable Interbody Device - Single</Description>
            <Size>Height: 7-16mm  Width: 10mm  Length: 28-32mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI368</BillingCode>
            <Name>Adaptix Cage</Name>
            <Description>TLIF Vertebral Body Spacer</Description>
            <Size>Length: 34-38 mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>126313</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN235</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JJ520</PriorBillingCode>
                <PriorBillingCode>JJ899</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CONCORDE Spine System</Name>
            <Description>Interbody Fusion Device</Description>
            <Size>7-18mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
                <ARTG>149723</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN247</BillingCode>
            <Name>CONDUIT EIT ALIF Cage</Name>
            <Description>Lumbar Cage with Titanium</Description>
            <Size>8-18mm heights</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN249</BillingCode>
            <Name>CONDUIT EIT TLIF Cage</Name>
            <Description>Titanium Lumbar Cage</Description>
            <Size>7-15mm heights</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN251</BillingCode>
            <Name>CONDUIT EIT SMART ALIF</Name>
            <Description>Cellular Titanium Cage with Graft Hole</Description>
            <Size>8-20mm height</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN254</BillingCode>
            <Name>CONDUIT EIT SMART TLIF</Name>
            <Description>Cellular Titanium Cage with Graft Hole</Description>
            <Size>7-15mm heights</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN255</BillingCode>
            <Name>CONDUIT EIT SMART LLIF system</Name>
            <Description>Lateral Lumbar Interbody Cage</Description>
            <Size>8-16mm Height</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>319880</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU103</BillingCode>
            <Name>Mectalif Oblique</Name>
            <Description>Oblique Transforaminal Interbody Fusion Device made with PEEK</Description>
            <Size>Width: 12mm. Length 28, 30, 32,34, 36 and 40 mm. Height: from 7 to 15 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>180172</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU105</BillingCode>
            <Name>Mectalif Transforaminal</Name>
            <Description>Transforaminal Interbody Fusion Device _ Banana Shape - made with PEEK</Description>
            <Size>Width: 12 and 14 mm. Length: 30 and 34 mm. Height from 8 to 15 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>180172</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU163</BillingCode>
            <Name>MectaLIF Anterior SIMPLE - PEEK Cages</Name>
            <Description>PEEK and Ti-PEEK Anterior Cages - Simple</Description>
            <Size>Cage dimensions: 24mm x 31mm, 27mm x 35mm, 30mm X 35mm, 30mm X 40mm&#xD;
Height: 10-18mm in 2mm increments&#xD;
Lordosis: from 5° to 20°.</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>291730</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV012</BillingCode>
            <Name>CoRoent</Name>
            <Description>TLIF cage - PEEK or Titanium</Description>
            <Size>Width 8-14mm x Length 20-40mm x Height 6-14mm x Lordosis 0-15°</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV013</BillingCode>
            <Name>CoRoent</Name>
            <Description>XLIF cage – PEEK or Titanium</Description>
            <Size>Width 16mm-26mm x Length 25-60mm x Height 4-20mm x Lordosis 0-35 degrees</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV014</BillingCode>
            <Name>CoRoent</Name>
            <Description>ALIF cage</Description>
            <Size>XLR</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV094</BillingCode>
            <Name>Brigade Ti System</Name>
            <Description>Interbody fusion implant</Description>
            <Size>10-20mm x 34-42mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV143</BillingCode>
            <Name>Base Interfixated</Name>
            <Description>Interbody fusion implant</Description>
            <Size>6-14mm tall, 34-42mm wide, 24-30mm deep and 0-30° lordosis</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV150</BillingCode>
            <Name>Nuvasive TLX Interbody System</Name>
            <Description>Expandable Lumbar Fusion Device</Description>
            <Size>Width 11mm x Length 26-36mm x Height 7-14mm x Lordosis 12-20 degrees</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV152</BillingCode>
            <Name>Modulus TLIF-A</Name>
            <Description>Titanium lumbar interbody fusion device</Description>
            <Size>Width: 9-14mm  Length: 30-40mm  Height: 7-14mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV153</BillingCode>
            <Name>Modulus TLIF-O</Name>
            <Description>Titanium lumbar interbody fusion device</Description>
            <Size>Width: 10-14mm  Length: 25-35mm  Height: 7-14mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV154</BillingCode>
            <Name>Modulus XLIF</Name>
            <Description>Lateral lumbar fusion cage</Description>
            <Size>Width: 18-26mm&#xD;
Length: 45-60mm&#xD;
Height: 8-14mm&#xD;
Lordosis 0-15 degree</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV167</BillingCode>
            <Name>3DP Interfixated ALIF</Name>
            <Description>Interbody fusion device with integral fixation</Description>
            <Size>6-10mm X 34-42mm X 24-32mm   10 - 20 degrees lordosis</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV168</BillingCode>
            <Name>Modulus ALIF </Name>
            <Description>Integrated fixation lumbar fusion cage</Description>
            <Size>6-12mm X 34-42mm X 24-32mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW047</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BH143</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Zyston Curved Interbody Spacer</Name>
            <Description>Transformaminal Lumbar Interbody Spacer, PEEK</Description>
            <Size>(7 to 18)mm height to (27x32)mm length, Parallel, Lordotic</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>287188</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW048</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZI949</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Timberline Lateral Fusion System</Name>
            <Description>Interbody Fusion Implant</Description>
            <Size>25-60mm length</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>287189</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH612</BillingCode>
            <Name>HumanTech - Adonis Spinal Fusion Cage System - TLIF/UNILIF</Name>
            <Description>Spinal Fusion Cage - TLIF/UNILIF</Description>
            <Size>L 30-35mm   W: 11-12mm H: 7-15mm   A: 0-5 </Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>316185</ARTG>
                <ARTG>316186</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH614</BillingCode>
            <Name>HumanTech - Adonis Spinal Fusion Cage System - ALIF</Name>
            <Description>Adonis Spinal Fusion Cage System - PLIF</Description>
            <Size>L: 22mm   W: 32 H1: 9-17mm   H2: 6.3 - 12.3 A: 7-12 </Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>316185</ARTG>
                <ARTG>316186</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB005</BillingCode>
            <Name>TLIF (D-REX) Cage</Name>
            <Description>Interbody fusion cage.</Description>
            <Size>Height: 7-15 mm.</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>215887</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB014</BillingCode>
            <Name>ATP Cage</Name>
            <Description>Lateral Interbody Spacer</Description>
            <Size>Width 22mm x Length 40-60mm x Height 8 - 20mm&#xD;
Angles 8, 15 &amp; 23 degree lordotic angle</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>215887</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ018</BillingCode>
            <Name>VerteLoc™ Spine System</Name>
            <Description>Interbody Fusion Device</Description>
            <Size>7mm - 18mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ019</BillingCode>
            <Name>Australis Spine System</Name>
            <Description>Thoracolumbar Cage</Description>
            <Size>small to extra large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ055</BillingCode>
            <Name>Australis Spine System</Name>
            <Description>Thoracolumbar Cage PC</Description>
            <Size>Small to extra large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI001</BillingCode>
            <Name>Bullet-Tip Interbody Fusion Device</Name>
            <Description>TLIF interbody fusion implant; PEEK with tantalum markers</Description>
            <Size>(8- 13)mm width X (22-32)mm long X (8-17)mm height; 0-6 degrees Lordosis</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>233565</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI003</BillingCode>
            <Name>CrossFuse II Interbody Fusion Device</Name>
            <Description>Interbody fusion implant for Lateral Approach (LLIF); PEEK with tantalum markers</Description>
            <Size>(14- 22)mm width X (35-70)mm long X (7-17)mm height; Lordosis 0-18 degrees; Cornal taper:&#xD;
0-6 degrees</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>233565</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI030</BillingCode>
            <Name>Fortilink® -TS</Name>
            <Description>Posterior lumbar interbody fusion device</Description>
            <Size>Width: 10mm  Length: 26mm-32mm  Height: 8-17mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI033</BillingCode>
            <Name>Fortilink®-SA</Name>
            <Description>Interbody fusion device with integrated locking mechanism</Description>
            <Size>Width 32mm-40mm  Length 25mm-29mm  Height 10mm -22mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI040</BillingCode>
            <Name>Fortilink® -TC</Name>
            <Description>Transforaminal interbody fusion device</Description>
            <Size>Width: 10mm  Length: 26-36mm  Height: 7-15mm </Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI046</BillingCode>
            <Name>Fortilink®-A</Name>
            <Description>Interbody fusion cage</Description>
            <Size>Width: 32-40mm  Length: 25-29mm   Height: 8-22mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RI047</BillingCode>
            <Name>Fortilink®-L</Name>
            <Description>Lateral interbody fusion device</Description>
            <Size>Width: 14-26mm  Length: 40-60mm  Height: 8-15mm</Size>
            <SupplierCode>RI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>346071</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF099</BillingCode>
            <Name>Advantage Plus Cage</Name>
            <Description>Plasma Coated PEEK Cage</Description>
            <Size>Small, medium, Medium Wide, Large, Extra Large</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF101</BillingCode>
            <Name>Revolve Cage</Name>
            <Description>Spinal Cage</Description>
            <Size>9-17mm high, 21-27mm length, 12-22 degrees, PEEK or Titanium</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF155</BillingCode>
            <Name>Ayers TLIF Cage</Name>
            <Description>TLIF interbody fusion device</Description>
            <Size>Curved and Straight, various sizes and angles.</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF160</BillingCode>
            <Name>Aerofoil Cage</Name>
            <Description>Lumbar interbody Cage</Description>
            <Size>Length 40-60mm, Height 8-16mm, Curvature 0 - 12 degrees</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF167</BillingCode>
            <Name>Elevator ALIF Cage</Name>
            <Description>Anterior Lumbar Cage with integral fixation (PEEK, HA PEEK)  </Description>
            <Size>Angle 8-25 degrees, Small, Medium, Medium Wide, Large, Extra Large, 11-19mm high</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF174</BillingCode>
            <Name>Spoiler ALF Cage</Name>
            <Description>PEEK/ PEEK HA Cage</Description>
            <Size>Small, Medium, Medium Wide, Large, Extra Large</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF178</BillingCode>
            <Name>Chinook PLIF Cage</Name>
            <Description>PLIF Spine Cage</Description>
            <Size>7-14mm high, 24-29mm length, 5-16 degrees, PEEK, PEEK/HA, Titanium</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SF183</BillingCode>
            <Name>Hornet ALIF Cage</Name>
            <Description>Integral fixated ALIF Cage</Description>
            <Size>Small, Medium, Medium Wide, Large, Extra Large</Size>
            <SupplierCode>SF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>181030</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ155</BillingCode>
            <Name>Neo Cage System</Name>
            <Description>Cage Kit  PLIF, TLIF  Straight, Lordotic</Description>
            <Size>22-26mm Length  7-14mm Width  7-14mm Height</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>316221</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ159</BillingCode>
            <Name>Neo Cage System </Name>
            <Description>Cage anatomical, straight, curved</Description>
            <Size>22-36mm length, 7-14mm width, 0-8 degrees</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>316221</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR050</BillingCode>
            <Name>AVS TL Peek Spacer System</Name>
            <Description>Transforaminal Lumbar Interbody Fusion cage, PEEK</Description>
            <Size>7-18mm x 25--30mm. 0-4 degree</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>315081</ARTG>
                <ARTG>315106</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR066</BillingCode>
            <Name>AVS AL PEEK Spacer System</Name>
            <Description>Anterior Lumbar Interbody Fusion Cage</Description>
            <Size>22mm deep x 28mm wide x 10mm - 50mm height and 28mm deep x 33mm wide x 10mm-50mm height.  Both base sizes come in 4 degree and 8 degree angulations</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>315080</ARTG>
                <ARTG>315081</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SR082</BillingCode>
            <Name>UniLIF</Name>
            <Description>PEEK Unilateral Lumbar Interbody Fusion Cage</Description>
            <Size>Width 11mm, Height 6mm to 13mm, Length 30mm - 33mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>315086</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY137</BillingCode>
            <Name>Syncage</Name>
            <Description>Interbody fusion cage</Description>
            <Size>9-19mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY300</BillingCode>
            <Name>Travios</Name>
            <Description>Interbody fusion cage, prefilled or unfilled</Description>
            <Size>5mm to 19mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY439</BillingCode>
            <Name>OPAL</Name>
            <Description>Cage Spacer</Description>
            <Size>7-177mm, 10 x 28-32mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY453</BillingCode>
            <Name>Oracle</Name>
            <Description>Lumbar Interbody Fusion Cage</Description>
            <Size>40-55mm M/L x 22mm A/P, 9-17mm Height</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY570</BillingCode>
            <Name>T-PAL</Name>
            <Description>Interbody Fusion Cage System - Lumbar</Description>
            <Size>7-17mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>133400</ARTG>
                <ARTG>231840</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UL009</BillingCode>
            <Name>Revolution Cage</Name>
            <Description>Spinal Cage</Description>
            <Size>9-17mm high, 21-27mm length, 12-22 degrees</Size>
            <SupplierCode>UL</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>285840</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UL011</BillingCode>
            <Name>Revolution TC/TS lumbar interbody fusion implant</Name>
            <Description>Revolution TC/TS lumbar interbody fusion implant</Description>
            <Size>21, 24, 27 lengths; 9-17mm heights; 12, 16, 22 deg lordosis</Size>
            <SupplierCode>UL</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>285840</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT001</BillingCode>
            <Name>CALIBER Lordotic Cage</Name>
            <Description>Lumbar fusion cage; PEEK, Titanium coated PEEK, 3D printed Titanium. </Description>
            <Size>Width: 9mm; Length: 24mm - 36mm; Height 6mm - 12mm; Lordosis: 6, 12, 18 degrees</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>322720</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UT018</BillingCode>
            <Name>Unity+ Lateral Standalone Cage</Name>
            <Description>Thoracolumbar fusion cage: PEEK, Titanium coated PEEK, or 3D printed Titanium.</Description>
            <Size>Width: 22mm, Height: 8mm, 9mm, 11mm, 13mm, 15mm, Width: 40mm, 45mm, 50mm, 55mm, 60mm, Lordosis: 8 or 15 degrees.</Size>
            <SupplierCode>UT</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>322720</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ031</BillingCode>
            <Name>Valeo II AL</Name>
            <Description>Anterior Lumbar Interbody Fusion Device</Description>
            <Size>Footprint: 30 x 24mm, 36 x 28mm, 39 x 30mm&#xD;
Height: 9-22mm&#xD;
Lordosis: 4-12 degrees</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>287982</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ033</BillingCode>
            <Name>Valeo II TL</Name>
            <Description>Transforaminal Lumbar Interbody Fusion Device</Description>
            <Size>Footprint: 10 x 27mm, 10 x 33mm, 12 x 27mm, 12 x 33mm&#xD;
Height: 7-16mm&#xD;
Lordosis: 6 degrees</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>287982</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ038</BillingCode>
            <Name>Valeo II and Valeo Gen 1 PL/OL</Name>
            <Description>PLIF lumbar interbody fusion device</Description>
            <Size>Footprint: 9 x 21mm, 9 x 25mm, 9 x 29mm, 9x 32mm&#xD;
Height: 7-18mm&#xD;
Lordosis: 0-6 degrees</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>287982</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ039</BillingCode>
            <Name>Valeo II LL</Name>
            <Description>Lateral Lumbar Interbody Fusion Device</Description>
            <Size>Footprint: 18-22mm x 40mm-60mm&#xD;
Height: 8-16mm&#xD;
Lordosis: 0 - 6 degrees</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1486</GroupID>
            <SubGroupID>4135</SubGroupID>
            <ARTGs>
                <ARTG>287982</ARTG>
            </ARTGs>
            <MinimumBenefit>3313</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC008</BillingCode>
            <Name>GL-DTRAX Expandable Cage System</Name>
            <Description>Expandable titanium cage</Description>
            <Size>One Size</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1487</GroupID>
            <ARTGs>
                <ARTG>290977</ARTG>
            </ARTGs>
            <MinimumBenefit>1326</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC009</BillingCode>
            <Name>GL -DTRAX Cervical Cage- B</Name>
            <Description>Cervical Cage with integral fixation.</Description>
            <Size>One Size</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1487</GroupID>
            <ARTGs>
                <ARTG>293579</ARTG>
            </ARTGs>
            <MinimumBenefit>1326</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FC010</BillingCode>
            <Name>GL-DTRAX Cervical Cage- T</Name>
            <Description>Titanium Cervical Cage</Description>
            <Size>One Size</Size>
            <SupplierCode>FC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1487</GroupID>
            <ARTGs>
                <ARTG>293579</ARTG>
            </ARTGs>
            <MinimumBenefit>1326</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ020</BillingCode>
            <Name>ZygoLoc</Name>
            <Description>Facet Fusion Cage</Description>
            <Size>3-15mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>174</SubCategoryID>
            <GroupID>1487</GroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>1326</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB347</BillingCode>
            <Name>activ C Cervical Disc Prosthesis</Name>
            <Description>Cervical disc prosthesis consisting of superior and inferior endplates, plasmapore coated with anatomical adapted footprint and shape.</Description>
            <Size>XS=16Wx13Lx5H or 6H; S=16Wx14Lx5H OR 6H; M=17WX15LX5H or 6H; L=18Wx16Lx5H or 6H; XL=19Wx17Lx5H or 6H; XXL=19Wx18Lx5H or 6H</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>181018</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR004</BillingCode>
            <Name>Freedom Cervical Disc</Name>
            <Description>Cervical disc replacement prosthesis.</Description>
            <Size>Footprints: 13x16mm, 15x18mm, 17x20mm &#xD;
Heights: 5, 6mm</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>280296</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU039</BillingCode>
            <Name>BAGUERA C</Name>
            <Description>Cervical Disc Prosthesis</Description>
            <Size>Height: 5-7mm  Footprint: 13-16mm X 16-18mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>166149</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER533</BillingCode>
            <Name>Simplify Disc</Name>
            <Description>Cervical disc prosthesis</Description>
            <Size>Footprints: 12mm x 15mm, 14mm x 16mm, 16mm x 18mm  Heights: 4mm, 5mm, 6mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>237772</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc C (Vivo)</Name>
            <Description>Prosthesis used to replace a cervical inter-vertebral disc and to restore disc height and segmental motion.</Description>
            <Size>5-7mm Hright  15-19 mm Width  12-18mm Depth</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>323813</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP011</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Prodisc-C</Name>
            <Description>Cervical Intervertebral Disc</Description>
            <Size>5-7mm Height; 15-19mm Width; 12-18mm Depth</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB104</BillingCode>
            <Name>SECURE Cervical Artificial Disc</Name>
            <Description>Cervical Disc Replacement System</Description>
            <Size>5mm - 9mm, 11x12 - 15x18mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>191978</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH490</BillingCode>
            <Name>M6C Artificial Cervical Disc</Name>
            <Description>The M6 artificial cervical disc is an intervertebral disc prosthesis designed to maintain motion of a functional spinal unit when the native disc is diseased.</Description>
            <Size>Footprints:&#xD;
12.5mm x 15mm&#xD;
15mm x 15mm&#xD;
14mm x 17mm&#xD;
16mm x 17mm&#xD;
Heights: &#xD;
6mm &amp; 7mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>177101</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM425</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK079</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Synergy Disc</Name>
            <Description>The Synergy Disc is a three-component system consisting of an Inferior titanium endplate, a UHMWPE core and a Superior titanium endplate.</Description>
            <Size>Small (A-P: 14 mm, Lateral: 15 mm), Medium (A-P: 16 mm, Lateral: 17 mm) and Large (A-P: 16 mm, Lateral: 17 mm).</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>238877</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI058</BillingCode>
            <Name>Bryan Cervical Disc</Name>
            <Description>Cervical intervertebral disc prosthesis consisting of a polyurethane nucleus designed to fit between two titanium alloy shells</Description>
            <Size>14mm-18mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>100706</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI059</BillingCode>
            <Name>Prestige Cervical Disc</Name>
            <Description>Cervical intervertebral disc prosthesis with ball-and-trough designed articulation</Description>
            <Size>5mm - 8mm x 12mm - 18mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>100706</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV171</BillingCode>
            <Name>Nuvasive Simplify Cervical Artificial Disc</Name>
            <Description>Cervical disc prosthesis</Description>
            <Size>Footprints: 12mm x 15mm, 14mm x 16mm, 16mm x 18mm  Heights: 4mm, 5mm, 6mm  Lordosis: 0, 5 degrees</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>387763</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NW041</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ZA057</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mobi-C Cervical Disc Prosthesis</Name>
            <Description>A cervical intervertebral disc replacement consisting of superior and inferior spinal plates and a mobile bearing insert.</Description>
            <Size>Depth (13-19mm) x width (15-19mm) x height (4.5-7mm)</Size>
            <SupplierCode>NW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>297897</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH521</BillingCode>
            <Name>CP ESP Cervical disc</Name>
            <Description>Cervical disc prosthesis</Description>
            <Size>13-15 x 15-20 H5/6/7</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>205414</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC025</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc C (Vivo)</Name>
            <Description>Prosthesis used to replace a cervical inter-vertebral disc and to restore disc height and segmental motion.</Description>
            <Size>5-7mm Hright  15-19 mm Width  12-18mm Depth</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>323813</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC026</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA032</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Prodisc-C</Name>
            <Description>Cervical Intervertebral Disc</Description>
            <Size>5-7mm Height; 15-19mm Width; 12-18mm Depth</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>196068</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY751</BillingCode>
            <Name>Prodisc-C</Name>
            <Description>Cervical Intervertebral Disc</Description>
            <Size>5-7mm Height; 15-19mm Width; 12-18mm Depth</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5487</SubGroupID>
            <ARTGs>
                <ARTG>133399</ARTG>
            </ARTGs>
            <MinimumBenefit>6021</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB361</BillingCode>
            <Name>activ L Lumbar Disc Prosthesis</Name>
            <Description>activ L is the lumbar disc prosthesis for the motion preserving treatment of degenerative disc disease of the lumbar spine.</Description>
            <Size>H= 8.5mm/10mm/ 12mm/ 14mm. &#xD;
Small: D= 26mm x W = 31mm&#xD;
Medium: D= 28mm x W = 34.5mm&#xD;
Large: D= 30mm x W = 39mm&#xD;
Extra Large: D= 33mm x W = 40mm</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5488</SubGroupID>
            <ARTGs>
                <ARTG>120419</ARTG>
            </ARTGs>
            <MinimumBenefit>8847</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DR001</BillingCode>
            <Name>Freedom Lumbar Disc</Name>
            <Description>Lumbar Disc Replacement Prosthesis</Description>
            <Size>26mmx36mm, 28mmx38mm, 30mmx40mm, 12-16mm, 4-12 degrees.</Size>
            <SupplierCode>DR</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5488</SubGroupID>
            <ARTGs>
                <ARTG>279935</ARTG>
            </ARTGs>
            <MinimumBenefit>8847</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU065</BillingCode>
            <Name>Baguera L  </Name>
            <Description>Lumbar Disc Prosthesis  </Description>
            <Size>Height: 8, 10, 12 mm.  Footprint: 27 x 35mm; 30 x 39mm; 31 x 42mm  </Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5488</SubGroupID>
            <ARTGs>
                <ARTG>338474</ARTG>
            </ARTGs>
            <MinimumBenefit>8847</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH531</BillingCode>
            <Name>M6L Artificial Lumbar Disc</Name>
            <Description>Intervertebral Artificial Disc – Lumbar</Description>
            <Size>(Medium, Large, Xlarge) footprint, 3 - 16 degrees lordosis</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5488</SubGroupID>
            <ARTGs>
                <ARTG>177102</ARTG>
            </ARTGs>
            <MinimumBenefit>8847</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH467</BillingCode>
            <Name>LP-ESP® Intervertebral Disc Prosthesis</Name>
            <Description>Lumbar disc prosthesis</Description>
            <Size>10-12mm thickness, 7/9/11 degrees</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1488</GroupID>
            <SubGroupID>5488</SubGroupID>
            <ARTGs>
                <ARTG>181919</ARTG>
            </ARTGs>
            <MinimumBenefit>8847</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA033</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH631</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, superior plate component</Description>
            <Size>3 Degree, 6 Degree, 11 Degree, Medium, Large</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>299018</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA034</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH632</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, inferior plate component</Description>
            <Size>0 Degree, 3 Degree, 8 Degree,Medium, Large</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>299018</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc L Superior Plate Component</Name>
            <Description>Pro-Disc L Superior Plate Component</Description>
            <Size>3 Degree, 6 Degree, 11 Degree, Medium, Large</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>323814</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc L Inferior Plate Component</Name>
            <Description>Pro-Disc L Inferior Plate Component</Description>
            <Size>0 Degree, 6 Degree, 8 Degree, Medium, Large</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>323814</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC027</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA021</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc L Superior Plate Component</Name>
            <Description>Pro-Disc L Superior Plate Component</Description>
            <Size>3 Degree, 6 Degree, 11 Degree, Medium, Large</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>323814</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC028</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA022</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc L Inferior Plate Component</Name>
            <Description>Pro-Disc L Inferior Plate Component</Description>
            <Size>0 Degree, 6 Degree, 8 Degree, Medium, Large</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>323814</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC029</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, superior plate component</Description>
            <Size>3 Degree, 6 Degree, 11 Degree, Medium, Large</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>299018</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC030</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, inferior plate component</Description>
            <Size>0 Degree, 3 Degree, 8 Degree,Medium, Large</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>299018</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY327</BillingCode>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, superior plate component</Description>
            <Size>3 Degree, 6 Degree, 11 Degree, Medium, Large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1489</GroupID>
            <ARTGs>
                <ARTG>133399</ARTG>
            </ARTGs>
            <MinimumBenefit>3891</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JA035</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>OH633</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, polyethylene inlay</Description>
            <Size>10,12,14mm, Medium, Large</Size>
            <SupplierCode>JA</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1490</GroupID>
            <ARTGs>
                <ARTG>299018</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JP003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc L - Core Component - Polyethylene Inlay</Name>
            <Description>Pro-Disc L - Core Component - Polyethylene Inlay</Description>
            <Size>10, 12, 14mm, Medium, Large</Size>
            <SupplierCode>JP</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1490</GroupID>
            <ARTGs>
                <ARTG>323814</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC031</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA023</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Pro-Disc L - Core Component - Polyethylene Inlay</Name>
            <Description>Pro-Disc L - Core Component - Polyethylene Inlay</Description>
            <Size>10, 12, 14mm, Medium, Large</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1490</GroupID>
            <ARTGs>
                <ARTG>323814</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PC032</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>JA035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, polyethylene inlay</Description>
            <Size>10,12,14mm, Medium, Large</Size>
            <SupplierCode>PC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1490</GroupID>
            <ARTGs>
                <ARTG>299018</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY328</BillingCode>
            <Name>Spine Solutions Prodisc</Name>
            <Description>Artificial mechanical disc, polyethylene inlay</Description>
            <Size>10,12,14mm, Medium, Large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>175</SubCategoryID>
            <GroupID>1490</GroupID>
            <ARTGs>
                <ARTG>133399</ARTG>
            </ARTGs>
            <MinimumBenefit>1065</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB137</BillingCode>
            <Name>Fortify® I Integrated Corpectomy Spacer System - Core</Name>
            <Description>PEEK and Titanium Cores with option of fixed lower endplate</Description>
            <Size>12mm, 14mm and 20mm diameter Height 24-90mm to 32-120mm (expanded)</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4136</SubGroupID>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>2032</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB066</BillingCode>
            <Name>XP and R Corpectomy Spacer System</Name>
            <Description>Expandable Corpectomy spacer</Description>
            <Size>Small, Medium,15-88mm in varying lordotic/kyphotic angles</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>Cervical</Suffix>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>2756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV102</BillingCode>
            <Name>X-Core Mini</Name>
            <Description>the NuVasive X-CORE Mini expandable VBR System is a vertebral body repalcement device for use in the spine (C3 to L5) to replace a diseased or damaged vertebral body caused by tumor or fracure, to restore height of a collapsed vertebral body, and to achieve decompression of the spinal cord and neural tissues,</Description>
            <Size>15-80mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>Cervical</Suffix>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>2756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY356</BillingCode>
            <Name>ECD - Expandable Corpectomy Device</Name>
            <Description>Vertebral body replacement system, PEEK/Titanium</Description>
            <Size>Angle 4.5Deg/7Deg, Height 17mm - 70mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>Cervical</Suffix>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>2756</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB288</BillingCode>
            <Name>Aesculap Vertebral Body System</Name>
            <Description>Vertebral Body System, Titanium Alloy</Description>
            <Size>All sizes</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>132297</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE756</BillingCode>
            <Name>KONG-TL</Name>
            <Description>KONG-TL VBR Extension with Screw</Description>
            <Size>19mm Diameter, 20 &amp; 35mm Heights</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>345871</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE773</BillingCode>
            <Name>KONG-TL</Name>
            <Description>KONG-TL VBR Bodies</Description>
            <Size>19mm Diameter:  19-23mm, 20-24mm, 22-29mm, 23-30mm, 27-37mm &amp; 33-49mm Heights  </Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>345871</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER184</BillingCode>
            <Name>SIGNUS Poseidon/POSEIDON ST Vertebral Body Replacement System-Vertebral Body</Name>
            <Description>SIGNUS POSIDON/POSEIDON ST Vertebral Body, porous titanium</Description>
            <Size>Dia 16/20mm x (Height 12-89mm)    </Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>216750</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER309</BillingCode>
            <Name>Ulrich Anterior Distraction Device</Name>
            <Description>Ulrich Anterior Distraction Device (ADD)-telescoping cage,  thoracolumbar</Description>
            <Size>dia (12-16 mm) x height collapsed (10-39 mm) x height extended (13-65 mm) x angle (0-6°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>279702</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER350</BillingCode>
            <Name>Ulrich Anterior Distraction Device System (ADDplus)-Telescopic cage</Name>
            <Description>Ulrich Anterior Distraction System (ADDplus) telescopic cage, integral end plate, cervical.</Description>
            <Size>dia 12 mm x collapsed height (13-40 mm) x expanded height (18-65 mm) x angle (0-18°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>279702</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER354</BillingCode>
            <Name>Ulrich thoracolumbar body replacement system (ObeliscPro)-Telescoping cage</Name>
            <Description>Ulrich thoracolumbar body replacement system (ObeliscPro)-Telescoping cage, thoracolumbar</Description>
            <Size>dia 20 mm x collapsed height (17-76 mm) x expanded height (23-132 mm)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>279702</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW757</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER210</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Capri Vertebral Body Replacement System-Cage</Name>
            <Description>Cage, Internal or External Component</Description>
            <Size>23 - 122mm height, multiple footprints</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>204117</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW770</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER471</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CAPRI Small  Expandable Corpectomy Cage System</Name>
            <Description>Vertebral Body Replacement</Description>
            <Size>(13-16) x (16-20) mm – height 18-74mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>291618</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB055</BillingCode>
            <Name>Xpand Corpectomy Spacer System</Name>
            <Description>Expandable corpectomy spacer</Description>
            <Size>small, Medium, Large. 15-120mm in varying lordotic/kyphotic angles</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB093</BillingCode>
            <Name>FORTIFY Ti Corpectomy Spacer Core</Name>
            <Description>Expandable corpectomy spacer</Description>
            <Size>12mm, 16mm and 20mm x 15mm-135mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB097</BillingCode>
            <Name>FORTIFY R Corpectomy Spacer Core</Name>
            <Description>Expandable corpectomy spacer</Description>
            <Size>14mm -20mm  15mm-120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC820</BillingCode>
            <Name>T2</Name>
            <Description>Expandable vertebral body replacement cage</Description>
            <Size>Diameters: 13 - 31mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI298</BillingCode>
            <Name>T2 Stratosphere Expandable Corpectomy System</Name>
            <Description>Centrepiece</Description>
            <Size>13-25mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV078</BillingCode>
            <Name>X-CORE (Expandable  cage)</Name>
            <Description>Expandable VBR Cage</Description>
            <Size>Diameter: 12-22mm&#xD;
Height: 15-121mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH576</BillingCode>
            <Name>SAMSON - Expandable Vertebral Body Replacement - Center Piece</Name>
            <Description>Center Piece</Description>
            <Size>Height 20mm - 120mm  Diam 20mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>316057</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ042</BillingCode>
            <Name>VerteLoc Expandable System</Name>
            <Description>Expandable Cage</Description>
            <Size>20-100mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK448</BillingCode>
            <Name>VLIFT</Name>
            <Description>Vertebral Body Replacement System, DIS Implant</Description>
            <Size>Diameters 12 to 22mm</Size>
            <SupplierCode>SK</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>130216</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY341</BillingCode>
            <Name>Expandable Cage Titanium</Name>
            <Description>Synex II, Titanium</Description>
            <Size>Height 14mm-123mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY343</BillingCode>
            <Name>Expandable Cage Titanium</Name>
            <Description>Synex, Titanium, with endplates</Description>
            <Size>Height 14mm - 93mm, Angle 0 - 40 degree</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY794</BillingCode>
            <Name>XRL</Name>
            <Description>Expandable Vertebral Body</Description>
            <Size>22 - 121mm Height</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4137</SubGroupID>
            <Suffix>ThoracoLumbar</Suffix>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>3921</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE757</BillingCode>
            <Name>KONG-TL</Name>
            <Description>KONG-TL VBR Endplates with Screw</Description>
            <Size>26-52mm Lengths  20-29mm Widths  0,4, 8 &amp; 12 Degree Angles</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>345871</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER185</BillingCode>
            <Name>SIGNUS POSEIDON/POSEIDON ST Vertebral Body Replacement System-End Plate</Name>
            <Description>SIGNUS POSEIDON/POSEIDON ST End Plate; porous titanium; </Description>
            <Size>Dia (16mm) x (18 mm - 20mm) x (18 mm – 59 mm); lordosis 0°/ 5°/10°/15°/20°</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>216750</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER355</BillingCode>
            <Name>Ulrich thoracolumbar body replacement system (ObeliscPRO)-End plates</Name>
            <Description>Ulrich thoracolumbar body replacement system (ObeliscPRO)-End plates, various shapes</Description>
            <Size>dia (20-32 mm) x angle (0-15°); oval (32x26 mm) x angle (0-15°); lateral length (35-55 mm) x angle (0-15°)</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>279702</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB096</BillingCode>
            <Name>FORTIFY Ti Corpectomy Spacer Endplate</Name>
            <Description>Expandable  corpectomy spacer endplate</Description>
            <Size>12 and 20mm x 12-50mm 0-12deg.  13mm Round, 16mm, 16mm Round,16mm Footprint. 16mm,  18mm Round, 18mm Footprint.  20mm Round, 20mm, 20mm Footprint. 12 X 13mm. 12mm X 13mm Footprint.  16 X 30mm Footprint, 16 x35mm Footprint, 16 x 40mm Footprint, 16 x 45mm Footprint, 18 x30mm Footprint, 18X 35mm Footprint, 18X40mm Footprint, 18 X 45mm Footprint</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB098</BillingCode>
            <Name>FORTIFY R Corpectomy Spacer Endplate</Name>
            <Description>Expandable corpectomy spacer endplate</Description>
            <Size>14-30mm X 14-25mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB138</BillingCode>
            <Name>Fortify I Integrated Corpectomy Spacer System - Endplates</Name>
            <Description>PEEK and Titanium endplates</Description>
            <Size>Lateral – 22mm X 40-50mm, 14mm X 14-16mm, 12-14mmX 14-16mm, 21x23mm and 25 X 30mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI299</BillingCode>
            <Name>T2 Stratosphere Expandable Corpectomy System</Name>
            <Description>End Cap</Description>
            <Size>13-30mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV079</BillingCode>
            <Name>X-CORE (End Cap)</Name>
            <Description>End plate</Description>
            <Size>Round 12-30mm x -8° to 16°; Rectangular 12-22mm x 15-60mm x -8° to 16°</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>132498</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH575</BillingCode>
            <Name>SAMSON - Expandable Vertebral Body Replacement - End Plates</Name>
            <Description>End Plates</Description>
            <Size>L: 20mm W: 25-55mm A: 0-8 </Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>316057</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY342</BillingCode>
            <Name>Expandable Cage Titanium</Name>
            <Description>Synex II, Titanium endplate</Description>
            <Size>Angle 0 - 40 degree. Endplate Size 19x20, 22x25, 26x30</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY795</BillingCode>
            <Name>XRL</Name>
            <Description>Endplate</Description>
            <Size>-10˚/+15˚ Degrees</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1492</GroupID>
            <SubGroupID>4138</SubGroupID>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>1014</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP513</BillingCode>
            <Name>Stackable Corpectomy CFRP Cage System</Name>
            <Description>Stackable Cage</Description>
            <Size>Xsmall-Xlarge</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY322</BillingCode>
            <Name>Carbon Fibre Interbody Fusion Device</Name>
            <Description>Stackable C/F Cage System Wedges</Description>
            <Size>11 Degree Small-Large</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER164</BillingCode>
            <Name>Signus Athlet VBR System - Main Body</Name>
            <Description>Peek Vertebral Body Replacement System (Main body)</Description>
            <Size>12, 18, 24, 30, 36 and 42mm lengths</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>216750</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER165</BillingCode>
            <Name>Signus Athlet VBR System - End Body</Name>
            <Description>Peek Vertebral Body Replacement System (End body)</Description>
            <Size>4, 6, 8mm heights</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>216750</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW752</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER175</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Santorini Stackable Corpectomy Cage-Small</Name>
            <Description>Corpectomy Cage, Peek  </Description>
            <Size>(12x17)mm footprint x (2-62)mm height</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>204117</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW753</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER176</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Santorini Stackable Corpectomy Cage-Medium/Large</Name>
            <Description>Corpectomy Cage, Peek </Description>
            <Size>(16x20) or (21x25)mm footprint x (2-98)mm height</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>204117</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC632</BillingCode>
            <Name>Verte-Stack</Name>
            <Description>XS Centre Piece. Stackable Corpectomy Device.</Description>
            <Size>Height 5-50mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV145</BillingCode>
            <Name>Monolith Corpectomy System</Name>
            <Description>Vertebral Body Replacement System</Description>
            <Size>Diameter 12-14mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>209197</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ021</BillingCode>
            <Name>VerteLoc Spine System</Name>
            <Description>Locking Screw</Description>
            <Size>20mm - 150mm</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ022</BillingCode>
            <Name>VerteLoc Spine System</Name>
            <Description>Stackable Cage</Description>
            <Size>Extra Small- Extra large</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>217031</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PZ023</BillingCode>
            <Name>VerteLoc Spine System</Name>
            <Description>Locking Nut</Description>
            <Size>one size only</Size>
            <SupplierCode>PZ</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1493</GroupID>
            <ARTGs>
                <ARTG>217033</ARTG>
            </ARTGs>
            <MinimumBenefit>3765</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF002</BillingCode>
            <Name>A-Mesh Spinal Titanium Mesh Spacer</Name>
            <Description>A-Mesh® Spinal Titanium Mesh is designed to restore biomechanical integrity throughout the thoracic and lumbar spine following vertebrectomy or corpectomy for patients with spine tumors or fractures.</Description>
            <Size>Diameter: 10mm, Length: 20mm, 50mm 70mm&#xD;
Diameter: 12mm, Length: 20mm, 50mm, 70mm&#xD;
Diameter: 14mm, Length: 20mm, 50mm, 70mm&#xD;
Diameter: 16mm, Length: 20mm, 50mm, 70mm, 90mm&#xD;
Diameter: 20mm, Length: 20mm, 50mm, 70mm, 90mm&#xD;
Diameter: 25mm, Length: 20mm, 50mm, 70mm, 90mm&#xD;
Diameter: 30mm, Length: 20mm, 50mm, 70mm, 90mm&#xD;
Diameter: 35mm, Length: 20mm, 50mm, 70mm, 90mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>187179</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DP427</BillingCode>
            <Name>Surgical Titanium Mesh System</Name>
            <Description>Various shapes</Description>
            <Size>10- 26 x 15 -150mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB196</BillingCode>
            <Name>COLOSSEUM Mesh Corpectomy Spacer</Name>
            <Description>Titanium mesh corpectomy spacer</Description>
            <Size>12-25mm X 14-30mm, 8-120mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>325140</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC378</BillingCode>
            <Name>Pyramesh</Name>
            <Description>Titanium Surgical Mesh</Description>
            <Size>51 - 500mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC379</BillingCode>
            <Name>Pyramesh</Name>
            <Description>Titanium Surgical Mesh</Description>
            <Size>5 - 50mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC449</BillingCode>
            <Name>Pyramesh</Name>
            <Description>Angled</Description>
            <Size>25 - 150mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC450</BillingCode>
            <Name>Pyramesh</Name>
            <Description>Curved / Round</Description>
            <Size>20 - 150mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC451</BillingCode>
            <Name>Pyramesh</Name>
            <Description>Ovoid</Description>
            <Size>8 - 130mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV017</BillingCode>
            <Name>Titanium Mesh</Name>
            <Description>Oval/Flat/Long/Round</Description>
            <Size>20mm + Diameter, 30mm - 90mm Length</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>132467</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH657</BillingCode>
            <Name>HTS Leander Cervical Vertebral Body Replacement</Name>
            <Description>Titanium alloy implant base bodies available in different heights for different defect heights</Description>
            <Size>Diameter 11.5mm; Height 16mm - 55mm</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>372782</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB054</BillingCode>
            <Name>Titanium Spinal Mesh</Name>
            <Description>Mesh, Round</Description>
            <Size>18 - 90 mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>215887</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK338</BillingCode>
            <Name>VBOSS/VLIFT</Name>
            <Description>Cage Body</Description>
            <Size>Available from 10 to 25mm in Diameter and from 8 to 120mm in Length</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>315419</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY293</BillingCode>
            <Name>Synmesh</Name>
            <Description>Mesh, Oblong</Description>
            <Size>6mm - 88mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY294</BillingCode>
            <Name>Synmesh</Name>
            <Description>Mesh, Round</Description>
            <Size>6mm - 88mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1494</GroupID>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>2972</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF020</BillingCode>
            <Name>A-Mesh Spinal Titanium Mesh Plate and Set Screw</Name>
            <Description>A-Mesh Spinal Titanium Mesh is designed to restore biomechanical integrity throughout the thoracic and lumbar spine following vertebrectomy or corpectomy for patients with spine tumors or fractures</Description>
            <Size>Diameter 10m 12, 14, 16, 20, 15, 30 or 35mm</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>187179</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY087</BillingCode>
            <Name>Surgical Titanium Mesh System</Name>
            <Description>End Plate or Screws or End Cap (Round / Oblong / Trapezoidal)</Description>
            <Size>10-33mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>128257</ARTG>
                <ARTG>97391</ARTG>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DY088</BillingCode>
            <Name>Surgical Titanium Mesh System</Name>
            <Description>Rings (Standard and Angled)</Description>
            <Size>17-26mm x 22-33mm</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>98094</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB197</BillingCode>
            <Name>COLLOSSEUM Mesh Endcap</Name>
            <Description>Endcap</Description>
            <Size>12-25mm X 14-30mm, 2-8mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>325140</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC539</BillingCode>
            <Name>Pyramesh</Name>
            <Description>End ring/cap</Description>
            <Size>10 - 25mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC821</BillingCode>
            <Name>T2</Name>
            <Description>End Cap</Description>
            <Size>13-31 mm, 0, 4, 8, 15 degree lordosis</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>169501</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OH658</BillingCode>
            <Name>HTS Leander VBR Endplates</Name>
            <Description>Titanium alloy Endplates available in different widths and angles for adaption to different vertebral body structures</Description>
            <Size>Length 12-14mm; Width 14-16mm; Angle 2.5, 5, 7.5 degrees</Size>
            <SupplierCode>OH</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>372782</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PB055</BillingCode>
            <Name>Titanium Spinal Mesh</Name>
            <Description>End rings</Description>
            <Size>10 - 24 mm</Size>
            <SupplierCode>PB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>215887</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SK424</BillingCode>
            <Name>VBOSS / VLIFT</Name>
            <Description>End cap</Description>
            <Size>Sizes 10 to 25mm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>315105</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-11-30</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SY295</BillingCode>
            <Name>Synmesh</Name>
            <Description>End rings</Description>
            <Size>round/oblong</Size>
            <SupplierCode>SY</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1495</GroupID>
            <ARTGs>
                <ARTG>133398</ARTG>
            </ARTGs>
            <MinimumBenefit>1121</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE758</BillingCode>
            <Name>KONG-C</Name>
            <Description>KONG-C VBR Body</Description>
            <Size>13mm Diameter  16-66mm, Height</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1814</GroupID>
            <ARTGs>
                <ARTG>345871</ARTG>
            </ARTGs>
            <MinimumBenefit>3340</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE759</BillingCode>
            <Name>KONG-C</Name>
            <Description>KONG-C VBR Endplates</Description>
            <Size>14x13mm, 16x13mm, 18x14mm  5.5mm Height  0,3 &amp; 6 Degree Angles</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1814</GroupID>
            <ARTGs>
                <ARTG>345871</ARTG>
            </ARTGs>
            <MinimumBenefit>3340</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW748</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER138</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Santorini Solid Corpectomy Cage System</Name>
            <Description>Cage, fixed height, Peek</Description>
            <Size>(12x14) or (16x20) mm footprint x (18-62) mm height</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1814</GroupID>
            <ARTGs>
                <ARTG>204117</ARTG>
            </ARTGs>
            <MinimumBenefit>3340</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW768</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER409</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Capri Small Solid Corpectomy Cage System</Name>
            <Description>Non Stackable vertebral body replacement</Description>
            <Size>(12 x14)mm or (13x16)mm footprint</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1814</GroupID>
            <ARTGs>
                <ARTG>291618</ARTG>
            </ARTGs>
            <MinimumBenefit>3340</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB131</BillingCode>
            <Name>Niko Corpectomy Spacer</Name>
            <Description>PEEK Thoracolumbar pre-assembled corpectomy cage</Description>
            <Size>Width 12 and 14mm, Length 14mm and 16mm, Height 15-33mm in 2mm increments</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1814</GroupID>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>3340</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB140</BillingCode>
            <Name>Fortify® I-R Static Corpectomy Spacer System -Spacer</Name>
            <Description>PEEK spacer with integrated titanium plates</Description>
            <Size>Footprint - 12 X14mm   Heights 15-33mm (2mm increments)</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>176</SubCategoryID>
            <GroupID>1814</GroupID>
            <ARTGs>
                <ARTG>190055</ARTG>
            </ARTGs>
            <MinimumBenefit>3340</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DU032</BillingCode>
            <Name>Romeo 2 PAD System</Name>
            <Description>Interspinous fusion device</Description>
            <Size>8mm to 18mm</Size>
            <SupplierCode>DU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>177</SubCategoryID>
            <GroupID>1496</GroupID>
            <ARTGs>
                <ARTG>198720</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB113</BillingCode>
            <Name>SP-Fix™ Spinous Process Fixation</Name>
            <Description>Posterior non-pedicle supplemental fixation device</Description>
            <Size>35-55mm</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>177</SubCategoryID>
            <GroupID>1496</GroupID>
            <ARTGs>
                <ARTG>237299</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM410</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK027</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Axle Interspinous fusion System</Name>
            <Description>Interspinous fusion plate system</Description>
            <Size>Plates: 28mm to 55mm  Inserts: 8-18mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>177</SubCategoryID>
            <GroupID>1496</GroupID>
            <ARTGs>
                <ARTG>160750</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC637</BillingCode>
            <Name>CD Horizon</Name>
            <Description>Spire Plate</Description>
            <Size>35-41mm</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>177</SubCategoryID>
            <GroupID>1496</GroupID>
            <ARTGs>
                <ARTG>169514</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NV064</BillingCode>
            <Name>Affix Plate</Name>
            <Description>Spinous process plate with an integrated canted-coil locking mechanism.</Description>
            <Size>25mm - 55mm</Size>
            <SupplierCode>NV</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>177</SubCategoryID>
            <GroupID>1496</GroupID>
            <ARTGs>
                <ARTG>132466</ARTG>
            </ARTGs>
            <MinimumBenefit>1321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE608</BillingCode>
            <Name>iFuse Implant System-Implant</Name>
            <Description>iFuse Implant System-Implant</Description>
            <Size>4-10.75 mm; length 30-90 mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>261</SubCategoryID>
            <GroupID>1821</GroupID>
            <Suffix>no suffix</Suffix>
            <ARTGs>
                <ARTG>212886</ARTG>
            </ARTGs>
            <MinimumBenefit>1853</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER345</BillingCode>
            <Name>Signus Diana SI Joint Fusion Device</Name>
            <Description>The DIANA® sacroiliac fusion device is a titanium alloy, tapered hollow cylindrical implant with radial fenestrations to encourage bony in-growth and a threaded outer surface for fixation and stabilisation of the sacroiliac joint.</Description>
            <Size>Tapered design: dia at wide point (13-21 mm) x dia at narrow point (12-20mm) x length 30mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>261</SubCategoryID>
            <GroupID>1821</GroupID>
            <Suffix>no suffix</Suffix>
            <ARTGs>
                <ARTG>216752</ARTG>
            </ARTGs>
            <MinimumBenefit>1853</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LB062</BillingCode>
            <Name>SI-LOK Stabilization System</Name>
            <Description>Fusion Screw</Description>
            <Size>8.0-12.0mm diameter x 25-60mm length</Size>
            <SupplierCode>LB</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>261</SubCategoryID>
            <GroupID>1821</GroupID>
            <Suffix>no suffix</Suffix>
            <ARTGs>
                <ARTG>199414</ARTG>
            </ARTGs>
            <MinimumBenefit>1853</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM422</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>NK045</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Silex Joint Fixation Device</Name>
            <Description>Single-Thread Sacroiliac Anchor Implant or Dual-Thread Sacroiliac Anchor Implant</Description>
            <Size>12.5mm x 30-70mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>261</SubCategoryID>
            <GroupID>1821</GroupID>
            <Suffix>no suffix</Suffix>
            <ARTGs>
                <ARTG>228758</ARTG>
            </ARTGs>
            <MinimumBenefit>1853</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI197</BillingCode>
            <Name>Rialto</Name>
            <Description>SI Fusion System</Description>
            <Size>12mm Dia. 40mm to 60mm Length</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>261</SubCategoryID>
            <GroupID>1821</GroupID>
            <Suffix>no suffix</Suffix>
            <ARTGs>
                <ARTG>281942</ARTG>
            </ARTGs>
            <MinimumBenefit>1853</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MU164</BillingCode>
            <Name>M.U.S.T. Sacro-Iliac Joint Screws and Washers</Name>
            <Description>Headless and Standard Sacro-Iliac Joint Screws and Washers</Description>
            <Size>Headless SI screws: Ø 7.5-11 mm, Lenght 30-100 mm.   Standard SI screws: Ø 8-10 mm, Lenght 25-80 mm.   Washers: Standard version Ø 13-20 mm; Favored angle version Ø 15-20 mm</Size>
            <SupplierCode>MU</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>261</SubCategoryID>
            <GroupID>1821</GroupID>
            <Suffix>no suffix</Suffix>
            <ARTGs>
                <ARTG>301842</ARTG>
            </ARTGs>
            <MinimumBenefit>1853</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER305</BillingCode>
            <Name>Barricaid</Name>
            <Description>Annular replacement prosthesis</Description>
            <Size>Height: 14mm; Width 8mm, 10mm, 12mm</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>19</CategoryID>
            <SubCategoryID>263</SubCategoryID>
            <GroupID>1823</GroupID>
            <ARTGs>
                <ARTG>273822</ARTG>
            </ARTGs>
            <MinimumBenefit>5132</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI050</BillingCode>
            <Name>Neofuser Plus</Name>
            <Description>Neofuser® Plus is a single-use, portable&#xD;
elastomeric infusion pump that provides&#xD;
medication at accurate continuous pre-fixed flow&#xD;
with additional bolus doses via patient controlled&#xD;
analgesia (PCA) module. Neofuser® Plus has&#xD;
been mainly designed for systemic or regional&#xD;
preoperative and postoperative pain&#xD;
management therapy.</Description>
            <Size>60 ml&#xD;
60 ml&#xD;
100ml&#xD;
100ml&#xD;
275ml&#xD;
275ml&#xD;
450 ml&#xD;
450 ml</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>306862</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX057</BillingCode>
            <Name>Autofuser Fixed Rate w/Bolus</Name>
            <Description>Fixed rate elastomeric infusion pump. Several basal rate options. Bolus volume options with several refill times available. Rigid, rounded, low profile housing. Front low pressure port for ease of filling. Graduated markings for monitoring infusion.    The Arrow  AutoFuser  Disposable Pain Pump from Teleflex is designed to safely and reliably deliver regional anaesthesia medications to help effectively manage post-operative pain in patients following surgery involving implanted prosthesis such as knee, hip or shoulder reconstructions. Effective management of postoperative pain in the immediate and early postoperative period facilitates early patient mobilisation and reduces the likelihood of implanted prosthesis failure. The device is also used to facilitate the delivery of epidural medical during labour in expectant mothers and can also be used for the delivery of medications necessary in the treatment of oncology patients.    The Arrow  AutoFuser  Disposable Pain Pump offers multiple  reservoir sizes and configurations to meet a variety of clinical demands. The AutoSelector  Variable Rate Selector gives the clinician the ability to adjust the basal infusion rate to meet the individualized needs of each patient to help control their post-operative pain. The patient controlled bolus gives patients the ability to address breakthrough pain without interrupting the basal rate.</Description>
            <Size>275ml, 550ml</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>288197</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TY001</BillingCode>
            <Name>mobiFUSER</Name>
            <Description>Disposable sterile non electronic elastomeric infusion device. Variable flow rates available. For continuous fluid/medication delivery</Description>
            <Size>Maximum Capacity 275ml</Size>
            <SupplierCode>TY</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>188661</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU024</BillingCode>
            <Name>Tuoren Infusion Pump</Name>
            <Description>Non electronic, elastomeric balloon driven, ambulatory infusion pump, which can be supplied in a variety of volumes and flow rates to meet different clinical applications.  Its primary purpose is for continuous delivery of fluids/medications.</Description>
            <Size>60ml - 300ml</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>323586</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX247</BillingCode>
            <Name>Intermate</Name>
            <Description>Sterile infusor devices, elastomeric driven</Description>
            <Size>SV 200 - 200ml/hr, nominal 100ml vol. max 105 mL. SV 100 - 100ml/hr, nominal 100ml vol. max 105 mL. LV 250, 250ml/hr, 275ml vol. SV 50 - 50ml/hr, nominal 100ml vol. max 105mL.  LV 100  - 100ml/hr, 275ml vol. LV 50, 50ml/hr, 275ml vol</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX281</BillingCode>
            <Name>Baxter Folfusor</Name>
            <Description>Sterile infusor devices, elastomeric driven.  Folfusor SV 0.5mL/hr 120mL (Baxter Code 2C4700K), Folfusor SV 2.5mL/hr 120mL (Baxter Code 2C4711K), Folfusor SV 5mL/hr 120mL (Baxter Code 2C4705K). The Baxter Folfusor is a disposable infusion pump used in an ambulatory setting for the continuous infusion of intravenous medications. The codes listed above represent three separate flow rates specific to Chemotherapy protocols.</Description>
            <Size>120mL Maximum Volume</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX287</BillingCode>
            <Name>Intermate XLV 250</Name>
            <Description>Sterile infusor devices, elastomeric driven.  The Intermate XLV 250 is an ambulatory device utilising elastomeric technology to deliver continuous infusion of parenteral therapy to patients in an ambulatory setting. The device is specifically suitable for patients requiring intravenous immunoglobulin therapy. The nominal flow rate of the Intermate XLV 250 is 250mL/hr, however when used for the administration of IVIG the flow rate is reduced to approximately 120mL/hr.</Description>
            <Size>Volume 500mL. Approximate infusion time for IVIG solutions is 4.2 hrs.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX327</BillingCode>
            <Name>Infusor</Name>
            <Description>Sterile Infusor Devices, Elastomeric Driven</Description>
            <Size>LV 10, 10ml/hr, 240ml vol  LV 5, 5ml/hr, 240ml vol</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX328</BillingCode>
            <Name>Infusor</Name>
            <Description>Sterile Infusor Devices, Elastomeric Driven</Description>
            <Size>LV 2, 2ml/hr, 275 ml vol;  LV 1.5, 1.5ml/hr, 275 ml vol.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CU003</BillingCode>
            <Name>Neofuser Pump</Name>
            <Description>Continuous flow rate ambulatory and disposable silicone balloon infusion pump</Description>
            <Size>Volume 100ml, 275ml, 450ml</Size>
            <SupplierCode>CU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>286078</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ146</BillingCode>
            <Name>ON-Q Pain Relief System</Name>
            <Description>Elastomeric Infusion Pump System</Description>
            <Size>100-400ml</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>142526</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UX001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DOSI-FUSER</Name>
            <Description>Non electronic, elastomeric balloon driven, ambulatory infusion pump, which can be supplied in a variety of volumes and flow rates to meet different clinical applications.  Its primary purpose is for continuous delivery of fluids/medications.</Description>
            <Size>65ml - 140mm x 45mm x 40mm; 100ml - 140mm x 52mm x 50mm; 150 - 140mm x 55mm x 55mm; 250ml - 140mm x 60mm x 60mm; 400ml, 500ml, 600ml</Size>
            <SupplierCode>UX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>324361</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UX002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH014</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DOSI-PAIN Kit</Name>
            <Description>The DOSI-PAIN® Kit is a complete pain kit for the administraton of analgesics required for post operative pain relief. The The DOSI-PAIN® Kit contains the DosiFuser elastomeric pump (already registered on the prosthesis listing), a wound catheter and a BD Plastipack syringe. The The DOSI-PAIN® Kit is designed to provide drug infusion at a constant flow without impeding patient mobility. It is indicated for Chemotherapy, antiviral treatments, administration of antibiotics, pain treatments, Aids treatments and immunosuppressants; continuous ambulatory infusion of anaesthetics, anti-emetic drugs, heparin, etc.; continuous ambulatory arterial or intravenous infusion of antibiotics, cytostatic drugs, etc.The DOSI-PAIN® Kit offers a wide range of flow rates.</Description>
            <Size>65ml - 140mm x 45mm x 40mm;  100ml - 140mm x 52mm x 50mm;  150ml - 140mm x 55mm x 55mm;  250ml - 140mm x 60mm x 60mm</Size>
            <SupplierCode>UX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>324361</ARTG>
            </ARTGs>
            <MinimumBenefit>145</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB349</BillingCode>
            <Name>Easypump</Name>
            <Description>Disposable Elastomeric infusion pump system</Description>
            <Size>LT: Filling Volume: 60ml - 400ml, Flow Rate: 0.5ml/h - 10ml/h&#xD;
ST: Filling Volume: 50ml - 500ml, Flow Rate: 50ml/h - 500ml/h</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <ARTGs>
                <ARTG>221448</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RN006</BillingCode>
            <Name>Surefuser+ Fixed Flow</Name>
            <Description>Elastomeric balloon driven, ambulatory infusion pump with a variety fixed infusion rates.</Description>
            <Size>50ml, 100ml, 250ml</Size>
            <SupplierCode>RN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <ARTGs>
                <ARTG>92233</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI049</BillingCode>
            <Name>Neofuser Pump</Name>
            <Description>Neofuser® is a single-use, portable elastomeric  infusion pump that provides medication at  accurate continuous pre-fixed flow.</Description>
            <Size>60mL, 100mL, 275mL, 450mL</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <ARTGs>
                <ARTG>306862</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX058</BillingCode>
            <Name>Autofuser Fixed Rate</Name>
            <Description>Fixed rate elastomeric infusion pump. Several basal rate options. Rigid, rounded, low profile housing. Front low pressure port for ease of filling. Graduated markings for monitoring infusion.      The Arrow  AutoFuser  Disposable Pain Pump from Teleflex is designed to safely and reliably deliver regional anaesthesia medications to help effectively manage post-operative pain in patients following surgery involving implanted prosthesis such as knee, hip or shoulder reconstructions. Effective management of postoperative pain in the immediate and early postoperative period facilitates early patient mobilisation and reduces the likelihood of implanted prosthesis failure. The device is also used to facilitate the delivery of epidural medical during labour in expectant mothers and can also be used for the delivery of medications necessary in the treatment of oncology patients.    The Arrow  AutoFuser  Disposable Pain Pump offers multiple  reservoir sizes and configurations to meet a variety of clinical demands. The AutoSelector  Variable Rate Selector gives the clinician the ability to adjust the basal infusion rate to meet the individualized needs of each patient to help control their post-operative pain. The patient controlled bolus gives patients the ability to address breakthrough pain without interrupting the continuous basal infusion.</Description>
            <Size>100ml, 150ml, 275ml</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5358</SubGroupID>
            <ARTGs>
                <ARTG>288197</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BU025</BillingCode>
            <Name>Tuoren Infusion Pump</Name>
            <Description>Non electronic, elastomeric balloon driven, ambulatory infusion pump, which can be supplied in a variety of volumes and flow rates to meet different clinical applications.  Its primary purpose is for continuous delivery of fluids/medications.</Description>
            <Size>60ml - 300ml</Size>
            <SupplierCode>BU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>323586</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX249</BillingCode>
            <Name>Multirate with PCM</Name>
            <Description>Sterile infusor devices, elastomeric driven</Description>
            <Size>Multirate 5, 7 or 12 ml/hr with PCM</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX330</BillingCode>
            <Name>Basal Bolus Infusor</Name>
            <Description>Sterile Infusor Devices, Balloon based</Description>
            <Size>Basal/Bolus 60, Basal 0.5ml/hr, Bolus 0.5 x 65ml&#xD;
Basal/Bolus 15, Basal 0.5ml/hr, Bolus 2ml/hr x 65ml&#xD;
Basal/Bolus infusor, Basal 2ml/hr, Bolus 2ml/hr x 65ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CU005</BillingCode>
            <Name>Neofuser Bolus Pump</Name>
            <Description>Ambulatory and disposable silicone balloon infusion pump with bolus function</Description>
            <Size>Volume 100ml, 275ml, 450ml</Size>
            <SupplierCode>CU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>286078</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RN007</BillingCode>
            <Name>Surefuser+ PCA</Name>
            <Description>Elastomeric balloon pump with variable infusion rate and a patient-controlled analgesia (PCA) infuser.</Description>
            <Size>50ml, 100ml, 150ml, 250ml, 300ml</Size>
            <SupplierCode>RN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>92233</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ037</BillingCode>
            <Name>ON-Q Pain Relief System</Name>
            <Description>Elastomeric Infusion Pump System with Bolus</Description>
            <Size>270-400ml</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>142526</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX059</BillingCode>
            <Name>Autofuser Autoselector Variable Rate w/Bolus</Name>
            <Description>Fixed rate elastomeric infusion pump. Several basal rate options. Bolus volume options with several refill times available. Rigid, rounded, low profile housing. Front low pressure port for ease of filling. Graduated markings for monitoring infusion. The Arrow  AutoFuser  Disposable Pain Pump from Teleflex is designed to safely and reliably deliver regional anaesthesia medications to help effectively manage post-operative pain in patients following surgery involving implanted prosthesis such as knee, hip or shoulder reconstructions. Effective management of postoperative pain in the immediate and early postoperative period facilitates early patient mobilisation and reduces the likelihood of implanted prosthesis failure. The device is also used to facilitate the delivery of epidural medical during labour in expectant mothers and can also be used for the delivery of medications necessary in the treatment of oncology patients.    The Arrow  AutoFuser  Disposable Pain Pump offers multiple  reservoir sizes and configurations to meet a variety of clinical demands. The AutoSelector  Variable Rate Selector gives the clinician the ability to adjust the basal infusion rate to meet the individualized needs of each patient to help control their post-operative pain. The patient controlled bolus gives patients the ability to address breakthrough pain without interrupting the basal rate.</Description>
            <Size>275ml, 550ml</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Bolus</Suffix>
            <ARTGs>
                <ARTG>288197</ARTG>
            </ARTGs>
            <MinimumBenefit>375</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CU004</BillingCode>
            <Name>Neofuser Vario Pump</Name>
            <Description>Variable flow rate ambulatory and disposable silicone balloon infusion pump</Description>
            <Size>Volume 60ml, 100ml, 180ml, 275ml, 450ml</Size>
            <SupplierCode>CU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>286078</ARTG>
            </ARTGs>
            <MinimumBenefit>321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ035</BillingCode>
            <Name>ON-Q Pain Relief System</Name>
            <Description>Elastomeric Infusion Pump System, Select-A-Flow, Dual</Description>
            <Size>270ml - 600ml</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>142526</ARTG>
            </ARTGs>
            <MinimumBenefit>321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UX003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DOSI-FUSER PCA Infusion System</Name>
            <Description>Designed to provide drug infusion at a constant rate. Facilitates the ability for a clinician to allow the patient to initiate a controlled bolus with a set lock out period. Bolus reservoir sizes of 0.5ml and 2ml are available with lock-out times of 15, 30, 60 and 80 minutes.</Description>
            <Size>65ml, 100ml, and 250ml</Size>
            <SupplierCode>UX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>324361</ARTG>
            </ARTGs>
            <MinimumBenefit>260</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>UX004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>DOSI-FUSER Multiflow System</Name>
            <Description>Elastomeric pump providing drug infusion at a constant flow. Facilitates the ability for a clinician to adjust the infusion rate of the contents of the infuser. Offers a wide range of flow rates from 1ml/h to 7ml/h in steps of 1ml/h, and from 2ml/h to 14ml/h in steps of 2ml/h.</Description>
            <Size>65ml, 100ml, 150ml, and 250ml.</Size>
            <SupplierCode>UX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>324361</ARTG>
            </ARTGs>
            <MinimumBenefit>321</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RN004</BillingCode>
            <Name>Surefuser+</Name>
            <Description>Elastomeric balloon driven, ambulatory infusion pump with variable infusion rate</Description>
            <Size>100ml, 250ml</Size>
            <SupplierCode>RN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <ARTGs>
                <ARTG>92233</ARTG>
            </ARTGs>
            <MinimumBenefit>142</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI051</BillingCode>
            <Name>Neofuser Vario</Name>
            <Description>Single-use, portable&#xD;
elastomeric multirate infusion pump</Description>
            <Size>1 - 7 ml/h&#xD;
2 - 14 ml/h&#xD;
1 - 7 ml/h&#xD;
2 - 14 ml/h&#xD;
1 - 7 ml/h&#xD;
2 - 14 ml/h&#xD;
1 - 7 ml/h&#xD;
2 - 14 ml/h</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <ARTGs>
                <ARTG>306862</ARTG>
            </ARTGs>
            <MinimumBenefit>142</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX060</BillingCode>
            <Name>Autofuser Autoselector Variable Rate</Name>
            <Description>Fixed rate elastomeric infusion pump. Several basal rate options. Bolus volume options with several refill times available. Rigid, rounded, low profile housing. Front low pressure port for ease of filling. Graduated markings for monitoring infusion.  The Arrow  AutoFuser  Disposable Pain Pump from Teleflex is designed to safely and reliably deliver regional anaesthesia medications to help effectively manage post-operative pain in patients following surgery involving implanted prosthesis such as knee, hip or shoulder reconstructions. Effective management of postoperative pain in the immediate and early postoperative period facilitates early patient mobilisation and reduces the likelihood of implanted prosthesis failure. The device is also used to facilitate the delivery of epidural medical during labour in expectant mothers and can also be used for the delivery of medications necessary in the treatment of oncology patients. The Arrow  AutoFuser  Disposable Pain Pump offers multiple  reservoir sizes and configurations to meet a variety of clinical demands. The AutoSelector  Variable Rate Selector gives the clinician the ability to adjust the basal infusion rate to meet the individualized needs of each patient to help control their post-operative pain. The patient controlled bolus gives patients the ability to address breakthrough pain without interrupting the continuous basal rate</Description>
            <Size>100ml, 275ml, 400ml.</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1524</GroupID>
            <SubGroupID>5359</SubGroupID>
            <ARTGs>
                <ARTG>288197</ARTG>
            </ARTGs>
            <MinimumBenefit>142</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE776</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TT005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Sapphire Infusion System</Name>
            <Description>The Sapphire Infusion System is a new device for ambulatory infusion and acute pain management. It is an infusion pump designed for the volumetric delivery of medications to patients at a programmable rate. Sapphire is the first pump to offer an intuitive, full colour touch screen interface in an ambulatory package, along with best-in-class +/-2.5% product delivery accuracy</Description>
            <Size>Size (in), Weight (oz) 5.6 x 3.8 x 1.9 in. 14.7 oz (including battery)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>201499</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK017</BillingCode>
            <Name>Agilia SP PCA Infusion System</Name>
            <Description>Agilia SP PCA is a programmable electronic medical system dedicated to administering a pre-determined volume of a syringe at a programmed rate. This syringe pump ensures a fluid delivery, by pushing the syringe plunger and advancing the liquid to the patient through an extension set. The Agilia SP PCA syringe pump can also be used for general infusions on adults, pediatrics, and neonatal patients for the intermittent or continuous delivery of parenteral fluids (such as solutions, colloids, parenteral nutrition), medications (such as diluted drugs, chemotherapy, anesthesia drugs), blood and blood derivatives, and medications through clinically accepted routes of administration.  It is intended for use by trained healthcare professionals in clinical healthcare facilities. In PCA therapy, it is also intended for use by the patient in order to self administer doses of analgesic agent, after receiving appropriate training and instructions from the clinical staff. Agilia SP PCA is a transportable and reusable device that can be used every day. </Description>
            <Size>The size of a syringe can be 5, 10, 20, 30 or 50/60 mL.  </Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>267873</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FX002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH004</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ambIT Infusion Pump</Name>
            <Description>The ambIT Reusable Infusion Pump is an external programmable electronic ambulatory infusion pump used for the delivery of fluid and medications via intravenous, epidural, subcutaneous or regional routes.  It can be programmed with different delivery profiles which include basal rate/continuous only, basal rate with PCA (Patient Controlled Analgesia), PCA Bolus Only or Intermittent Bolus Dose (PIB). It is operated in conjunction with a ambIT disposable administration cassette</Description>
            <Size>AmbIT Single use Pump - 55mm x 36mm x 175mm  AmbIT Single use administration cassette - 20mm x 10mm x 15mm</Size>
            <SupplierCode>FX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>228804</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RE001</BillingCode>
            <Name>Bodyguard Pump</Name>
            <Description>Ambulatory Infusion Pump, Battery Powered</Description>
            <Size>One size only</Size>
            <SupplierCode>RE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>119623</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RE002</BillingCode>
            <Name>REM Systems Ambulatory Infusion Pump</Name>
            <Description>Ambulatory infusion pump, syringe.&#xD;
Models: NIKI T34 Standard; T34L PCA; T34L</Description>
            <Size>One size only</Size>
            <SupplierCode>RE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>131232</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI034</BillingCode>
            <Name>CADD-Solis VIP Ambulatory Infusion Pump</Name>
            <Description>Ambulatory Infusion Pump</Description>
            <Size>One size only</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>109467</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI045</BillingCode>
            <Name>CADD®- Solis Pain Management System</Name>
            <Description>Ambulatory Infusion Pump, Battery Powered</Description>
            <Size>680g excluding accessories</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>109467</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI052</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SI037</PriorBillingCode>
                <PriorBillingCode>SI038</PriorBillingCode>
                <PriorBillingCode>SI039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>CADD Legacy</Name>
            <Description>CADD Legacy One, CADD Legacy Plus, CADD Legacy PCA</Description>
            <Size>Variants - Continuous, Continuous + Intermittent, PCA</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4185</SubGroupID>
            <ARTGs>
                <ARTG>109467</ARTG>
            </ARTGs>
            <MinimumBenefit>3470</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DQ002</BillingCode>
            <Name>Weight Dose Dispensor</Name>
            <Description>Programmable Infusion Pump</Description>
            <Size>50ml</Size>
            <SupplierCode>DQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4186</SubGroupID>
            <ARTGs>
                <ARTG>321942</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FX003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ambIT Single Use Regional Kit</Name>
            <Description>The ambIT Single Use Regional Kit contains: a single use ambIT pump, single use administration cassette with male luer lock fitting, 420ml Medibag, the choice of 75mm, 127mm or 154mm fenestrated nerve/wound catheter, a peel away introducer sheath, button guard and patient carry bag.</Description>
            <Size>ambIT Single Use Pump - 55mm x 36mm x 175mm  Ambit Single use administration cassette - 20mm x 10mm x 15mm   </Size>
            <SupplierCode>FX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4186</SubGroupID>
            <ARTGs>
                <ARTG>228805</ARTG>
                <ARTG>228804</ARTG>
                <ARTG>190934</ARTG>
                <ARTG>243381</ARTG>
                <ARTG>190922</ARTG>
                <ARTG>190933</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FX004</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH013</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ambIT Single Use</Name>
            <Description>Kit contains: a single use ambIT infusion pump, single use administration cassette with spike fitting, Button Guard, 2 x AA batteries, and patient carry bag</Description>
            <Size>AmbIT Single use Pump  - 55mm X 36mm X 175mm  AmbIT Single use administration cassette - 20mm X 10mm X 15mm</Size>
            <SupplierCode>FX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1525</GroupID>
            <SubGroupID>4186</SubGroupID>
            <ARTGs>
                <ARTG>228804</ARTG>
                <ARTG>228805</ARTG>
            </ARTGs>
            <MinimumBenefit>407</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CU001</BillingCode>
            <Name>BeeLINE MotIV Infusion Pump (275ml)</Name>
            <Description>External infusion pump, spring powered, fixed flow rate, 275ml set: set includes reservoir, introducer needle, tubing set, priming/flushing syringes, saturation catheter, dressing, syringes.  30min - 7 day infusion</Description>
            <Size>275ml infuser reservoir = 19cm (7.5") x 7cm (2.8")</Size>
            <SupplierCode>CU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1540</GroupID>
            <SubGroupID>4188</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>167182</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CU002</BillingCode>
            <Name>BeeLINE MotIV Infusion Pump (100ml)</Name>
            <Description>External infusion pump, spring powered, fixed flow rate, 100ml set: set includes reservoir, introducer needle, tubing set, priming/flushing syringes, saturation catheter, dressing, syringes.  30min - 7 day infusion</Description>
            <Size>100ml infusor reservoir = 13cm (5.1") x 7cm (2.8")</Size>
            <SupplierCode>CU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1540</GroupID>
            <SubGroupID>4188</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>167182</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DQ001</BillingCode>
            <Name>BioQ Pharma ReadyfusOR</Name>
            <Description>Non-electric pre-filled infusion pain kit</Description>
            <Size>250 ml</Size>
            <SupplierCode>DQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1540</GroupID>
            <SubGroupID>4188</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>292140</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LE002</BillingCode>
            <Name>Springfusor Infusion System  - Component # 1 Springfusor Pump/s</Name>
            <Description>#1 Spring Powered Fixed Rate Ambulatory Infusion Pump </Description>
            <Size> Pumps are available as 10ml, 30ml, 50ml</Size>
            <SupplierCode>LE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1540</GroupID>
            <SubGroupID>4188</SubGroupID>
            <Suffix>Set</Suffix>
            <ARTGs>
                <ARTG>159494</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX326</BillingCode>
            <Name>Infusor</Name>
            <Description>Sterile Infusor Devices, Spring Powered</Description>
            <Size>SV Half, 5ml/hr, nominal 60ml vol, max 65ml.&#xD;
SV Single day, 2ml/hr, nominal 48ml vol, max 65ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1540</GroupID>
            <SubGroupID>4188</SubGroupID>
            <ARTGs>
                <ARTG>168893</ARTG>
            </ARTGs>
            <MinimumBenefit>76</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX286</BillingCode>
            <Name>Painfusor Catheter</Name>
            <Description>The Painfusor Catheter is an extended fenestration catheter for the administration of analgesic drugs into surgical wounds to manage acute post-operative pain. Pack contains fenestrated catheter, peel away introducer needle accommodating 19Ga (100 mm length), 3M Tegaderm IV Transparent Film Dressing with border 1633, and GripLok catheter securement device</Description>
            <Size>Catheters are 35cm + Fenestrated section:     (35cm + 2.5cm) - total length 37.5cm, (35cm + 7.5cm) - total length 42.5cm, (35cm + 15cm) - total length 50cm, (35cm + 22.5cm) - total length 57.5cm, (35cm + 30 cm) - total length 65cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4190</SubGroupID>
            <ARTGs>
                <ARTG>177499</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ070</BillingCode>
            <Name>ON-Q Pain Relief System</Name>
            <Description>Expansion kit with Soaker catheter, or SilverSoaker antimicrobial catheter</Description>
            <Size>2.5-25cm</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4190</SubGroupID>
            <ARTGs>
                <ARTG>162583</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ142</BillingCode>
            <Name>ON-Q Pain Relief System</Name>
            <Description>QuikBloc Over-The-Needle Catheter Set</Description>
            <Size>Needles: 20GA 100mm-150mm&#xD;
Catheters: 16GA 76mm-127mm&#xD;
Stimulating, Non-stimulating</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4190</SubGroupID>
            <ARTGs>
                <ARTG>162583</ARTG>
            </ARTGs>
            <MinimumBenefit>72</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX245</BillingCode>
            <Name>Patient Control Module</Name>
            <Description>Sterile infusor devices, spring or elastomeric driven</Description>
            <Size>Module 0.5ml dose, Module 2 ml dose</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4191</SubGroupID>
            <ARTGs>
                <ARTG>168892</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE777</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>TT006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Sapphire Infusion Cassette and Set</Name>
            <Description>The Sapphire Infusion Cassette and set is a one piece microfibre infusion set with non vented spike, pinch clamp, administration cassette, female luer lock, entrance with a back check valve, pinch clamp and spin male leur lock for use with the sapphire infusion system. The materail components are made from PVC-Non DEHP (tubing, connectors), silicon (Y site and tubing and polypropylene (valves)</Description>
            <Size>210cm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4191</SubGroupID>
            <ARTGs>
                <ARTG>200689</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FX001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AH005</PriorBillingCode>
            </PriorBillingCodes>
            <Name>ambIT Infusion Pump Cassette</Name>
            <Description>Single use sterile disposable administration set for use with the ambIT Infusion Pump.  The cassette contains a rotary mechanism that pumps the infusion solution at an accurate and controlled rate.  The cassette includes an administration line with either a spike fitting or a luer lock fitting depending on the solution bag used. The line has an inline air filter.</Description>
            <Size>20mm x 10mm x 15mm</Size>
            <SupplierCode>FX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4191</SubGroupID>
            <ARTGs>
                <ARTG>228805</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RE003</BillingCode>
            <Name>Bodyguard Pump infusion sets</Name>
            <Description>Single use sterile disposble infusion set for use with Bodyguard Infusion Pump</Description>
            <Size>230 cm length</Size>
            <SupplierCode>RE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4191</SubGroupID>
            <ARTGs>
                <ARTG>119624</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI024</BillingCode>
            <Name>CADD Medication Cassettes</Name>
            <Description>Medication Cassettes for use with CADD pumps</Description>
            <Size>50 mL, 100mL, 250mL</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4191</SubGroupID>
            <ARTGs>
                <ARTG>145297</ARTG>
                <ARTG>316997</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AN016</BillingCode>
            <Name>t:slim Cartridge</Name>
            <Description>Cartridge for use with the t:slim X2 System</Description>
            <Size>Pack of 10</Size>
            <SupplierCode>AN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4192</SubGroupID>
            <ARTGs>
                <ARTG>304681</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RX002</BillingCode>
            <Name>Medical Specialties "Walkmed Drug Administration Reservoir" (McKinley, USA)</Name>
            <Description>Ambulatory Infusion Pump System, Administration Sets and Accessories</Description>
            <Size>Walkmed Drug Administration Reservoirs</Size>
            <SupplierCode>RX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4192</SubGroupID>
            <ARTGs>
                <ARTG>212508</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>RX003</BillingCode>
            <Name>Medical Specialties "Walkmed Drug Administration Sets"  (McKinley, USA)</Name>
            <Description>Ambulatory Infusion Pump System, Administration Sets and Accessories</Description>
            <Size>Walkmed Drug Administration Sets</Size>
            <SupplierCode>RX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4193</SubGroupID>
            <ARTGs>
                <ARTG>212508</ARTG>
            </ARTGs>
            <MinimumBenefit>7</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI026</BillingCode>
            <Name>CADD Administration Set 175cm TOTM tubing</Name>
            <Description>For use with SI036</Description>
            <Size>250 mL</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4193</SubGroupID>
            <ARTGs>
                <ARTG>145297</ARTG>
            </ARTGs>
            <MinimumBenefit>7</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI028</BillingCode>
            <Name>CADD Extention Set</Name>
            <Description>CADD Extension set for use with CADD Pumps</Description>
            <Size>Various</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4193</SubGroupID>
            <ARTGs>
                <ARTG>145297</ARTG>
                <ARTG>317222</ARTG>
            </ARTGs>
            <MinimumBenefit>7</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI040</BillingCode>
            <Name>Administration Set</Name>
            <Description>Administration Set for use with CADD pump</Description>
            <Size>Various configurations</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4193</SubGroupID>
            <ARTGs>
                <ARTG>316996</ARTG>
                <ARTG>145297</ARTG>
            </ARTGs>
            <MinimumBenefit>7</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SI046</BillingCode>
            <Name>Pump Pouch, single use</Name>
            <Description>Pump pouch, single use 50/100mL</Description>
            <Size>50/100mL</Size>
            <SupplierCode>SI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4194</SubGroupID>
            <ARTGs>
                <ARTG>109467</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SQ069</BillingCode>
            <Name>ON-Q Pain Relief System</Name>
            <Description>Tunneller, Sheath, Needle</Description>
            <Size>15.2-30.5cm  11-17GA</Size>
            <SupplierCode>SQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>188</SubCategoryID>
            <GroupID>1541</GroupID>
            <SubGroupID>4194</SubGroupID>
            <ARTGs>
                <ARTG>201353</ARTG>
                <ARTG>201495</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI010</BillingCode>
            <Name>Corflo Max 20fg PEG Kit "Pull Type"</Name>
            <Description>Sterile enteral feeding tube with  accessories</Description>
            <Size>20fg</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1544</GroupID>
            <ARTGs>
                <ARTG>196774</ARTG>
            </ARTGs>
            <MinimumBenefit>161</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA047</BillingCode>
            <Name>Gastrostomy Tube</Name>
            <Description>Silicone Tubes and Replacement Tubes</Description>
            <Size>12Fr - 28Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>141582</ARTG>
                <ARTG>141583</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS141</BillingCode>
            <Name>EndoVive Initial Feeding Tube</Name>
            <Description>Silicone enteral feeding tube</Description>
            <Size>Up to 24 Fr</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>159455</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE536</BillingCode>
            <Name>Capsule Monarch G Tube</Name>
            <Description>Conventional Length Non Balloon Gastronomy Tube.</Description>
            <Size>12F, 14F, 18F, 20F, 10cm length, available with or without guidewire.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>181742</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE541</BillingCode>
            <Name>Balloon G-Tube</Name>
            <Description>Conventional Length Balloon Gastrostomy tube</Description>
            <Size>12F-24F; &#xD;
Length: 10cm;&#xD;
Balloon fill volumes from 2 -15ml depending on French size.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>181742</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE546</BillingCode>
            <Name>Capsule Dome G-Tube</Name>
            <Description>Conventional Length Dome Gastrostomy Tube</Description>
            <Size>20Fr, 10cm length, available with or without guidewire.</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>181742</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE564</BillingCode>
            <Name>Mini ONE Balloon Button</Name>
            <Description>Low Profile Balloon Gastrostomy Tube</Description>
            <Size>12F to 24F and length 0.8 - 6.5cms; Balloon Fill Volumes: 2-15ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>181741</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DO020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AS205</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Kangaroo Skin Level Cage Gastrostomy Kit</Name>
            <Description>Skin level non-balloon internal retention bolster gastrostomy kit, including gastrostomy tube, accessory bolus and continuous feeding tubes syringes for inflation and flushing. Patient handbook</Description>
            <Size>12fg x 1.2cm, 12fg x 1.5cm, 12fg x 2.0cm, 12fg x 2.5cm, 12fg x 3.0cm, 12fg x 3.5cm, 12fg x 4.0cm, 12fg x 4.5cm, 12fg x 5.0cm, 16fg x 1.5cm, 16fg x 1.7cm, 16fg x 2.0cm, 16fg x 2.4cm, 16fg x 2.7cm, 16fg x 3.0cm, 16fg x 3.5cm, 20fg x 1.5cm, 20fg x 2.0cm, 20fg x 2.5cm, 20fg x 3.0cm, 20fg x 3.5cm, 20fg x 4.0cm, 20fg x 4.5cm</Size>
            <SupplierCode>DO</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>185673</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DO022</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AS207</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Kangaroo Skin Level Balloon Gastrostomy Kit</Name>
            <Description>Skin level silicone balloon gastrostomy kit, including gastronomy tube accessory bolus and continuous feeding tubes, syringes for inflation and flushing, Patient Handbook</Description>
            <Size>12-24 Fr., 0.8-5 cm, 3-8ml.</Size>
            <SupplierCode>DO</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>185673</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DO023</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AS210</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Kangaroo Single Pass PEG</Name>
            <Description>Single Pass PEG</Description>
            <Size>16fg, 20fg</Size>
            <SupplierCode>DO</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>141188</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK008</BillingCode>
            <Name>Freka PEG, ENFit</Name>
            <Description>PEG polyurethane tube with a proximal cone and integrated fixation loop, radio-opaque strip, measuring marks over a length of l-16 cm at 2 cm intervals, radio-opaque silicone retention plate, and a rounded distal opening</Description>
            <Size>9 Fr x 30 cm &#xD;
15 Fr x 35 cm&#xD;
20 Fr x 35 cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>126460</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK011</BillingCode>
            <Name>Freka Pexact, FR 15 set II, ENFit</Name>
            <Description>Kit consisting of a gastropexy device (Loop Fixture II), trocar with peel-away sheath, and silicone balloon tube for direct puncture gastrostomy</Description>
            <Size>Trocar with peel-away sheath:16 Fr, length 17.5 cm&#xD;
Silicone balloon tube:15 Fr, shaft length 23 ± 1 cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>285517</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK013</BillingCode>
            <Name>Freka Belly Button Comfort Kit, ENFit</Name>
            <Description>Gastric replacement system consisting of Freka Belly Button, insertion introducer, 2 compresses, syringe for filling balloon, lubricant gel, Seldinger wire, Freka Button Extension Sets 1 and 2, and Freka Connect. An Initial Placement System (PEG) would have been placed at least 4 weeks prior.</Description>
            <Size>12 Fr x 1.0cm ,12 Fr x 1.5cm, 12 Fr x 2.0cm, 12 Fr x 2.5cm, 12 Fr x 3.0cm, 12 Fr x 3.5cm, 12 Fr x 4.0cm, 12 Fr x 4.5cm,12 Fr x 5.0cm &#xD;
&#xD;
14 Fr x 1.0cm, 14 Fr x 1.5cm, 14 Fr x 2.0cm, 14 Fr x 2.5cm, 14 Fr x 3.0cm, 14 Fr x 3.5cm,14 Fr x 4.0cm,14 Fr x 4.5cm, 14 Fr x 5.0cm&#xD;
&#xD;
16 Fr x 1.0cm, 16 Fr x 1.5cm, 16 Fr x 2.0cm, 16 Fr x 2.5cm, 16 Fr x 3.0cm, 16 Fr x 3.5cm,16 Fr x 4.0cm,16 Fr x 4.5cm, 16 Fr x 5.0cm&#xD;
&#xD;
18 Fr x 1.0cm, 18 Fr x 1.5cm, 18 Fr x 2.0cm, 18 Fr x 2.5cm, 18 Fr x 3.0cm, 18 Fr x 3.5cm,18 Fr x 4.0cm,18 Fr x 4.5cm, 18 Fr x 5.0cm&#xD;
&#xD;
20 Fr x 1.0cm, 20 Fr x 1.5cm, 20 Fr x 2.0cm, 20 Fr x 2.5cm, 20 Fr x 3.0cm, 20 Fr x 3.5cm,20 Fr x 4.0cm, 20 Fr x 4.5cm, 20 Fr x 5.0cm&#xD;
&#xD;
24 Fr x 1.0cm, 24 Fr x 1.5cm, 24 Fr x 2.0cm, 24 Fr x 2.5cm, 24 Fr x 3.0cm, 24 Fr x 3.5cm, 24 Fr x 4.0cm, 24 Fr x 4.5cm, 24 Fr x 5.0cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>126462</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK018</BillingCode>
            <Name>Freka Belly Button  Basic Kit, ENFit</Name>
            <Description>Gastric replacement system consisting of 1 Freka Belly Button, 1 insertion introducer, 2 compresses, 1 Luer syringe for filling balloon, 1 lubricant gel, 1 X10 ml ampoule of sterile water. An Initial Placement System (PEG) would have been placed at least 4 weeks prior.</Description>
            <Size>12 Fr x 1.0cm ,12 Fr x 1.5cm, 12 Fr x 2.0cm, 12 Fr x 2.5cm, 12 Fr x 3.0cm, 12 Fr x 3.5cm, 12 Fr x 4.0cm, 12 Fr x 4.5cm,12 Fr x 5.0cm              14 Fr x 1.0cm, 14 Fr x 1.5cm, 14 Fr x 2.0cm, 14 Fr x 2.5cm, 14 Fr x 3.0cm, 14 Fr x 3.5cm,14 Fr x 4.0cm,14 Fr x 4.5cm, 14 Fr x 5.0cm              16 Fr x 1.0cm, 16 Fr x 1.5cm, 16 Fr x 2.0cm, 16 Fr x 2.5cm, 16 Fr x 3.0cm, 16 Fr x 3.5cm,16 Fr x 4.0cm,16 Fr x 4.5cm, 16 Fr x 5.0cm              18 Fr x 1.0cm, 18 Fr x 1.5cm, 18 Fr x 2.0cm, 18 Fr x 2.5cm, 18 Fr x 3.0cm, 18 Fr x 3.5cm,18 Fr x 4.0cm,18 Fr x 4.5cm, 18 Fr x 5.0cm              20 Fr x 1.0cm, 20 Fr x 1.5cm, 20 Fr x 2.0cm, 20 Fr x 2.5cm, 20 Fr x 3.0cm, 20 Fr x 3.5cm,20 Fr x 4.0cm, 20 Fr x 4.5cm, 20 Fr x 5.0cm              24 Fr x 1.0cm, 24 Fr x 1.5cm, 24 Fr x 2.0cm, 24 Fr x 2.5cm, 24 Fr x 3.0cm, 24 Fr x 3.5cm, 24 Fr x 4.0cm, 24 Fr x 4.5cm, 24 Fr x 5.0cm  </Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>126462</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI001</BillingCode>
            <Name>HALYARD* MIC*Percutaneous Endoscopic Gastrostomy (P.E.G) Feeding Tubes / Kits, Enfit and Non-Enfit</Name>
            <Description>Sterile enteral feeding tube with accessories</Description>
            <Size>14Fr, 20Fr, 24Fr</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>248293</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI002</BillingCode>
            <Name>Halyard* MIC* Percutaneous Endoscopic Gastrostomy (P.E.G) Feeding BASIC Tubes/Kits Enfit and Non-Enf</Name>
            <Description>Sterile enteral feeding tube with accessories</Description>
            <Size>14 Fr, 20 Fr, 24 Fr</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>248293</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI004</BillingCode>
            <Name>MIC-KEY Low Profile Balloon Gastrostomy Feeding Tubes/Kits, ENFit</Name>
            <Description>Sterile Low Profile Enteral Feeding Tube with Accessories</Description>
            <Size>14FR to 24 Fr ; 0.8cm to 5.0cm</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>260222</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC185</BillingCode>
            <Name>Percutaneous Endoscopic Gastrostomy (PEG) System</Name>
            <Description>PEG Enteral Feeding Kit - Push or Pull System</Description>
            <Size>18, 20, 24 FR</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4197</SubGroupID>
            <ARTGs>
                <ARTG>135063</ARTG>
            </ARTGs>
            <MinimumBenefit>185</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BS142</BillingCode>
            <Name>EndoVive Replacement Feeding Tube</Name>
            <Description>Silicone enteral feeding tube</Description>
            <Size>Up to 28 Fr</Size>
            <SupplierCode>BS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>159455</ARTG>
                <ARTG>160876</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DO021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AS206</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Kangaroo Gastrostomy Feeding Tubes</Name>
            <Description>100% silicone gastrostomy with internal retention balloon</Description>
            <Size>12fg, 14fg, 16fg, 18fg, 20fg, 22fg, 24fg</Size>
            <SupplierCode>DO</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>185454</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DO024</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MI288</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Kangaroo™ Percutaneous Endoscopic Gastrostomy Feeding Tube Accessories</Name>
            <Description>Feeding Adaptors</Description>
            <Size>16Fr/Ch, 20Fr/Ch - PEG Adaptors</Size>
            <SupplierCode>DO</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>184804</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK012</BillingCode>
            <Name>Freka Gastrotube, FR 15, ENFit</Name>
            <Description>Gastric replacement system intended for use for long-term intragastric feeding within a fully formed and healed stoma. An Initial Placement System (PEG) would have been placed at least 4 weeks prior. Made of silicone rubber.</Description>
            <Size>Fits 15 Fr</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>126462</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI005</BillingCode>
            <Name>MIC-KEY Low Profile Balloon Feeding Accessories</Name>
            <Description>MIC-KEY Extension Sets, ENFit, available in a variety of sizes and options including, bolus and y-port with straight or right-angle connectors.     MIC-KEY Medication Set is also available, ENFit. </Description>
            <Size>30.5cm, 60.9cm, 5.1cm</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>261430</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI007</BillingCode>
            <Name>MIC* Gastrostomy Feeding Tube; MIC* Bolus Gastrostomy Feeding Tube, ENFit</Name>
            <Description>Medical Grade Silicone Construction. Inflatable Silicone Internal Retention Balloon, SECUR-LOK* External Retention Ring, ENFit Feeding Port Connector, Tapered Distal Tip, Radiopaque Stripe along length of Tube</Description>
            <Size>12Fr - 2-3ml balloon, 14Fr - 3-5ml balloon, 16Fr - 3-5ml balloon, 18Fr - 7-10ml balloon, 20Fr - 7-10ml balloon, 22Fr - 7-10ml balloon, 24Fr - 7-10ml balloon, 26Fr - 7-10ml balloon, 28Fr - 7-10ml balloon, 30Fr - 7-10ml balloon</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>248293</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>NF001</BillingCode>
            <Name>Flocare Gastrostomy tube (G-tube)</Name>
            <Description>The Flocare Gastrostomy tube can be used as a replacement of an existing gastrostomy tube (PEG or G-tube) or as an initial gastrostomy tube during a surgical intervention. This balloon tube is made of medical grade silicone.</Description>
            <Size>Ch14, 18, 20</Size>
            <SupplierCode>NF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>120000</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC334</BillingCode>
            <Name>Entuit Thrive Balloon Retention Gastrostomy Feeding Tube</Name>
            <Description>The gastrostomy feeding tube is a sterile device consisting of a silicone balloon, bi-lumen shaft, three-port funnel and bolster.</Description>
            <Size>12-24 Fr</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>4198</SubGroupID>
            <ARTGs>
                <ARTG>226890</ARTG>
            </ARTGs>
            <MinimumBenefit>82</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC335</BillingCode>
            <Name>Entuit Start Initial Placement Gastrostomy Set</Name>
            <Description>Used to assist with the initial placement of feeding tubes while performing a gastrostomy. The set contains multiple dilators, Peel-Away sheath introducer(s) with dilator(s), a wire guide and needle.</Description>
            <Size>Small (dilator 12, 14 Fr), Medium (dilator 16,18 Fr) and Large (dilator 20,22,24 Fr). </Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1545</GroupID>
            <SubGroupID>6037</SubGroupID>
            <ARTGs>
                <ARTG>219806</ARTG>
            </ARTGs>
            <MinimumBenefit>101</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK009</BillingCode>
            <Name>Freka Intestinal Tube, ENFit</Name>
            <Description>Intestinal extension tube for the gastric Freka PEG FR 15 or FR 20. Made with integrated Teflon-coated wire with fitted Y-Connector and blue fixation screw, radio-opaque strip, interval markings every 10 cm, distal pigtail bend tip, 4 lateral outlet ports, straight open flexible tube with small antenna end</Description>
            <Size>9 Fr x 120 cm &#xD;
12 Fr x 120 cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>126461</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK010</BillingCode>
            <Name>Freka FCJ Set FR 9, ENFit</Name>
            <Description>System consisting of Freka polyurethrane tube, Freka ENfit Connector, Freka fixation plate, Freka tube clamp, long cannula with blunt steel mandrin for catheterisation of the jejenum, and short cannula for puncturing the abdominal wall</Description>
            <Size>9 Fr, length 75 cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>126461</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK014</BillingCode>
            <Name>Freka Endolumina, ENFit</Name>
            <Description>Single lumen feeding tube for the early jejunal feeding for ICU patients</Description>
            <Size>8 Fr, length 270 cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>125846</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK015</BillingCode>
            <Name>Freka EasyIn, ENFit</Name>
            <Description>Double lumen feeding and decompression tube for the early jejunal feeding and gastric decompression for ICU patients</Description>
            <Size>Intestinal tube: 8 Fr, 270 cm&#xD;
Gastric tube: 16 Fr, 100 cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>125846</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FK016</BillingCode>
            <Name>Freka Trelumina, ENFit</Name>
            <Description>Transanasal, 3-lumen polyurethane tube for early jejunal feeding and gastric decompression in ICU patients</Description>
            <Size>Intestinal feeding lumen: 9 Fr, length 150 cm &#xD;
Gastric decompression lumen: 16 Fr, length 95 cm&#xD;
Gastric ventilation valve: internal diameter 1.2 mm, length 95 cm</Size>
            <SupplierCode>FK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>125846</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI014</BillingCode>
            <Name>MIC* Jejunostomy Feeding Tube</Name>
            <Description>Sterile Jejunal Enteral Feeding Tube with Suture Wings (2 eaches per case)</Description>
            <Size>14fg / 9fg</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>248294</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>KI006</PriorBillingCode>
                <PriorBillingCode>KI015</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MIC* &amp; MIC-KEY* Gastric-Jejunal Feeding Tubes, ENFit</Name>
            <Description>MIC* Standard Gastric-Jejunal Feeding Tube: Medical Grade Silicone Construction, Inflatable Internal Retention Balloon, Gastric Decompression/Drainage Port, Multiple Gastric &amp; Jejunal Exit Ports, Tungsten Weighted Jejunal Portion, SECUR-LOK* External Retention Ring.    MIC-KEY* Low-Profile Gastric-Jejunal Feeding Tube: Low-profile Design, Medical Grade Silicone Construction, Inflatable Internal Retention Balloon, Gastric Decompression/Drainage Port, Multiple Gastric &amp; Jejunal Exit Ports, Tungsten Weighted Jejunal Portion, SECUR-LOK* Connection Mechanism for Extension Sets</Description>
            <Size>MIC*: 16 - 22 French, 15cm - 45cm Jejunal Length  MIC-KEY*: 14 - 22 French, 15cm - 45cm Jejunal Length, 1cm - 7cm Stoma Length</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>248294</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KI017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>KI009</PriorBillingCode>
                <PriorBillingCode>KI008</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MIC* &amp; MIC-KEY* Balloon Jejunal Feeding Tubes</Name>
            <Description>MIC* Standard Balloon Jejunal Feeding Tube and MIC-KEY* Low-Profile Balloon Feeding Tube are designed for the delivery of enteral nutrition and medication into the distal duodenum or proximal jejunum. They have a medical grade silicone construction with a single access port labeled 'Jejunal'. Wide range of sizes available.</Description>
            <Size>MIC*: 12 - 24 French, 2-3ml Balloon (12Fr) 7-10ml Balloon volume (14-24Fr)  MIC-KEY*: 14 &amp; 18 French, 0.8cm - 4.5cm stoma length, 5ml balloon (max fill volume 10ml)</Size>
            <SupplierCode>KI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <Suffix>Port</Suffix>
            <ARTGs>
                <ARTG>248294</ARTG>
            </ARTGs>
            <MinimumBenefit>451</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC098</BillingCode>
            <Name>Cook Jejunostomy Catheters</Name>
            <Description>Composition - Catheter Radiopaque Stripe, includes Wireguide, Airplug, Fixation Device</Description>
            <Size>12fr, length 66cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <ARTGs>
                <ARTG>139342</ARTG>
            </ARTGs>
            <MinimumBenefit>154</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC099</BillingCode>
            <Name>Cook Jejunostomy Catheters</Name>
            <Description>Composition - Catheter Radiopaque Stripe, includes Wireguide, Airplug, Fixation Device</Description>
            <Size>9fr, Length 60cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1546</GroupID>
            <ARTGs>
                <ARTG>139342</ARTG>
            </ARTGs>
            <MinimumBenefit>154</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC197</BillingCode>
            <Name>Cook Irrigation Catheter</Name>
            <Description>Chait Percutaneous Cecostomy Catheter</Description>
            <Size>10fr, Standard or Extra Long</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>189</SubCategoryID>
            <GroupID>1547</GroupID>
            <ARTGs>
                <ARTG>138361</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PV001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DV024</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Haemorrhage Occluder Pin with applicator</Name>
            <Description>Designed to control severe presacral bleeding during pelvic surgery.</Description>
            <Size>Two sizes: 10mm and 14mm</Size>
            <SupplierCode>PV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1551</GroupID>
            <ARTGs>
                <ARTG>133897</ARTG>
            </ARTGs>
            <MinimumBenefit>327</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WA004</BillingCode>
            <Name>Hemospray Endoscopic Hemostat</Name>
            <Description>Inorganic haemostatic agent</Description>
            <Size>20 grams of powder  Catheter: 7-10Fr, length 220cm.</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <SubGroupID>5984</SubGroupID>
            <Suffix>&gt; 10 grams</Suffix>
            <ARTGs>
                <ARTG>276342</ARTG>
            </ARTGs>
            <MinimumBenefit>497</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VM001</BillingCode>
            <Name>EndoClot Kit</Name>
            <Description>Polysaccharide haemostatic system</Description>
            <Size>2g particles, 2300mm catheter length</Size>
            <SupplierCode>VM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <SubGroupID>5984</SubGroupID>
            <ARTGs>
                <ARTG>204921</ARTG>
            </ARTGs>
            <MinimumBenefit>154</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA284</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BA263</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arista AH FlexiTip XL-R Applicator</Name>
            <Description>Rigid Dual lumen applicator for Arista AH, 38cm long specifically designe for Robotic surgery</Description>
            <Size>38 cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <SubGroupID>5985</SubGroupID>
            <ARTGs>
                <ARTG>258012</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA285</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>BA263</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Arista AH Flextip and Flextip XL</Name>
            <Description>Extender tip for delivery of Arista AH powder</Description>
            <Size>14cm  38cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <SubGroupID>5985</SubGroupID>
            <ARTGs>
                <ARTG>258012</ARTG>
            </ARTGs>
            <MinimumBenefit>46</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB083</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE604</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HaemoCer Haemostatic Powder</Name>
            <Description>Absorbable Polysaccharide Haemostat</Description>
            <Size>5gms</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>205062</ARTG>
            </ARTGs>
            <MinimumBenefit>220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB084</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DE605</PriorBillingCode>
            </PriorBillingCodes>
            <Name>HaemoCer Haemostatic Powder</Name>
            <Description>Absorbable Polysaccharide Haemostat</Description>
            <Size>2gms</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>205062</ARTG>
            </ARTGs>
            <MinimumBenefit>90</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA260</BillingCode>
            <Name>Arista AH</Name>
            <Description>Arista Absorbable Haemostatic Particles</Description>
            <Size>1g</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>233611</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA261</BillingCode>
            <Name>Arista AH</Name>
            <Description>Arista Absorbable Haemostatic Particles</Description>
            <Size>3g</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>233611</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA262</BillingCode>
            <Name>Arista AH</Name>
            <Description>Arista Absorbable Haemostatic Particles</Description>
            <Size>5g</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>233611</ARTG>
            </ARTGs>
            <MinimumBenefit>220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA301</BillingCode>
            <Name>Avitene MCH</Name>
            <Description>Avitene MCH Flour is a Microfibrillar 100% bovine collagen, topical haemostat which does not contain Thrombin. Flour is defined as a loose fibrous which can be manipulated to conform to any shape or surface. Avitene™ (MCH), in contact with a bleeding surface, attracts platelets which adhere to the fibrils  and undergo the release phenomenon to trigger aggregation of platelets into thrombi in the interstices of the fibrous mass.</Description>
            <Size>0.5 gram  1.0 gram  5.0 gram</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>332522</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF024</BillingCode>
            <Name>NexStat</Name>
            <Description>The Topical Hemostatic powder consists of purified potato starch polysaccharide. These products are sterile packed and intended for single use.</Description>
            <Size>3grams</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>280607</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX336</BillingCode>
            <Name>OSTENE Bone Haemostasis material 2.5g</Name>
            <Description>OSTENE is a water soluble polymer which provides immediate bone haemostasis, ie a bone haemostasis material, in surgical procedures</Description>
            <Size>2.5g per stick</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>229426</ARTG>
            </ARTGs>
            <MinimumBenefit>109</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX337</BillingCode>
            <Name>Ostene 3.5g Bone Haemostasis material</Name>
            <Description>OSTENE is a water soluble polymer which provides immediate bone haemostasis, ie a bone haemostasis material, in surgical procedures</Description>
            <Size>3.5g</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>229426</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX345</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AB079</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PerClot Laparascopic</Name>
            <Description>PerClot Polysaccharide Hemostatic System</Description>
            <Size>3 grams</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>164507</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX346</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AB080</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PerClot Standard &amp; XL - 1 gram</Name>
            <Description>PerClot Polysaccharide Hemostatic System</Description>
            <Size>1 gram</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>162991</ARTG>
                <ARTG>275318</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX347</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AB081</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PerClot Standard &amp; XL - 3 grams</Name>
            <Description>PerClot Polysaccharide Hemostatic System</Description>
            <Size>3 grams</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>162991</ARTG>
                <ARTG>275318</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX348</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AB082</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PerClot Standard</Name>
            <Description>PerClot Polysaccharide Hemostatic System</Description>
            <Size>5 gram</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>162991</ARTG>
            </ARTGs>
            <MinimumBenefit>220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ636</BillingCode>
            <Name>Spongostan Absorbable Haemostatic Gelatin Powder</Name>
            <Description>1 g Porcine Absorbable Haemostatic Gelatin Powder</Description>
            <Size>1 gram</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>144853</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH408</BillingCode>
            <Name>Geli Putty(Powder, 1g)</Name>
            <Description>Geli Putty is a single- use, water insoluble, fully bioabsorbable gelatin powder comprising milled sponges (Gelita-Spon) made from 100% pharmaceutical grade porcine gelatin mixed with sterile liquid (e.g. saline or antibiotic solution) prior to use.</Description>
            <Size>1 gram</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>155091</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN234</BillingCode>
            <Name>Surgicel Powder</Name>
            <Description>Absorbable Haemostatic Powder</Description>
            <Size>3.0grams</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>296463</ARTG>
            </ARTGs>
            <MinimumBenefit>134</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SV053</BillingCode>
            <Name>Starsil Haemostat</Name>
            <Description>Plant based haemostatic powder</Description>
            <Size>1g</Size>
            <SupplierCode>SV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>230577</ARTG>
            </ARTGs>
            <MinimumBenefit>45</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SV054</BillingCode>
            <Name>Starsil Haemostat</Name>
            <Description>Plant based haemostatic powder</Description>
            <Size>2g</Size>
            <SupplierCode>SV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>230577</ARTG>
            </ARTGs>
            <MinimumBenefit>90</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SV055</BillingCode>
            <Name>Starsil Haemostat</Name>
            <Description>Plant based haemostatic powder</Description>
            <Size>5g</Size>
            <SupplierCode>SV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1552</GroupID>
            <ARTGs>
                <ARTG>230577</ARTG>
            </ARTGs>
            <MinimumBenefit>220</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ006</BillingCode>
            <Name>Spongostan Absorbable Haemostat</Name>
            <Description>Anal 20s (Box of 20)</Description>
            <Size>80 x 30mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <Suffix>Anatomically Conforming</Suffix>
            <ARTGs>
                <ARTG>144852</ARTG>
            </ARTGs>
            <MinimumBenefit>15</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ007</BillingCode>
            <Name>Spongostan Absorbable Haemostat</Name>
            <Description>Anal 5s (Box of 5)</Description>
            <Size>80 x 30mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <Suffix>Anatomically Conforming</Suffix>
            <ARTGs>
                <ARTG>144852</ARTG>
            </ARTGs>
            <MinimumBenefit>15</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PU059</BillingCode>
            <Name>Gelfoam Sterile Sponge</Name>
            <Description>Sterile, pliable, nonantigenic surgical sponge prepared from specially treated purified gelatine solution</Description>
            <Size>12 - 20mm x 60mm x 7mm, individually packaged for use</Size>
            <SupplierCode>PU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <Suffix>Low Antigenicity</Suffix>
            <ARTGs>
                <ARTG>17051</ARTG>
            </ARTGs>
            <MinimumBenefit>15</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ003</BillingCode>
            <Name>Spongostan Absorbable Haemostat</Name>
            <Description>Standard (Box of 20)</Description>
            <Size>70 x 50 x 10mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>144852</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ005</BillingCode>
            <Name>Spongostan Absorbable Haemostat</Name>
            <Description>Special (Box of 20)</Description>
            <Size>70 x 50 x 1mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>144852</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ015</BillingCode>
            <Name>Spongostan Absorbable Haemostat</Name>
            <Description>Dental (Box of 24)</Description>
            <Size>10 x 10 x 10mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>144852</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH405</BillingCode>
            <Name>Gelita-Spon Absorbable Gelatin Sponge-Gelita- Spon IR Sponge</Name>
            <Description>Gelita- Spon IR is a sterile, single-use, fully bioabsorbable gelatin sponge indicated to achieve rapid haemostasis(e.g. surgically or trauma induced) by tamponade, and arterial embolisation. also indicated for use as a vehicle for a wide range of therapeutic agents including antibiotics, thrombin and chemotherapeutics without reduction in the sponge's haemostatic effect.</Description>
            <Size>GS-322-Gelita-Spon IR Sponge; 200s-3x2x2mm                                                        GS- 344- Gelita- Spon IR Sponge; 100s-4x4x4mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>155094</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH410</BillingCode>
            <Name>Gelita-Spon Absorbable Gelatin Sponge Anal-Vaginal Tampon</Name>
            <Description>'Gelita-Spon Anal-Vaginal Tampon is a sterile, single use, fully bioabsorbable gelatin sponge  indicated to achieve rapid haemostasis by tamponade, also indicated for use as a vehicle for a wide range of therapeutic agents, including antibiotics, thrombin and chemotherapeutics without reduction in the sponge's haemostatic effect.</Description>
            <Size>3x8cm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>155095</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH411</BillingCode>
            <Name>Gelita-Spon Absorbable Gelatin Sponge - Gelita-Spon ENT Sponge</Name>
            <Description>GelitaSpon  ENT Sponge is a sterile, single use, water insoluble, fully bioabsorbable, firm, high-density gelatin sponge  indicated to achieve rapid haemostasis during ENT surgery .</Description>
            <Size>8x5x1 cm &amp; 1x1x1cm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>155092</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH412</BillingCode>
            <Name>Gelita-Spon Absorbable Gelatin Sponge-Gelita- Spon Dental Cube</Name>
            <Description>Gelita-Spon Dental Cube is a  sterile, single-use, indicated to achieve rapid haemostasis dental surgery (oral bone and soft tissue), a void filler to mitigate against the risk of sclerosis created by tooth extraction, root amputations, and the removal of cysts, tumours and impacted teeth.  its absorptive capacity being a function of the amount of gelatin incorporated and, hence, the physical size of the sponge. also indicated for use as a vehicle for a wide range of therapeutic agents.</Description>
            <Size>GS-310 - Gelita-Spon Dental Cubes; 50s - 10 x 10 x 10mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>155093</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH414</BillingCode>
            <Name>Gelita-Spon Absorbable Gelatin Sponge-Gelita- Spon Standard</Name>
            <Description>Gelita-Spon Standard is a sterile, single- use, fully bioabsorbable gelatin sponge indicated to achieve rapid haemostasis(e.g. surgically or trauma induced)by tamponade, and arterial embolisation . also indicated for use as a vehicle for a wide range of therapeutic agents, including antibiotics, thrombin and chemotherapeutics without reduction in the sponge's haemostatic effect.</Description>
            <Size>GS-010-Gelita-Spon Standard; 10s-80x50x10m       GS-060-Gelita-Spon Standard Size 12-7; 10s-60x20x7mm                                                                       GS-060-Gelita-Spon Standard Size 12-7; 10s-60x20x7mm                                                                       GS-650- Gelita Spon Standard Size 200; 10s-125x80x10mm                                                                  GS-110-Gelita-Spon Standard Size Special 20; 20s-80x50x1mm                                                              GS-950-Gelita-Spon Standard Film; 20s-200x70x0.5mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4199</SubGroupID>
            <ARTGs>
                <ARTG>155096</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>PU060</BillingCode>
            <Name>Gelfoam Sterile Sponge</Name>
            <Description>Sterile, pliable, nonantigenic surgical sponge prepared from specially treated purified gelatine solution</Description>
            <Size>100 - 80mm x 125mm x 10mm in individual packet</Size>
            <SupplierCode>PU</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4200</SubGroupID>
            <Suffix>Low Antigenicity</Suffix>
            <ARTGs>
                <ARTG>17051</ARTG>
            </ARTGs>
            <MinimumBenefit>64</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ004</BillingCode>
            <Name>Spongostan Absorbable Haemostat</Name>
            <Description>Film (Box of 20)</Description>
            <Size>200 x 70 x 0.5mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1553</GroupID>
            <SubGroupID>4200</SubGroupID>
            <ARTGs>
                <ARTG>144852</ARTG>
            </ARTGs>
            <MinimumBenefit>27</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BG002</BillingCode>
            <Name>BloodStop iX</Name>
            <Description>BloodStop iX is a new generation haemostat made from water soluble, oxidised-etherified regenerated cellulose</Description>
            <Size>1.3x5cm, 5x5cm, 5x10cm</Size>
            <SupplierCode>BG</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity</Suffix>
            <ARTGs>
                <ARTG>240712</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ013</BillingCode>
            <Name>Surgicel ORIGINAL Absorbable Haemostat</Name>
            <Description>Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal</Description>
            <Size>5 x 7.5cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity</Suffix>
            <ARTGs>
                <ARTG>171589</ARTG>
                <ARTG>177702</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ014</BillingCode>
            <Name>Surgicel ORIGINAL Absorbable Haemostat</Name>
            <Description>Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal</Description>
            <Size>1.25  x 5cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity</Suffix>
            <ARTGs>
                <ARTG>171589</ARTG>
                <ARTG>177702</ARTG>
            </ARTGs>
            <MinimumBenefit>19</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ009</BillingCode>
            <Name>Surgicel Fibrillar Absorbable Haemostat</Name>
            <Description>Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description>
            <Size>2.5 x 5.1cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix>
            <ARTGs>
                <ARTG>166221</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN112</BillingCode>
            <Name>Surgicel Non-Woven (SNoW) Absorbable Haemostat</Name>
            <Description>Absorbable haemostat, Structured Non-Woven</Description>
            <Size>2.5 x 5cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix>
            <ARTGs>
                <ARTG>191054</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ023</BillingCode>
            <Name>Surgicel Nu-Knit Absorbable Haemostat</Name>
            <Description>High density, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description>
            <Size>2.5 x 2.5cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Woven</Suffix>
            <ARTGs>
                <ARTG>177701</ARTG>
            </ARTGs>
            <MinimumBenefit>33</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ432</BillingCode>
            <Name>SURGICEL Nu knit Absorbable Haemostat</Name>
            <Description>High density , oxidised regenerated cellulose, the material is biocompatible and also bactericidal.</Description>
            <Size>2.5 x 8.75cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Woven</Suffix>
            <ARTGs>
                <ARTG>177701</ARTG>
            </ARTGs>
            <MinimumBenefit>33</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH424</BillingCode>
            <Name>Gelitacel Oxidised Resorbable Cellulose Gauze (15)</Name>
            <Description>Gelitacel is a white, single-use, non-toxic, sterile, bioarbsorbable, weakly acidic, viscose-free, knitted haemostatic fabric (USP)</Description>
            <Size>5 x 7 cm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <ARTGs>
                <ARTG>157255</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM487</BillingCode>
            <Name>Haemostatic Gauze  </Name>
            <Description>Haemostatic Gauze</Description>
            <Size>≤50cm²</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6008</SubGroupID>
            <ARTGs>
                <ARTG>332360</ARTG>
            </ARTGs>
            <MinimumBenefit>8</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ030</BillingCode>
            <Name>Surgicel Fibrillar Absorbable Haemostat</Name>
            <Description>Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description>
            <Size>5.1 x 10.2cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6009</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix>
            <ARTGs>
                <ARTG>166221</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN116</BillingCode>
            <Name>Surgicel Non-Woven (SNoW) Absorbable Haemostat</Name>
            <Description>Absorbable haemostat, Structured Non-Woven</Description>
            <Size>5 x 10.2cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6009</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix>
            <ARTGs>
                <ARTG>191054</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ008</BillingCode>
            <Name>Surgicel Nu-Knit Absorbable Haemostat</Name>
            <Description>High density, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description>
            <Size>7.5 x 10cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6009</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Woven</Suffix>
            <ARTGs>
                <ARTG>177701</ARTG>
            </ARTGs>
            <MinimumBenefit>49</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ012</BillingCode>
            <Name>Surgicel ORIGINAL Absorbable Haemostat</Name>
            <Description>Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal</Description>
            <Size>5-10.2 x 20-35cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6010</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity</Suffix>
            <ARTGs>
                <ARTG>171589</ARTG>
                <ARTG>177702</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ029</BillingCode>
            <Name>Surgicel Fibrillar Absorbable Haemostat</Name>
            <Description>Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description>
            <Size>10.2 x 10.2cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6010</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix>
            <ARTGs>
                <ARTG>166221</ARTG>
            </ARTGs>
            <MinimumBenefit>98</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN117</BillingCode>
            <Name>Surgicel Non-Woven (SNoW) Absorbable Haemostat</Name>
            <Description>Absorbable haemostat, Structured Non-Woven</Description>
            <Size>10.2 x 10.2cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6010</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix>
            <ARTGs>
                <ARTG>191054</ARTG>
            </ARTGs>
            <MinimumBenefit>98</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ433</BillingCode>
            <Name>SURGICEL Nu knit Absorbable Haemostat</Name>
            <Description>High density , oxidised regenerated cellulose, the material is biocompatible and also bactericidal.</Description>
            <Size>15.2 x 22.9cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6010</SubGroupID>
            <Suffix>Antimicrobial, Low Antigenicity, Woven</Suffix>
            <ARTGs>
                <ARTG>177701</ARTG>
            </ARTGs>
            <MinimumBenefit>91</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BG001</BillingCode>
            <Name>BloodStop iX</Name>
            <Description>BloodStop iX is a new generation haemostat made from water soluble, oxidised-etherified regenerated cellulose</Description>
            <Size>10x20cm, 5x35cm</Size>
            <SupplierCode>BG</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6010</SubGroupID>
            <ARTGs>
                <ARTG>240712</ARTG>
            </ARTGs>
            <MinimumBenefit>33</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH423</BillingCode>
            <Name>Gelitacel Oxidised Resorbable Cellulose Gauze (10)</Name>
            <Description>Gelitacel is a white, single use, non-toxic, sterile, hydrophilic bioabsorbable, weakly acidic, viscose-free, knitted haemostatic fabric (USP)</Description>
            <Size>5 x 35 cm, 10 x 20 cm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6010</SubGroupID>
            <ARTGs>
                <ARTG>157255</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM486</BillingCode>
            <Name>Haemostatic Gauze </Name>
            <Description>Haemostatic Gauze </Description>
            <Size>&gt;75cm²</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1554</GroupID>
            <SubGroupID>6010</SubGroupID>
            <ARTGs>
                <ARTG>332360</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX258</BillingCode>
            <Name>FloSeal Hemostatic Matrix</Name>
            <Description>FloSeal is a proprietary combination of collagen-derived particles and topical thrombin. Comes with a syringe with needle or needle free  vial adapter.  It is not sponge, but is a high viscosity gel for haemostasis.  Clinical proven to control bleeding from capillary oozing to arterial spurting.</Description>
            <Size>5ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4213</SubGroupID>
            <Suffix>Complete Biomaterial</Suffix>
            <ARTGs>
                <ARTG>330266</ARTG>
            </ARTGs>
            <MinimumBenefit>489</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FY001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ038</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Purastat</Name>
            <Description>Haemostatic material in the form of a pre-filled syringe</Description>
            <Size>1ml, 2ml, 5ml</Size>
            <SupplierCode>FY</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4213</SubGroupID>
            <Suffix>Complete Biomaterial</Suffix>
            <ARTGs>
                <ARTG>267486</ARTG>
                <ARTG>283717</ARTG>
            </ARTGs>
            <MinimumBenefit>489</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ640</BillingCode>
            <Name>Surgiflo Haemostatic Matrix</Name>
            <Description>Absorbable Porcine Gelatin Matrix Pre-packaged in a Syringe</Description>
            <Size>6ml</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4213</SubGroupID>
            <ARTGs>
                <ARTG>204900</ARTG>
            </ARTGs>
            <MinimumBenefit>369</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX259</BillingCode>
            <Name>FloSeal Hemostatic Matrix</Name>
            <Description>FloSeal is a proprietary combination of collagen-derived particles and topical thrombin. Comes with a syringe with needle or needle free  vial adapter. It is not sponge, but is a high viscosity gel for haemostasis.  Clinically proven to control bleeding from capillary oozing to arterial spurting.</Description>
            <Size>10ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4214</SubGroupID>
            <Suffix>Complete Biomaterial</Suffix>
            <ARTGs>
                <ARTG>330266</ARTG>
            </ARTGs>
            <MinimumBenefit>745</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN172</BillingCode>
            <Name>Surgiflo Haemostatic Matrix with Thrombin</Name>
            <Description>Absorbable Porcine Gelatin Matrix pre-packaged in a syringe and with plasma derived Human Thrombin</Description>
            <Size>8mls</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4214</SubGroupID>
            <Suffix>Complete Biomaterial</Suffix>
            <ARTGs>
                <ARTG>226071</ARTG>
                <ARTG>280654</ARTG>
            </ARTGs>
            <MinimumBenefit>745</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AN009</BillingCode>
            <Name>Collatamp G</Name>
            <Description>Biodegradeable collagen implant with gentamicin</Description>
            <Size>5cm x 5cm x 0.5cm</Size>
            <SupplierCode>AN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4215</SubGroupID>
            <Suffix>Antibiotic</Suffix>
            <ARTGs>
                <ARTG>156287</ARTG>
            </ARTGs>
            <MinimumBenefit>122</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AN008</BillingCode>
            <Name>Collatamp G</Name>
            <Description>Biodegradable collagen implant with gentamicin</Description>
            <Size>10cm x 10cm x 0.5cm, 20cm x 5cm x 0.5cm</Size>
            <SupplierCode>AN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4216</SubGroupID>
            <Suffix>Antibiotic</Suffix>
            <ARTGs>
                <ARTG>156287</ARTG>
            </ARTGs>
            <MinimumBenefit>277</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FY003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ040</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PuraStat Applicator Type E</Name>
            <Description>PuraStat is used as an adjunct to haemostasis when control of bleeding by ligature or conventional surgical procedures is ineffective or impractical.</Description>
            <Size>1600mm, 2200mm</Size>
            <SupplierCode>FY</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4217</SubGroupID>
            <ARTGs>
                <ARTG>283717</ARTG>
            </ARTGs>
            <MinimumBenefit>28</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN154</BillingCode>
            <Name>Evicel® 45cm Flexible Tip</Name>
            <Description>Triple lumen, clog resistant flexible tip for drip or spray applications</Description>
            <Size>45cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4217</SubGroupID>
            <ARTGs>
                <ARTG>197994</ARTG>
            </ARTGs>
            <MinimumBenefit>28</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB001</BillingCode>
            <Name>HEMOBLAST 35cm Laparoscopic Applicator</Name>
            <Description>Single-use laparoscopic applicator device, designed to deliver HEMOBLAST Bellows hemostatic powder.</Description>
            <Size>35cm in length</Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>4217</SubGroupID>
            <ARTGs>
                <ARTG>304086</ARTG>
            </ARTGs>
            <MinimumBenefit>28</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>VB002</BillingCode>
            <Name>HEMOBLAST Bellows</Name>
            <Description>Haemostatic powder comprised of collagen, chondroitin sulfate, and thrombin.</Description>
            <Size>1.65 gm powder/1500 IU thrombin</Size>
            <SupplierCode>VB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1555</GroupID>
            <SubGroupID>7345</SubGroupID>
            <Suffix>Complete Biomaterial</Suffix>
            <ARTGs>
                <ARTG>337110</ARTG>
            </ARTGs>
            <MinimumBenefit>903</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BF021</BillingCode>
            <Name>SealFoam, High Density</Name>
            <Description>SealFoam is an absorbable Polysaccharide Haemostat</Description>
            <Size>60mm x 40mm x 2mm&#xD;
60mm x 40mm x 4mm&#xD;
120mm x 25mm x 4mm (2/pack)</Size>
            <SupplierCode>BF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1797</GroupID>
            <ARTGs>
                <ARTG>194564</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW582</BillingCode>
            <Name>NasoPore / OtoPore</Name>
            <Description>NasoPore / OtoPore is a bioresorbable foam packing for the nasal or ear cavity.</Description>
            <Size>4cm and 8cm</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1797</GroupID>
            <ARTGs>
                <ARTG>232794</ARTG>
                <ARTG>243332</ARTG>
                <ARTG>273654</ARTG>
                <ARTG>274616</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ME230</BillingCode>
            <Name>NexPak X</Name>
            <Description>Intranasal splint</Description>
            <Size>8cms</Size>
            <SupplierCode>ME</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1797</GroupID>
            <ARTGs>
                <ARTG>328036</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL081</BillingCode>
            <Name>STAMMBERGER SINU-FOAM</Name>
            <Description>Viscous CMC-based dissolvable foam for the nasal cavity</Description>
            <Size>One size</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1797</GroupID>
            <ARTGs>
                <ARTG>212973</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SL083</BillingCode>
            <Name>Nasastent</Name>
            <Description>Dissolvable intranasal splint made from CMC that absorbs nasal fluids, it turns into a hydrocolloidal gel that naturally drains from the nasal cavity</Description>
            <Size>5cm</Size>
            <SupplierCode>SL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>191</SubCategoryID>
            <GroupID>1797</GroupID>
            <ARTGs>
                <ARTG>212973</ARTG>
            </ARTGs>
            <MinimumBenefit>110</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ010</BillingCode>
            <Name>Interceed Absorbable Adhesion Barrier</Name>
            <Description>Oxidized Regenerated Cellulose</Description>
            <Size>7.6cm x 10.2cm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5431</SubGroupID>
            <ARTGs>
                <ARTG>137081</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ464</BillingCode>
            <Name>Divide Absorbable Adhesion Barrier</Name>
            <Description>Oxidised regenerated cellulose</Description>
            <Size>3.8 x 5.1cmm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5431</SubGroupID>
            <ARTGs>
                <ARTG>137984</ARTG>
            </ARTGs>
            <MinimumBenefit>158</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET051</BillingCode>
            <Name>Surgiwrap</Name>
            <Description>Bio Absorbable Antiadhesion Barrier</Description>
            <Size>All sizes with and without suture holes</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5432</SubGroupID>
            <Suffix>Complex, Bioresorbable</Suffix>
            <ARTGs>
                <ARTG>91233</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM084</BillingCode>
            <Name>Polyganics Vivosorb</Name>
            <Description>A bioresorbable co polyester sheet</Description>
            <Size>2cm x 3cm to 13cm x 20cm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5432</SubGroupID>
            <Suffix>Complex, Bioresorbable</Suffix>
            <ARTGs>
                <ARTG>148712</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX342</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>GE006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Seprafilm Adhesion Barrier</Name>
            <Description>Sodium hyaluronate carbomethylcellulose membrane</Description>
            <Size>13cm  x 15cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5432</SubGroupID>
            <ARTGs>
                <ARTG>206261</ARTG>
            </ARTGs>
            <MinimumBenefit>312</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX260</BillingCode>
            <Name>ADEPT Adhesion Reduction Solution</Name>
            <Description>ADEPT Adhesion Reduction Solution is a single use, sterile fluid for intraperitoneal administration. ADEPT is intended to be used as an instillate for the reduction of adhesions following gynaecologicalpelvic laparoscopic surgery of the abdominalpelvic cavity in adults</Description>
            <Size>1500ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>4246</SubGroupID>
            <ARTGs>
                <ARTG>299826</ARTG>
            </ARTGs>
            <MinimumBenefit>226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FJ001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH534</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Oxiplex/AP Absorbable Adhesion Barrier Gel</Name>
            <Description>Combination of Polyethylene Oxide (PEO) and Sodium Carboxylmethylcellulose stabilised with Calcium and made isotonic with Sodium Chloride.  Kit contains 2 x 20ml Sterile syringes , 1 x Applicator</Description>
            <Size>2 x 20ml Sterile Syringes, 1 x Applicator</Size>
            <SupplierCode>FJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5433</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>152224</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FJ002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Oxiplex Absorbable Adhesion Barrier Gel</Name>
            <Description>Oxiplex Absorbable Adhesion Barrier gel (Oxiplex is a co-polymer gel composed of carboxymethylcellulose and polyethylene.)</Description>
            <Size>3ml in sterile 3ml syringe</Size>
            <SupplierCode>FJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5433</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>149294</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FJ003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LM196</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Dynavisc</Name>
            <Description>Absorbable adhesion barrier gel</Description>
            <Size>1 ml</Size>
            <SupplierCode>FJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>2963</GroupID>
            <SubGroupID>7377</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>208839</ARTG>
            </ARTGs>
            <MinimumBenefit>411</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FJ004</BillingCode>
            <Name>Oxiplex/IU</Name>
            <Description>Oxiplex/IU® is a clear, single use flowable gel. The gel is a sterile, absorbable  combination of sodium carboxymethylcellulose (CMC) and polyethylene oxide (PEO) with calcium chloride and sodium chloride in water. Oxiplex/IU is intended for use as a mechanical barrier to adhesion formation. Oxiplex/IU is intended to be used as an adjunct to intrauterine procedures for reducing the incidence, extent, and severity of adhesions.</Description>
            <Size>1 x 10ml pre-filled syringe and vaginal applicator.</Size>
            <SupplierCode>FJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5433</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>313985</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH001</BillingCode>
            <Name>Oxiplex Absorbable Adhesion Barrier Gel</Name>
            <Description>Oxiplex Absorbable Adhesion Barrier gel (Oxiplex is a co-polymer gel composed of carboxymethylcellulose and polyethylene.)</Description>
            <Size>3ml in sterile 3ml syringe</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5433</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>149294</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH534</BillingCode>
            <Name>Oxiplex/AP Absorbable Adhesion Barrier Gel</Name>
            <Description>Combination of Polyethylene Oxide (PEO) and Sodium Carboxylmethylcellulose stabilised with Calcium and made isotonic with Sodium Chloride.  Kit contains 2 x 20ml Sterile syringes , 1 x Applicator</Description>
            <Size>2 x 20ml Sterile Syringes, 1 x Applicator</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5433</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>152224</ARTG>
            </ARTGs>
            <MinimumBenefit>851</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MC618</BillingCode>
            <Name>Medishield Anti-Adhesion Gel</Name>
            <Description>MediShield Anti-Adhesion Gel is an adhesion barrier gel for prevention of complications after spinal surgery.  MediShield is a co-polymer gel composed of carboxymethylcellulose and polyethylene oxide.</Description>
            <Size>3cc Syringe</Size>
            <SupplierCode>MC</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5433</SubGroupID>
            <Suffix>Complex</Suffix>
            <ARTGs>
                <ARTG>137951</ARTG>
            </ARTGs>
            <MinimumBenefit>1173</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET082</BillingCode>
            <Name>PureRegen Gel Sinus</Name>
            <Description>PureRegen Gel Sinus is a gel adhesion barrier comprised of a hyaluronic acid based hydrogel. The product does not contain any medicinal, human or animal components. It is removed from the application site by natural elimination.</Description>
            <Size>2ml, 5ml, 6ml, 8ml, 10ml, 20ml.</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1579</GroupID>
            <SubGroupID>5433</SubGroupID>
            <Suffix>Sinus</Suffix>
            <ARTGs>
                <ARTG>264407</ARTG>
            </ARTGs>
            <MinimumBenefit>104</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB075</BillingCode>
            <Name>BioGlue Surgical Adhesive - 2ml Syringe System</Name>
            <Description>Model No BG3502-5-A (BioGlue Surgical Adhesive)</Description>
            <Size>2ml</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>137751</ARTG>
            </ARTGs>
            <MinimumBenefit>325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX214</BillingCode>
            <Name>TISSEEL Two Component Fibrin Sealant Syringe</Name>
            <Description>Active ingedients:Sealer Protein Solution &amp; Thrombin Solution - deep-frozen</Description>
            <Size>2.0 ml (containing 1.0 ml of Sealer Protein Solution and 1.0 ml of Thrombin Solution)</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>147141</ARTG>
            </ARTGs>
            <MinimumBenefit>325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX283</BillingCode>
            <Name>ARTISS Fibrin Sealant 2ml</Name>
            <Description>ARTISS is a proprietary fibrin sealant with 4UI/ml human thrombin.  It is two-component fibrin sealant made from pooled human plasma, a double virus-inactivated (vapour heated and solvent/detergent treated) and frozen (≤ -20°C) plasma derived biological agent.</Description>
            <Size>The two components are formulated as two sterile frozen solutions.  Each solution is presented in a separate pre-loaded chamber (1ml) of a double chamber syringe.  One chamber contains sealer protein solution with aprotinin while the other chamber contains thrombin solution with calcium chloride, resulting in a 2ml total volume of product for use.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>163515</ARTG>
            </ARTGs>
            <MinimumBenefit>325</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB382</BillingCode>
            <Name>Histoacryl Flexible</Name>
            <Description>Topical Skin Adhesive</Description>
            <Size>0.5ml per ampoule</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>221444</ARTG>
            </ARTGs>
            <MinimumBenefit>31</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB383</BillingCode>
            <Name>Histoacryl</Name>
            <Description>Topical and Surgical Adhesive</Description>
            <Size>0.5ml per ampoule</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>206441</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX252</BillingCode>
            <Name>CoSeal Surgical Sealant</Name>
            <Description>Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into one syringe, a dilute hydrogen chloride solution and a sodium phosphate/sodium carbonate solution</Description>
            <Size>2ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>181132</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE720</BillingCode>
            <Name>Glubran 2</Name>
            <Description>Synthetic cyanoacrylic surgical glue: N-Butyl (2) cyanoacrylate and methacryloxysulfolane co-monomer</Description>
            <Size>0.25 ml, 0.5 ml, 1 ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>158438</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE721</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG047</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Glubran Tiss2</Name>
            <Description>Tissue adhesive</Description>
            <Size>0.25 ml, 0.35 ml, 0.50 ml</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>158442</ARTG>
            </ARTGs>
            <MinimumBenefit>31</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH596</BillingCode>
            <Name>Liquiband Surgical</Name>
            <Description>Surgical Adhesive</Description>
            <Size>0.8gm ampoule</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>151324</ARTG>
            </ARTGs>
            <MinimumBenefit>31</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH597</BillingCode>
            <Name>LiquiBand Topical</Name>
            <Description>Topical Skin Adhesive</Description>
            <Size>0.25g – 0.8g ampoule</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>151324</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI286</BillingCode>
            <Name>LiquiBand® Exceed™</Name>
            <Description>Topical Tissue Adhesive with Applicator</Description>
            <Size>0.8 mL, 0.36mL</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>266148</ARTG>
            </ARTGs>
            <MinimumBenefit>31</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI317</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>SQ124</PriorBillingCode>
            </PriorBillingCodes>
            <Name>INDERMIL Flexifuze</Name>
            <Description>Topical Tissue Adhesive with Applicator</Description>
            <Size>0.75g per ampoule</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>322769</ARTG>
            </ARTGs>
            <MinimumBenefit>31</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN229</BillingCode>
            <Name>Dermabond</Name>
            <Description>Topical Skin Adhesive</Description>
            <Size>Per 0.36 - 0.75ml vial</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>171563</ARTG>
            </ARTGs>
            <MinimumBenefit>31</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN230</BillingCode>
            <Name>Dermabond Prineo</Name>
            <Description>Topical skin adhesive with self-adhering mesh</Description>
            <Size>22 - 60cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4247</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>185773</ARTG>
            </ARTGs>
            <MinimumBenefit>180</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB003</BillingCode>
            <Name>BioGlue Surgical Adhesive - 5ml Syringe System</Name>
            <Description>Model No BG3515-5-A (BioGlue Surgical Adhesive)</Description>
            <Size>One size only</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4248</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>137751</ARTG>
            </ARTGs>
            <MinimumBenefit>594</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX215</BillingCode>
            <Name>TISSEEL Two Component Fibrin Sealant Syringe</Name>
            <Description>Active ingedients:Sealer Protein Solution &amp; Thrombin Solution - deep-frozen</Description>
            <Size>4.0 ml (containing 2.0 ml of Sealer Protein Solution and 2.0 ml of Thrombin Solution)</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4248</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>147141</ARTG>
            </ARTGs>
            <MinimumBenefit>594</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX284</BillingCode>
            <Name>ARTISS Fibrin Sealant 4ml</Name>
            <Description>ARTISS is a proprietary fibrin sealant with 4UI/ml human thrombin.  It is two-component fibrin sealant made from pooled human plasma, a double virus-inactivated (vapour heated and solvent/detergent treated) and frozen (≤ -20°C) plasma derived biological agent.</Description>
            <Size>The two components are formulated as two sterile frozen solutions.  Each solution is presented in a separate pre-loaded chamber (2ml) of a double chamber syringe.  One chamber contains sealer protein solution with aprotinin while the other chamber contains thrombin solution with calcium chloride, resulting in a 4ml total volume of product for use.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4248</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>163515</ARTG>
            </ARTGs>
            <MinimumBenefit>594</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX253</BillingCode>
            <Name>CoSeal Surgical Sealant</Name>
            <Description>Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into a syringe, a dilute hydrogen chloride solution and a sodium phosphate sodium carbonate solution</Description>
            <Size>4ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4248</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>181132</ARTG>
            </ARTGs>
            <MinimumBenefit>516</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB004</BillingCode>
            <Name>BioGlue Surgical Adhesive - 10ml Syringe System</Name>
            <Description>Model No BG3510-5-A (BioGlue Surgical Adhesive)</Description>
            <Size>One size only</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4249</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>137751</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX216</BillingCode>
            <Name>TISSEEL Two Component Fibrin Sealant Syringe</Name>
            <Description>Active ingedients:Sealer Protein Solution &amp; Thrombin Solution - deep-frozen</Description>
            <Size>10.0 ml (containing 5.0 ml of Sealer Protein Solution and 5.0 ml of Thrombin Solution)</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4249</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>147141</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX285</BillingCode>
            <Name>ARTISS Fibrin Sealant 10ml</Name>
            <Description>ARTISS is a proprietary fibrin sealant with 4UI/ml human thrombin.  It is two-component fibrin sealant made from pooled human plasma, a double virus-inactivated (vapour heated and solvent/detergent treated) and frozen (≤ -20°C) plasma derived biological agent.</Description>
            <Size>The two components are formulated as two sterile frozen solutions.  Each solution is presented in a separate pre-loaded chamber (5ml) of a double chamber syringe.  One chamber contains sealer protein solution with aprotinin while the other chamber contains thrombin solution with calcium chloride, resulting in a 10ml total volume of product for use.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4249</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>163515</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN204</BillingCode>
            <Name>Evicel Solutions for Fibrin Sealant</Name>
            <Description>Human fibrinogen and Human thrombin</Description>
            <Size>10mL kit</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4249</SubGroupID>
            <Suffix>Biological</Suffix>
            <ARTGs>
                <ARTG>181319</ARTG>
            </ARTGs>
            <MinimumBenefit>1188</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX254</BillingCode>
            <Name>CoSeal Surgical Sealant</Name>
            <Description>Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into a syringe, a dilute hydrogen chloride solution and a sodium phosphate sodium carbonate solution</Description>
            <Size>8ml</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4249</SubGroupID>
            <Suffix>Synthetic</Suffix>
            <ARTGs>
                <ARTG>181132</ARTG>
            </ARTGs>
            <MinimumBenefit>963</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB008</BillingCode>
            <Name>BioGlue Surgical Adhesive - Syringe Standard Applicator Tip</Name>
            <Description>Model No BGAT-SY (BioGlue Surgical Adhesive)</Description>
            <Size>Standard Applicator Tip</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Applicator Tip</Suffix>
            <ARTGs>
                <ARTG>137420</ARTG>
            </ARTGs>
            <MinimumBenefit>22</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA267</BillingCode>
            <Name>Progel Platinum Surgical Sealant Spray Tip</Name>
            <Description>Spray tip to be used in conjunction with Progel Platinum Surgical Sealant</Description>
            <Size>5cm (packs of 2)</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Applicator Tip</Suffix>
            <ARTGs>
                <ARTG>260665</ARTG>
            </ARTGs>
            <MinimumBenefit>22</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX266</BillingCode>
            <Name>TISSEEL DUPLOSPRAY MIS APPLICATOR REPLACEMENT TIPS</Name>
            <Description>Two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>Packs of 10 sterile packs each containing 2 tips and an installation tool</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Applicator Tip</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>22</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX270</BillingCode>
            <Name>COSEAL Applicator Tips 7 cm</Name>
            <Description>Applicator tips for COSEAL. Coseal which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description>
            <Size>A 7cm long applicator tip</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Applicator Tip</Suffix>
            <ARTGs>
                <ARTG>180922</ARTG>
            </ARTGs>
            <MinimumBenefit>22</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE722</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Glubran 2 Applicators</Name>
            <Description>Dispensing tip/Drop control device for applying Glubran 2.</Description>
            <Size>5-6 and 7-8 French</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Applicator Tip</Suffix>
            <ARTGs>
                <ARTG>162589</ARTG>
            </ARTGs>
            <MinimumBenefit>22</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB009</BillingCode>
            <Name>BioGlue Surgical Adhesive - Syringe 10cm Extender</Name>
            <Description>Model No BGAT-10-SY (BioGlue Surgical Adhesive)</Description>
            <Size>10cm Extender</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>137420</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB010</BillingCode>
            <Name>BioGlue Surgical Adhesive - Syringe 27CM Extender</Name>
            <Description>Model No BGAT-27-SY (BioGlue Surgical Adhesive)</Description>
            <Size>27cm Extender</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>137420</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB076</BillingCode>
            <Name>BioGlue Surgical Adhesive - Spreader Tips</Name>
            <Description>Spreader (extender) Tips (various sizes), (Pack of 3)</Description>
            <Size>12mm, 16mm</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>137420</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX261</BillingCode>
            <Name>Tisseel Duplospray MIS WITH SNAPLOCK Applicator 20cm</Name>
            <Description>Two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>A 20cm long dual lumen metal cannula</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX262</BillingCode>
            <Name>TISSEEL DUPLOCATH 180cm</Name>
            <Description>Double lumen flexible catheters for Tisseel: Tisseel is Two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>A 180cm long double lumen flexible application catheter</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>299913</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX263</BillingCode>
            <Name>COSEAL Spray Accessory Kit</Name>
            <Description>Spray Accessory kit for Coseal: A hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description>
            <Size>One size available</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>299913</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX264</BillingCode>
            <Name>TISSEEL DUPLOTIP WITH SNAPLOCK 20g x 26.4cm</Name>
            <Description>Two component Fibrin Sealant containing derived fibrinogen and thrombin.</Description>
            <Size>A 26.4cm long dual umen applicator</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX269</BillingCode>
            <Name>TISSEEL Easyspray Set</Name>
            <Description>Easyspray Set for Tisseel, a two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>One size</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>299913</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX271</BillingCode>
            <Name>TISSEEL DUPLOTIP with SNAPLOCK 20g x 10.4cm</Name>
            <Description>Two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>10.4cm long dual lumen applicator</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX272</BillingCode>
            <Name>TISSEEL DUPLOCATH 25cm</Name>
            <Description> Double lumen flexible application catheter for Tisseel, a two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>A 25cm long double lumen flexible application catheter</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>299913</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX275</BillingCode>
            <Name>COSEAL Extended Applicator 22 cm</Name>
            <Description>22cm extended applicator for COSEAL. Coseal, is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description>
            <Size>A 22 cm long malleable applicator</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>180922</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX282</BillingCode>
            <Name>Floseal Special Applicator Tips</Name>
            <Description>Floseal Malleable and Trimmable Applicator with Tips specifically designed for use with Floseal Haemostatic Matrix</Description>
            <Size>14cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>167776</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE723</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG035</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Glubran 2 Catheter for Laparoscopy</Name>
            <Description>Catheter for laparoscopic application of Glubran 2.</Description>
            <Size>One size only</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Extender</Suffix>
            <ARTGs>
                <ARTG>162589</ARTG>
            </ARTGs>
            <MinimumBenefit>26</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AB065</BillingCode>
            <Name>BioGlue Delivery Tip Extension (various sizes)</Name>
            <Description>Rigid Extender Tip (BGDTE range)</Description>
            <Size>10cm, 27cm, 35cm</Size>
            <SupplierCode>AB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Laparoscopic Extender</Suffix>
            <ARTGs>
                <ARTG>137420</ARTG>
            </ARTGs>
            <MinimumBenefit>53</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX268</BillingCode>
            <Name>TISSEEL DUPLOCATH 35cm MIC/MIS</Name>
            <Description>MIS (with MIS adaptor 5mm) Double lumen flexible application catheter for Tisseel, a two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>A 35cm long double lumen flexible application catheter</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Laparoscopic Extender</Suffix>
            <ARTGs>
                <ARTG>299913</ARTG>
            </ARTGs>
            <MinimumBenefit>53</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX277</BillingCode>
            <Name>TISSEEL DUPLOSPRAY MIS SNAPLOCK APPLICATOR 30 cm</Name>
            <Description>Two component Fibrin Sealant containing human derived fibrinogen and thrombin.</Description>
            <Size>A 30 cm long dual lumen metal cannula</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Laparoscopic Extender</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>53</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX279</BillingCode>
            <Name>Coseal Duplospray Applicator 30cm</Name>
            <Description>COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description>
            <Size>30cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Laparoscopic Extender</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>53</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX280</BillingCode>
            <Name>Coseal Duplospray Applicator 20cm</Name>
            <Description>COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts. COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking. This a</Description>
            <Size>20 cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Laparoscopic Extender</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>53</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA266</BillingCode>
            <Name>Progel Platinum Surgical Sealant Extender Spray Tip</Name>
            <Description>Extender Spray tip to be used in conjunction with Progel Platinum Surgical Sealant</Description>
            <Size>16cm, 29cm</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>260665</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX265</BillingCode>
            <Name>TISSEEL DUPLOTIP WITH SNAPLOCK   31.8 cm and 40cm</Name>
            <Description>Duplotip for Two component Fibrin Sealant containing human derived fibrinogen and thrombin  "Black Beauty" and bariatric surgery</Description>
            <Size>A 31.8cm long dual lumen applicator or   40 cm long dual lumen applicator</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX267</BillingCode>
            <Name>TISSEEL DUPLOSPRAY MIS WITH SNAPLOCK APPLICATOR 40 cm</Name>
            <Description>Two component Fibrin Sealant containing human derived fibrinogen and thrombin, with or without a malleable tip.</Description>
            <Size>A 40 cm long dual lumen metal cannula</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX273</BillingCode>
            <Name>Floseal Endoscopic Applicator</Name>
            <Description>Used as an adjunct to haemostasis when control of bleeding by ligature or conventional surgical procedures is ineffective or impractical.</Description>
            <Size>A 41cm - 47cm long disposable cannulated applicator, with or without malleable tip.</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2008-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX340</BillingCode>
            <Name>FIBRIJET® Gasless Stray Tip</Name>
            <Description>Gasless spray tip use during open surgery. The spray tip is compatible with both Prima and legacy TISSEEL frozen syringes.</Description>
            <Size>One size only</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>299913</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX341</BillingCode>
            <Name>EASYGRIP FLO-41</Name>
            <Description>sterile, single-use endoscopic applicator device designed for single handed application, particularly  during laparoscopic and robotic procedures through an easy, precise, and controlled delivery of Floseal.</Description>
            <Size>41cm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>115590</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE727</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG044</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Glubran 2 Spray Device</Name>
            <Description>Spray device for nebulized application of Glubran 2</Description>
            <Size>Cannula length: 5cm, 40cm, 30cm, 33cm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>321253</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FY002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MQ039</PriorBillingCode>
            </PriorBillingCodes>
            <Name>PuraStat Applicator</Name>
            <Description>PuraStat is used as an adjunct to haemostasis when control of bleeding by ligature or conventional surgical procedures is ineffective or impractical.</Description>
            <Size>250mm</Size>
            <SupplierCode>FY</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>283717</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN041</BillingCode>
            <Name>Endoscopic Applicator</Name>
            <Description>Rigid applicator</Description>
            <Size>34cm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>174430</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN153</BillingCode>
            <Name>Evicel</Name>
            <Description>Rigid tip applicators</Description>
            <Size>35cm, control and spray tip</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4250</SubGroupID>
            <Suffix>Rigid Delivery System</Suffix>
            <ARTGs>
                <ARTG>197994</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX334</BillingCode>
            <Name>Peri-strips dry with Veritas Collagen Matrix Circular Staple Line Reinforcement</Name>
            <Description>Peri-Strips Dry with Veritas is a remodelable material designed to increase staple line strength for surgical repair of soft tissue deficiencies</Description>
            <Size>One circular stapler firing: 20-400mm diameter</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4251</SubGroupID>
            <ARTGs>
                <ARTG>219234</ARTG>
                <ARTG>219235</ARTG>
            </ARTGs>
            <MinimumBenefit>301</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX335</BillingCode>
            <Name>Peri-Strips dry with Veritas Collagen Matrix Linear Single Firing</Name>
            <Description>Peri-Strips Dry with Veritas is a remodeable material designed to increase staple line strength for surgical repair of soft tissue deficiencies</Description>
            <Size> 30-130mm</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4251</SubGroupID>
            <ARTGs>
                <ARTG>219227</ARTG>
            </ARTGs>
            <MinimumBenefit>301</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JI006</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH572</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Steritalc</Name>
            <Description>Sterile granules of talc implanted in pleural space to act as permanent adhesive</Description>
            <Size>3 grams &amp; 4 grams</Size>
            <SupplierCode>JI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>4252</SubGroupID>
            <ARTGs>
                <ARTG>143613</ARTG>
            </ARTGs>
            <MinimumBenefit>129</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS212</BillingCode>
            <Name>Veriset</Name>
            <Description>Veriset is an absorbable topical hemostatic device intended for use in surgical procedures as an adjunct to hemostatsis when conventional methods are ineffective or impractical.  Veriset does not consist of any human or animal components</Description>
            <Size>2cm x 4cm (8cm2)</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>5424</SubGroupID>
            <ARTGs>
                <ARTG>202060</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KF001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>YN003</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TachoSil</Name>
            <Description>TachoSil is a broad use haemostat for intra-operative tissue management. The TachoSil sponge is off-white, with yellow colouring on the active side (coated with fibrinogen and thrombin), and is ready to use (store at room temperature).</Description>
            <Size>One small patch: 3.0cm x 2.5cm</Size>
            <SupplierCode>KF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>5424</SubGroupID>
            <ARTGs>
                <ARTG>176631</ARTG>
            </ARTGs>
            <MinimumBenefit>58</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KF003</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>YN002</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TachoSil</Name>
            <Description>TachoSil is a broad use haemostat for intra-operative tissue management. The TachoSil sponge is off-white, with yellow colouring on the active side (coated with fibrinogen and thrombin), and is ready to use (store at room temperature).</Description>
            <Size>One medium patch: 4.8cm x 4.8cm</Size>
            <SupplierCode>KF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>5425</SubGroupID>
            <ARTGs>
                <ARTG>176631</ARTG>
            </ARTGs>
            <MinimumBenefit>208</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS213</BillingCode>
            <Name>Veriset</Name>
            <Description>Veriset is an absorbable topical hemostatic device intended for use in surgical procedures as an adjunct to hemostasis when conventional methods are ineffective or impractical.  Veriset does not consist of any human or animal components.</Description>
            <Size>5cm x 10cm (50cm2)&#xD;
8 cm x 16 cm (128cm2)</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>5426</SubGroupID>
            <ARTGs>
                <ARTG>202060</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>KF002</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>YN001</PriorBillingCode>
            </PriorBillingCodes>
            <Name>TachoSil</Name>
            <Description>TachoSil is a broad use haemostat for intra-operative tissue management. The TachoSil sponge is off-white, with yellow colouring on the active side (coated with fibrinogen and thrombin), and is ready to use (store at room temperature).</Description>
            <Size>One large patch: 9.5cm x 4.8cm</Size>
            <SupplierCode>KF</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>5426</SubGroupID>
            <ARTGs>
                <ARTG>176631</ARTG>
            </ARTGs>
            <MinimumBenefit>412</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA265</BillingCode>
            <Name>Progel Platinum Surgical Sealant</Name>
            <Description>Progel Pleural Air Leak Sealant is a single use device intended for application to visceral pleura.</Description>
            <Size>4ml</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1580</GroupID>
            <SubGroupID>5768</SubGroupID>
            <ARTGs>
                <ARTG>262979</ARTG>
            </ARTGs>
            <MinimumBenefit>718</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE698</BillingCode>
            <Name>LocaClip</Name>
            <Description>Polymer ligating clip</Description>
            <Size>Large, Extra Large and Medium/Large</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <Suffix>Polymeric Non-resorbable</Suffix>
            <ARTGs>
                <ARTG>316566</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EB136</BillingCode>
            <Name>Click’aV® polymer non-absorbable ligating clips, cartridge of 6</Name>
            <Description>Click’aV® ligating clips are intended for ligating of any linear tissue structures or vessels during an operation for haemostasis where use of non-absorbable clips is required. &#xD;
Click’aV® ligating clips are sterile and disposable. They are made of non-absorbable polymer suitable for implantation. Clip is equipped with latch for reliable closure and lateral clip legs stability. The clips are placed around the tissue and closed with the grip of a clip applier.</Description>
            <Size>Medium&#xD;
Medium Large&#xD;
Large&#xD;
Extra Large</Size>
            <SupplierCode>EB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <Suffix>Polymeric Non-resorbable</Suffix>
            <ARTGs>
                <ARTG>280976</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EB137</BillingCode>
            <Name>Click’aV® polymer non-absorbable ligating clips, cartridge of 4</Name>
            <Description>Click’aV® ligating clips are intended for ligating of any linear tissue structures or vessels during an operation for haemostasis where use of non-absorbable clips is required.   Click’aV® ligating clips are sterile and disposable. They are made of non-absorbable polymer suitable for implantation. Clip is equipped with latch for reliable closure and lateral clip legs stability. The clips are placed around the tissue and closed with the grip of a clip applier.</Description>
            <Size>Medium  Medium large  Large  Extra large</Size>
            <SupplierCode>EB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <Suffix>Polymeric Non-resorbable</Suffix>
            <ARTGs>
                <ARTG>280976</ARTG>
            </ARTGs>
            <MinimumBenefit>29</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>EB138</BillingCode>
            <Name>Click’aV® polymer non-absorbable ligating clips, cartridge of 2</Name>
            <Description>Click’aV® ligating clips are intended for ligating of any linear tissue structures or vessels during an operation for haemostasis where use of non-absorbable clips is required.   Click’aV® ligating clips are sterile and disposable. They are made of non-absorbable polymer suitable for implantation. Clip is equipped with latch for reliable closure and lateral clip legs stability. The clips are placed around the tissue and closed with the grip of a clip applier.</Description>
            <Size>Medium Large  Large  Extra Large</Size>
            <SupplierCode>EB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <Suffix>Polymeric Non-resorbable</Suffix>
            <ARTGs>
                <ARTG>280976</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX023</BillingCode>
            <Name>Hem-o-Lok Polymer Non-Absorbable Ligating Clip</Name>
            <Description>Hem-o-lok Medium (M), Medium-Large (ML) and Large (L) Polymer Clips</Description>
            <Size>Small, Medium, Medium-Large, Large (6 clips/cartridge)</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <Suffix>Polymeric Non-resorbable</Suffix>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX025</BillingCode>
            <Name>Hem-o-lok Polymer Non-Absorbable Ligating Clip</Name>
            <Description>Hem-o-lok Extra-large (XL) Polymer Clips</Description>
            <Size>Extra-large (XL) (6 clips/cartridge)</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <Suffix>Polymeric Non-resorbable</Suffix>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>40</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ036</BillingCode>
            <Name>Absolok* Extra Absorbable Ligating Clips </Name>
            <Description>Polydioxanone clips contained in a plastic cartridge</Description>
            <Size>Small to Extralarge</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <Suffix>Resorbable</Suffix>
            <ARTGs>
                <ARTG>121372</ARTG>
            </ARTGs>
            <MinimumBenefit>81</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB294</BillingCode>
            <Name>Aesculap Ligating Clips</Name>
            <Description>Aesculap Ligating Clips- Ligation Clips Titanium;</Description>
            <Size>PL561T- Large; 6 clips/cartridge</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB297</BillingCode>
            <Name>Aesculap Ligating Clips</Name>
            <Description>Aesculap Ligating Clips Titanium</Description>
            <Size>PL565T - Small; 6 clips/cartridge</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB298</BillingCode>
            <Name>Aesculap Ligating Clips</Name>
            <Description>Aesculap Ligating Clips Titanium</Description>
            <Size>PL566T - small cardiopack of 24</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB299</BillingCode>
            <Name>Aesculap Ligating Clips</Name>
            <Description>Aesculap Ligating Clips Titanium</Description>
            <Size>PL567T - medium; 6 clips/cartridge</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB300</BillingCode>
            <Name>Aesculap Ligating Clips</Name>
            <Description>Aesculap Ligating Clips Titanium</Description>
            <Size>PL568T - medium/large; 6 clips/cartridge</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE616</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>RH006</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Vitalitec Titanium Hemostatic Clips</Name>
            <Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description>
            <Size>Micro, Small, Small/Medium, Medium, Medium/Large and Large. 6 clips per cartridge</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>194411</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE617</BillingCode>
            <Name>Vitalitec Titanium Hemostatic Clips</Name>
            <Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description>
            <Size>Small &amp; Medium Clips (24 clips per pouch - 6 clips per cartridge, 4 cartridges per pouch)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>194411</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE618</BillingCode>
            <Name>Vitalitec Titanium Hemostatic Clips</Name>
            <Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description>
            <Size>Micro, Small, Small/Medium, Medium (9 clips per cartridge)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>194411</ARTG>
            </ARTGs>
            <MinimumBenefit>12</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE619</BillingCode>
            <Name>Vitalitec Titanium Hemostatic Clips</Name>
            <Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description>
            <Size>Small and Medium (27 clips per pouch - 9 clips per cartridge, 3 cartridges per pouch)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>194411</ARTG>
            </ARTGs>
            <MinimumBenefit>34</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE724</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG045</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Everest Ligating Clip</Name>
            <Description>Titanium clip</Description>
            <Size>Small, Medium, Medium-Large, Large (6 per cartridge)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>235137</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE725</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG046</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Everest Ligating Clip</Name>
            <Description>Titanium clip</Description>
            <Size>Small, Medium (24 per cartridge)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>235137</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ033</BillingCode>
            <Name>Ligaclip* Ligating Clips - titanium</Name>
            <Description>Titanium clips contained in a plastic cartridge</Description>
            <Size>3-5mm; 6 clips per cartridge</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ034</BillingCode>
            <Name>Ligaclip* Ligating Clips - titanium</Name>
            <Description>Titanium clips contained in a plastic cartridge</Description>
            <Size>9-12 mm; 6 clips per cartage</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>10</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ035</BillingCode>
            <Name>Ligaclip* Ligating Clips - titanium</Name>
            <Description>Titanium clips contained in a plastic cartridge</Description>
            <Size>3-5 mm; 20 clips per cartridge</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>32</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LM042</BillingCode>
            <Name>Microclip</Name>
            <Description>Malleable titanium clip</Description>
            <Size>1.5-2.5mm x 2-3.5mm</Size>
            <SupplierCode>LM</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>339703</ARTG>
            </ARTGs>
            <MinimumBenefit>2</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX006</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX007</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <Description>Ligation Clips Titanium </Description>
            <Size>Small  (24 per cartridge)</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93346</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX008</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX009</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <Description>Ligation Clips Titanium </Description>
            <Size>Medium  (24 per cartridge)</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX010</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX011</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <Description>Ligation Clips Titanium </Description>
            <Size>Medium/Large (24 per cartridge)</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX012</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>11</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX013</BillingCode>
            <Name>Horizon Ligating Clips  </Name>
            <Description>Ligation Clips Titanium </Description>
            <Size>Large (24 per cartridge)</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4256</SubGroupID>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>41</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE606</BillingCode>
            <Name>Cor-Knot® Device Kit</Name>
            <Description>The Cor-Knot Device kit contains two Cor Knot devices which deliver and crimp a titanium fastener around a suture placed using routine suture placement techniques, trimming any excess suture tails</Description>
            <Size>Each kit contains two Cor- Knot sterile devices</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4257</SubGroupID>
            <ARTGs>
                <ARTG>219812</ARTG>
            </ARTGs>
            <MinimumBenefit>249</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE609</BillingCode>
            <Name>Cor-Knot Mini Device Kit</Name>
            <Description>The Cor-Knot Mini Device Kit contains two Cor-Knot Mini Devices which deliver and crimp a titanium fastener around a suture placed using routine suture placement techniques, trimming any excess suture tails.</Description>
            <Size>2 x Cor-Knot Mini Sterile Devices (14cm length shaft) in each kit</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4257</SubGroupID>
            <ARTGs>
                <ARTG>219812</ARTG>
            </ARTGs>
            <MinimumBenefit>249</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV081</BillingCode>
            <Name>Open Clip Applier</Name>
            <Description>Titanium</Description>
            <Size>25 medium size titanium clips</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4257</SubGroupID>
            <ARTGs>
                <ARTG>131194</ARTG>
            </ARTGs>
            <MinimumBenefit>125</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS074</BillingCode>
            <Name>ENDOCLIP*</Name>
            <Description>Titanium Surgical Stapler</Description>
            <Size>10mm (ML, M, L)-(20 clips)</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>182307</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK003</BillingCode>
            <Name>Endox Visu-Loc Clip Applier</Name>
            <Description>Single-use laparoscopic clip applier</Description>
            <Size>Medium, Large</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>137044</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ186</BillingCode>
            <Name>Ligaclip Endoscopic Multiclip Applier</Name>
            <Description>Metal/plastic stapler with titanium clips</Description>
            <Size>10-12 mm shaft diameter, medium to large clip</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ482</BillingCode>
            <Name>LIGAMAX 5mm Endoscopic Clip Applier</Name>
            <Description>LIGAMAX 5mm Endoscopic Clip Applier</Description>
            <Size>Medium / Large</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2006-03-24</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV076</BillingCode>
            <Name>Reflex ELC 530 Automatic Clip Applier</Name>
            <Description>Titanium Endoscopic Clip Applier</Description>
            <Size>Medium/Large, 10mm, 20 Clips</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>131194</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LV086</BillingCode>
            <Name>Reflex 5mm Automatic Clip Applier</Name>
            <Description>Autofeeding disposable clip applier. Contains 15 non absorbable polymer locking clips</Description>
            <Size>medium/large</Size>
            <SupplierCode>LV</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>212478</ARTG>
            </ARTGs>
            <MinimumBenefit>112</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MH015</BillingCode>
            <Name>Epix™ Disposable Laparoscopic Clip Applier w/ TiGold M/L titanium clips</Name>
            <Description>Epix™ Disposable Laparoscopic Clip Applier w/ TiGold M/L titanium clips 5mm</Description>
            <Size>5mm</Size>
            <SupplierCode>MH</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>116980</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI213</BillingCode>
            <Name>Endo Clip</Name>
            <Description>Laparoscopic Clip Applier</Description>
            <Size>5mm device with various clip sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>182307</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX024</BillingCode>
            <Name>Weck Hem-o-lok</Name>
            <Description>Hem-o-lok Automatic Endo Applier</Description>
            <Size>15 Clips per applier&#xD;
12 Clips per applier for Large Clips</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Laparoscopic</Suffix>
            <ARTGs>
                <ARTG>121043</ARTG>
                <ARTG>93446</ARTG>
            </ARTGs>
            <MinimumBenefit>250</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ037</BillingCode>
            <Name>Ligaclip* Multiple Clip Applier </Name>
            <Description>Metal/plastic applier preloaded with titanium clips</Description>
            <Size>3-12 mm; 20 clips per applier</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Open</Suffix>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>163</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ038</BillingCode>
            <Name>Ligaclip* Multiple Clip Applier </Name>
            <Description>Metal/plastic applier preloaded with titanium clips</Description>
            <Size>3-12 mm; 30 clips per applier</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Open</Suffix>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>163</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ039</BillingCode>
            <Name>Ligaclip* Multiple Clip Applier </Name>
            <Description>Metal/plastic applier preloaded with titanium clips; reloadable </Description>
            <Size>5-6mm; 20 clips per applier</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Open</Suffix>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>163</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI217</BillingCode>
            <Name>Surgiclip</Name>
            <Description>Ligation Clips - Disposable clip applier and ligating clips</Description>
            <Size>Small, Medium, Large device with various clip sizes</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4258</SubGroupID>
            <Suffix>Open</Suffix>
            <ARTGs>
                <ARTG>183878</ARTG>
                <ARTG>235587</ARTG>
            </ARTGs>
            <MinimumBenefit>163</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB016</BillingCode>
            <Name>Challenger Ligating Clips</Name>
            <Description>Challenger Ligating Clips Titanium Multifire</Description>
            <Size>Medium-large</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB301</BillingCode>
            <Name>Challenger Ligating Clips</Name>
            <Description>Challenger Ligating Clips Titanium Multifire</Description>
            <Size>PL572T - small/medium</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BB321</BillingCode>
            <Name>Pneumatic Challenger Multifire Clips</Name>
            <Description>Challenger TI-P SM-Ligat. Clips 12 Cartridge (PL574T)  Challenger TI-P ML-Ligat. Clips 12 Cartridge (PL579T)</Description>
            <Size>small-medium, medium-large</Size>
            <SupplierCode>BB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>136103</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK001</BillingCode>
            <Name>Microline Pentax Disposable 10ml Titanium K2 Clip Cartridge</Name>
            <Description>Disposable cartridge containing 19 surgical grade titanium clips delivered using a re-usable hand piece applier</Description>
            <Size>medium/large clip</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>129715</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>CK002</BillingCode>
            <Name>Microline Pentax Disposable 10ml Titanium K2 clip Cartridge</Name>
            <Description>Disposable cartridge containing 10 surgical grade titanium clips delivered using a reusable hand piece applier.</Description>
            <Size>Medium/Large Clip</Size>
            <SupplierCode>CK</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>129715</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GQ006</BillingCode>
            <Name>Microline Surgical Disposable 19 Titanium K2 Clip Cartridge</Name>
            <Description>Disposable cartridge containing 19 surgical grade titanium clips delivered using a reusable handpiece applier</Description>
            <Size>19 Clips per cartridge</Size>
            <SupplierCode>GQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>326239</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GQ007</BillingCode>
            <Name>Microline Surgical Disposable 10 Titanium K2 Clip Cartridge</Name>
            <Description>Disposable cartridge containing 10 surgical grade titanium clips delivered using a reusable handpiece applier</Description>
            <Size>10 Clips per cartridge</Size>
            <SupplierCode>GQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>326239</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ040</BillingCode>
            <Name>Ligaclip* 20/20 Reload Unit</Name>
            <Description>Metal reload cartridge containing titanium clips</Description>
            <Size>5 mm; 20 clips</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4259</SubGroupID>
            <ARTGs>
                <ARTG>122810</ARTG>
            </ARTGs>
            <MinimumBenefit>54</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET065</BillingCode>
            <Name>HAL-RAR</Name>
            <Description>HAL-Ligating Suture, AMI HAL-Ligating suture, prosthetic component of AMI HAL-RAR Doppler System</Description>
            <Size>One size</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>4260</SubGroupID>
            <ARTGs>
                <ARTG>180973</ARTG>
            </ARTGs>
            <MinimumBenefit>75</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2011-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER279</BillingCode>
            <Name>OverStitchTM Endoscopic Suturing System</Name>
            <Description>Needle Driver, Anchor Exchange and Tissue Helix Device</Description>
            <Size>1 size only</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>5769</SubGroupID>
            <Suffix>Endoscopic System</Suffix>
            <ARTGs>
                <ARTG>237773</ARTG>
                <ARTG>237774</ARTG>
            </ARTGs>
            <MinimumBenefit>1625</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ER280</BillingCode>
            <Name>OverStitchTM Endoscopic Suturing System - 2.0 Suture</Name>
            <Description>Endoscopic Polyproprylene Suture with Cinch</Description>
            <Size>2-0 suture</Size>
            <SupplierCode>ER</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>6101</SubGroupID>
            <Suffix>Endoscopic System</Suffix>
            <ARTGs>
                <ARTG>236906</ARTG>
                <ARTG>245894</ARTG>
            </ARTGs>
            <MinimumBenefit>233</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>FQ002</BillingCode>
            <Name>FlexDex Gastric Bypass and Gastrectomy Kit</Name>
            <Description>Kit includes a single-use articulating laparoscopic needle driver with seven degrees of motion and sutures</Description>
            <Size>One size only</Size>
            <SupplierCode>FQ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1581</GroupID>
            <SubGroupID>7361</SubGroupID>
            <ARTGs>
                <ARTG>315333</ARTG>
            </ARTGs>
            <MinimumBenefit>680</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ475</BillingCode>
            <Name>Proximate Contour Curved Cutter/Stapler</Name>
            <Description>Contour Curved Cutter/Stapler 30 &amp; 40mm reload cartridges</Description>
            <Size>Blue (3.85mm) &amp; Green (4.5mm)</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Curved</Suffix>
            <ARTGs>
                <ARTG>124512</ARTG>
            </ARTGs>
            <MinimumBenefit>226</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS186</BillingCode>
            <Name>Endo GIA™ Reload with TriStaple™ Technology</Name>
            <Description>Endo GIA™ Reload with TriStaple™ Technology provides three staggered rows of staples on either side of the cut line.</Description>
            <Size>45mm, 60mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>186247</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE472</BillingCode>
            <Name>Endowrist Stapler 45</Name>
            <Description>Endowrist Stapler 45 White Reload, 45 Blue Reload, 45 Green Reload</Description>
            <Size>Length of reload: 45mm&#xD;
Staple height: 2.5mm, 3.5mm, 4.3mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>239813</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE560</BillingCode>
            <Name>EndoWrist Stapler Reloads (used with IS Endowrist Stapler)</Name>
            <Description>Endowrist Stapler Reload.</Description>
            <Size>Length of Reload : 30 - 60mm,   Staple Height: 0.75 - 2.3mm</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>239813</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ021</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME225</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Endoscopic Linear Cutter Reload</Name>
            <Description>The Endoscopic Linear Cutter Reload has applications in resection, transection and/or anastomosis of tissue in open or laparoscopic procedures.</Description>
            <Size>Cartridge Reload - 30mm, 45mm, 60mm staple lengths. Open leg length: 2.0mm - 4.5mm, closed staple height: 0.75mm - 2.0mm.</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>207254</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI282</BillingCode>
            <Name>Tri-Staple™ 2.0 reloads</Name>
            <Description>Tri-Staple™ 2.0 reloads with intelligent chip that communicates with Signia™ stapler</Description>
            <Size>30mm, 45mm, 60mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>350111</ARTG>
                <ARTG>350112</ARTG>
                <ARTG>292807</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN219</BillingCode>
            <Name>Echelon</Name>
            <Description>Staple Reload</Description>
            <Size>35 - 60mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>125609</ARTG>
                <ARTG>234042</ARTG>
                <ARTG>276233</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX037</BillingCode>
            <Name>Mirus Endocutter Staple Reloads</Name>
            <Description>Titanium staples</Description>
            <Size>Open Length - 2.5mm-4.8mm&#xD;
Close Length - 1.0mm-2.0mm</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>289171</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ069</BillingCode>
            <Name>AEON Endostapler Reload</Name>
            <Description>Reload Staples</Description>
            <Size>45mm-60mm</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>329235</ARTG>
            </ARTGs>
            <MinimumBenefit>320</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS076</BillingCode>
            <Name>ENDO TA* reloading unit</Name>
            <Description>Titanium Surgical Stapler DLU</Description>
            <Size>30mm -2.5, 30mm-3.5</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>182307</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS081</BillingCode>
            <Name>ENDO GIA* reloading unit</Name>
            <Description>Titanium Surgical Stapler DLU</Description>
            <Size>30 - 35mm; 45mm; 60mm.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>181429</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS092</BillingCode>
            <Name>ENDO - Herna reloading unit; VERSA TACK* reloading unit.</Name>
            <Description>Titanium Surgical Stapler DLU</Description>
            <Size>4mm, 4.8mm (10 staples).</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>181429</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ017</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME220</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Linear Stapler Reloads</Name>
            <Description>Linear stapler single use reload with titanium staples</Description>
            <Size>32mm; 46mm; 60mm; 90mm</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>207254</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ019</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME222</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Linear Cutter Reloads</Name>
            <Description>Single use, linear cutter reload cartridge containing titanium staples</Description>
            <Size>61mm; 81mm; 100mm</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>207254</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI215</BillingCode>
            <Name>PI/TA Reloading Units</Name>
            <Description>PI/TA Disposable Surgical Loading Unit</Description>
            <Size>30mm, 45mm, 60mm, 90mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>181429</ARTG>
                <ARTG>185017</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI216</BillingCode>
            <Name>GIA/ILA Reloading Units</Name>
            <Description>Single Use Loading Units</Description>
            <Size>50mm, 60mm, 80mm, 90mm, 100mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>181429</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI455</BillingCode>
            <Name>Tri-Staple GIA Reloading Units</Name>
            <Description>Single use loading units</Description>
            <Size>60mm, 80mm  </Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>331482</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN213</BillingCode>
            <Name>Proximate Linear Stapler</Name>
            <Description>Staple reload</Description>
            <Size>30 to 100mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>132170</ARTG>
                <ARTG>133407</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN218</BillingCode>
            <Name>Endopath Linear Cutter</Name>
            <Description>Staple reload</Description>
            <Size>35-45mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>132171</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN220</BillingCode>
            <Name>EES Linear Cutter</Name>
            <Description>Staple reload</Description>
            <Size>55-75mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>155639</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB003</BillingCode>
            <Name>Touchstone Linear Cutter Stapler Cartridge (Reloads) 80mm</Name>
            <Description>A disposable staple cartridge used in conjunction with a matched Touchstone Linear Cutter Stapler that lays a double staggered row of staples on each side a cutting knife.  Used for extensive bowel, gastric, gynaecological and thoracic surgical stapling procedures.</Description>
            <Size>80mm length in staple line with choice of 3.8mm, 4.2mm and 4.5mm titanium staples</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>262505</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB006</BillingCode>
            <Name>Touchstone Linear Cutter Stapler Cartridge (Reloads) 100mm</Name>
            <Description>A disposable staple cartridge used in conjunction with a matched Touchstone Linear Cutter Stapler that lays a double staggered row of staples on each side a cutting knife.  Used for extensive bowel, gastric, gynaecological and thoracic surgical stapling procedures.</Description>
            <Size>100mm length in staple line with choice of 3.8mm and 4.5mm titanium staples</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>262505</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB010</BillingCode>
            <Name>JustRight 5mm Reload</Name>
            <Description>Endoscopic manual linear cutting Stapler, Single-use</Description>
            <Size>5mm shaft diameter  25mm jaw length  20cm length</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>306951</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX038</BillingCode>
            <Name>Mirus Disposable Linear Cutter Staple Reloads</Name>
            <Description>Titanium staple reloads</Description>
            <Size>Open Length - 3.8mm-4.8mm&#xD;
Close Length - 1.5mm-2.0mm&#xD;
Number of staples - 64-104</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>289171</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX039</BillingCode>
            <Name>Mirus Auto Linear Stapler Staple Reloads</Name>
            <Description>Titanium staple reloads</Description>
            <Size>Open Length - 3.5mm-4.8mm&#xD;
Close Length - 1.5mm-2.0mm&#xD;
Number of Staples - 11-33</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>289171</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX040</BillingCode>
            <Name>Mirus Dial Linear Stapler Staple Reloads</Name>
            <Description>Titanium staple reloads</Description>
            <Size>Open Length - 4.2mm&#xD;
Number of Staples - 11-33</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4317</SubGroupID>
            <ARTGs>
                <ARTG>289171</ARTG>
            </ARTGs>
            <MinimumBenefit>210</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS134</BillingCode>
            <Name>DST Series EEA Or Vil</Name>
            <Description>Accessory</Description>
            <Size>21mm, 25mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>178497</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-12-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ903</BillingCode>
            <Name>Echelon</Name>
            <Description>Disposable stapling device</Description>
            <Size>45-60mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>155639</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS046</BillingCode>
            <Name>Endo GIA Stapling System</Name>
            <Description>Endoscopic/thoroscopic</Description>
            <Size>12mm; One size only.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>346475</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ020</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME224</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Endoscopic Linear Cutter</Name>
            <Description>The Endoscopic Linear Cutter and Reloads have applications in resection, transection and/or anastomosis of tissue in open or laparoscopic procedures.</Description>
            <Size>Stapler Unit - 280mm, 330mm, 380mm, 430mm, 480mm in 12.5mm shaft OD.  Reloadable Cartridges - 30mm, 45mm, 60mm staple lengths.</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>205331</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ904</BillingCode>
            <Name>Echelon</Name>
            <Description>Stapler</Description>
            <Size>45 - 60mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>155639</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN206</BillingCode>
            <Name>Endopath Cutter</Name>
            <Description>Cutter and Stapler</Description>
            <Size>45mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>155639</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX031</BillingCode>
            <Name>Mirus Endocutter</Name>
            <Description>A stapler with triple staggered rows of titanium staples used to cut and close soft tissue.</Description>
            <Size>Small - shaft length 60mm&#xD;
Medium - shaft length 160mm&#xD;
Long - shaft length 260mm</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>289071</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ZZ068</BillingCode>
            <Name>AEON Endostapler</Name>
            <Description>Endoscopic articulated stapler</Description>
            <Size>Short (60mm)  Medium (160mm)  Long (260mm)</Size>
            <SupplierCode>ZZ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>329207</ARTG>
            </ARTGs>
            <MinimumBenefit>357</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE683</BillingCode>
            <Name>SureForm</Name>
            <Description>Disposable stapling device</Description>
            <Size>45mm (staple line length)  60mm (staple line length)</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix>
            <ARTGs>
                <ARTG>309263</ARTG>
            </ARTGs>
            <MinimumBenefit>447</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI227</BillingCode>
            <Name>Signia™ Powered Intelligent Stapling System</Name>
            <Description>Powered, articulating, endoscopic intelligent stapler with Adaptive Firing and real time technology</Description>
            <Size>30mm, 45mm, 60mm lengths</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix>
            <ARTGs>
                <ARTG>287262</ARTG>
                <ARTG>287417</ARTG>
                <ARTG>287923</ARTG>
            </ARTGs>
            <MinimumBenefit>447</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN215</BillingCode>
            <Name>Echelon</Name>
            <Description>Disposable powered stapling device</Description>
            <Size>35 to 60mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix>
            <ARTGs>
                <ARTG>195695</ARTG>
            </ARTGs>
            <MinimumBenefit>447</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN214</BillingCode>
            <Name>EES Linear Cutter</Name>
            <Description>Single use, reloadable stapler</Description>
            <Size>55 to 75mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4318</SubGroupID>
            <ARTGs>
                <ARTG>155639</ARTG>
            </ARTGs>
            <MinimumBenefit>69</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS209</BillingCode>
            <Name>Endo GIA Reinforced Reload with Tri-Staple Technology</Name>
            <Description>The Endo GIA Reinforced Reload with Tri-Staple Technology is an endoscopic stapler reload pre-attached with a non-woven absorbable polyglycolic acid staple line reinforcement mesh. This reinforced reload places a triple-staggered row of titanium staples and two layers of absorbable reinforcement material on either side of the cut line.</Description>
            <Size>45mm and 60mm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4319</SubGroupID>
            <Suffix>Integrated</Suffix>
            <ARTGs>
                <ARTG>231041</ARTG>
            </ARTGs>
            <MinimumBenefit>521</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI287</BillingCode>
            <Name>Tri-Staple  2.0 Reinforced reloads</Name>
            <Description>Tri-Staple  2.0 Reinforced reload preloaded with polyglycolic acid staple line reinforcement mesh and with intelligent chip that communicates with Signia  stapler.</Description>
            <Size>45mm, 60mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4319</SubGroupID>
            <Suffix>Integrated</Suffix>
            <ARTGs>
                <ARTG>350110</ARTG>
            </ARTGs>
            <MinimumBenefit>521</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT224</BillingCode>
            <Name>GORE®  SEAMGUARD® Bioabsorbable Staple Line Reinforcement</Name>
            <Description>GORE® SEAMGUARD® Reinforcement is a synthetic 100% bioabsorbable material, constructed from Polyglycolic Acid:Trimethylene Carbonate. Buttressing material is engineered to reduce perioperative leaks and bleeding in a variety of minimally invasive surgeries.</Description>
            <Size>1BSGEC60- for 60mm Ethicon Stapler Straight, 1BSGEC60A- for 60mm Ethicon Stapler, 1BSGEC45- for 45mm Ethicon Stapler, 1BSGTRI45P- for 45mm Endo GIA Tristapler Purple, 1BSGTRI45B-  for 45mm Endo GIA Tristapler Black, 1BSGTRI60P- for 60mm Endo GIA Tristapler Purple, 1BSGTRI60B- for 60mm Endo GIA Tristapler Black</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4319</SubGroupID>
            <ARTGs>
                <ARTG>153351</ARTG>
            </ARTGs>
            <MinimumBenefit>198</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>GT228</BillingCode>
            <Name>GORE® SEAMGUARD® Bioabsorbable Staple Line Reinforcement (Circular)</Name>
            <Description>GORE® SEAMGUARD® Reinforcement is a synthetic 100% bioabsorbable material, constructed from Polyglycolic Acid:Trimethylene Carbonate. Buttressing material is engineered to reduce perioperative leaks and bleeding in a variety of minimally invasive surgeries. Configured for a range of circular/EEA staplers- 25mm, 28mm, 29mm, 31mm, 33mm &amp; 34mm</Description>
            <Size>Circular Seamguard is configured for a range of circular/EEA staplers- 25mm, 28mm, 29mm, 31mm, 33mm &amp; 34mm for both Johnson &amp; Johnson &amp; Medtronic Circular Staplers</Size>
            <SupplierCode>GT</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4319</SubGroupID>
            <ARTGs>
                <ARTG>153352</ARTG>
            </ARTGs>
            <MinimumBenefit>198</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ056</BillingCode>
            <Name>Proximate Articulating Linear Stapler</Name>
            <Description>Articulating linear stapler preloaded with titanium staples</Description>
            <Size>55mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>132167</ARTG>
            </ARTGs>
            <MinimumBenefit>662</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS179</BillingCode>
            <Name>EEA Haemorrhoid and Prolapse Stapler</Name>
            <Description>Stapling instrument for control of rectal prolapse and haemorrhoid disease.</Description>
            <Size>33mm Circular Stapling line, 3.5 mm and 4.8mm Staple leg length.</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>178674</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ014</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME218</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Haemorrhoidal (CPH) Stapler</Name>
            <Description>Circular stapler for rectal prolapse and haemorrhoids preloaded with titanium staples</Description>
            <Size>Outside diameter: 32.5mm; 34.5mm</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>205330</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ016</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME217</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Circular Stapler</Name>
            <Description>Curved intraluminal stapler preloaded with titanium staples.</Description>
            <Size>21mm; 25mm; 28mm; 32mm</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>292060</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ443</BillingCode>
            <Name>Proximate Intraluminal Stapler PPH</Name>
            <Description>Proximate Hemorrhoidal Circular Stapler PPH</Description>
            <Size>One Size Only</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>99218</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB004</BillingCode>
            <Name>Touchstone Circular Stapler</Name>
            <Description>A surgical implanting device for placing s specific size of double staggered row of titanium staples in a circular fashion in the large bowel, small bowel or oesophagus to maintain function of the digestive tract.  A suitable size is used to match the lumen size of the patient's digestive tract</Description>
            <Size>External dimension - 21mm, 25mm, 29mm or 33mm</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>263001</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB007</BillingCode>
            <Name>Touchstone Prolapse Haemorrhoid Stapler</Name>
            <Description>A surgical implanting device for placing a specific size of double staggered row of titanium staples in a circular fashion in the Anal and/or Rectal region for the circumferential excision of the prolapsed distal rectal muscosa, as described by Dr. Longo, Italy.</Description>
            <Size>33mm and 36mm</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>262507</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX035</BillingCode>
            <Name>Mirus Circular Intraluminal Stapler</Name>
            <Description>Disposable circular stapler with mechanism to measure tissue thickness</Description>
            <Size>Available in 2 rows and 3 rows of staples</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>289056</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX036</BillingCode>
            <Name>Mirus Hemorrhoids Stapler</Name>
            <Description>Disposable stapler with 2 or 3 staggered rows of titanium staples</Description>
            <Size>Available in models with 2 rows and 3 rows of staples</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Circular</Suffix>
            <ARTGs>
                <ARTG>289057</ARTG>
            </ARTGs>
            <MinimumBenefit>648</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ812</BillingCode>
            <Name>CONTOUR Curved Cutter Stapler</Name>
            <Description>Curved cutter and stapler for gastrointestinal transaction and resection.</Description>
            <Size>40mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Curved</Suffix>
            <ARTGs>
                <ARTG>118291</ARTG>
            </ARTGs>
            <MinimumBenefit>559</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS075</BillingCode>
            <Name>ENDO TA*</Name>
            <Description>Titanium Surgical Stapler</Description>
            <Size>30mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>185016</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS077</BillingCode>
            <Name>ENDO GIA*</Name>
            <Description>Titanium Surgical Stapler</Description>
            <Size>30 - 35mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>181272</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ184</BillingCode>
            <Name>Endopath Multi Stapler</Name>
            <Description>Endoscopic titanium stapler with staples</Description>
            <Size>11mm shaft diameter</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>124512</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI219</BillingCode>
            <Name>EEA Circular Stapler</Name>
            <Description>Circular staplers</Description>
            <Size>21mm to 34mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Endoscopic, Circular</Suffix>
            <ARTGs>
                <ARTG>178517</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI281</BillingCode>
            <Name>EEA Circular Stapler with Tri Staple Technology</Name>
            <Description>Circular staplers with 3 row staples, slope faced cartridge with a different  staple size in each staple row.</Description>
            <Size>21mm to 33mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Endoscopic, Circular</Suffix>
            <ARTGs>
                <ARTG>293808</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN216</BillingCode>
            <Name>Ethicon Intraluminal Stapler</Name>
            <Description>Proximate and  Endopath staplers</Description>
            <Size>21 - 33mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <Suffix>Endoscopic, Circular</Suffix>
            <ARTGs>
                <ARTG>99218</ARTG>
                <ARTG>124512</ARTG>
            </ARTGs>
            <MinimumBenefit>671</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS110</BillingCode>
            <Name>DFS Disposable Fascia Stapler</Name>
            <Description>Stainless Steel</Description>
            <Size>One Size Only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>180134</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>ET066</BillingCode>
            <Name>Insorb Subcuticular Stapler</Name>
            <Description>A subcuticular (dermal) surgical delivery system loaded with resorbable staples/prostheses</Description>
            <Size>Each staple is 5mm x 3mm</Size>
            <SupplierCode>ET</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>178665</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME219</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Linear Cutter Stapler</Name>
            <Description>Single use, reloadable, linear cutter stapler containing titanium staples</Description>
            <Size>61mm; 81mm; 100mm</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>205319</ARTG>
                <ARTG>205331</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IJ018</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ME221</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Frankenman Linear Stapler</Name>
            <Description>Linear stapler preloaded with titanium staples</Description>
            <Size>32mm; 46mm; 60mm; 90mm</Size>
            <SupplierCode>IJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>205331</ARTG>
                <ARTG>205319</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JJ050</BillingCode>
            <Name>Proximate* Linear Stapler</Name>
            <Description>Metal/Plastic linear stapler preloaded with titanium staples, manual closure</Description>
            <Size>55 - 60mm</Size>
            <SupplierCode>JJ</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>132167</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI212</BillingCode>
            <Name>PI/TA Stapler</Name>
            <Description>Disposable Surgical Stapler and Loading Unit</Description>
            <Size>30mm, 45mm, 60mm, 90mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>181434</ARTG>
                <ARTG>185015</ARTG>
                <ARTG>185733</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI214</BillingCode>
            <Name>GIA Linear Cutter Stapler and single use loading units</Name>
            <Description>single use, reloadable stapler</Description>
            <Size>2.5mm, 3.8mm, 4.8mm,  60mm, 75mm, 80mm, 100mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>181272</ARTG>
                <ARTG>182206</ARTG>
                <ARTG>185453</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI456</BillingCode>
            <Name>GIA Stapler with Tri-Staple technology</Name>
            <Description>Single use, reloadable stapler</Description>
            <Size>60mm, 80mm</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>331481</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN217</BillingCode>
            <Name>Proximate</Name>
            <Description>Preloaded stapler</Description>
            <Size>30-100mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>132166</ARTG>
                <ARTG>132167</ARTG>
                <ARTG>133406</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB002</BillingCode>
            <Name>Touchstone Linear Cutter Stapler 80mm</Name>
            <Description>A device that incorporates a disposable staple cartridge that lays a double staggered row of staples on each side of a cutting knife.  Used for extensive bowel, gastric, gynaecological and thoracic surgical stapling procedures.</Description>
            <Size>80mm length in staple line with choice of 3.8mm, 4.2mm and 4.5mm titanium staples</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>262505</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB005</BillingCode>
            <Name>Touchstone Linear Cutter Stapler 100mm</Name>
            <Description>A device that incorporates a disposable staple cartridge that lays a double staggered row of staples on each side of a cutting knife.  Used for extensive bowel, gastric, gynaecological and thoracic surgical stapling procedures.</Description>
            <Size>100mm length in staple line with choice of 3.8mm and 4.5mm titanium</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>262505</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OB009</BillingCode>
            <Name>JustRight 5mm Stapler</Name>
            <Description>Endoscopic manual linear cutting stapler, single use</Description>
            <Size>5mm shaft diameter  25mm jaw length  20cm length</Size>
            <SupplierCode>OB</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>306951</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX032</BillingCode>
            <Name>Mirus Disposable Linear Cutter</Name>
            <Description>Disposable, reloadable linear cutter stapler</Description>
            <Size>Stapling line lengths of 60mm, 80mm and 100mm</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>289076</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX033</BillingCode>
            <Name>Mirus Dial Linear Stapler</Name>
            <Description>A disposable, reloadable linear stapler with dial</Description>
            <Size>Accommodates staple line lengths of 30mm, 45mm, 60mm and 90mm.</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>289086</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>OX034</BillingCode>
            <Name>Mirus Auto Linear Stapler</Name>
            <Description>A disposable, reloadable linear stapler</Description>
            <Size>Accommodates staple line lengths of 30mm, 45mm, 60mm and 90mm.</Size>
            <SupplierCode>OX</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4320</SubGroupID>
            <ARTGs>
                <ARTG>289086</ARTG>
            </ARTGs>
            <MinimumBenefit>302</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS246</BillingCode>
            <Name>ABSORBATACK</Name>
            <Description>Absorbable Fixation Device</Description>
            <Size>5mm</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Absorbable</Suffix>
            <ARTGs>
                <ARTG>181415</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA204</BillingCode>
            <Name>SorbaFix</Name>
            <Description>Open of Laparoscopic Absorbable Fixation System.</Description>
            <Size>15 Fasteners; 30 Fasteners</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Absorbable</Suffix>
            <ARTGs>
                <ARTG>170112</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA269</BillingCode>
            <Name>Bard Absorbable Fixation System</Name>
            <Description>Open or Laparoscopic Absorbable Fixation System</Description>
            <Size>30 Absorbable Fastners, 15 Absorbale Fastners</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Absorbable</Suffix>
            <ARTGs>
                <ARTG>278914</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN115</BillingCode>
            <Name>SECURESTRAP™</Name>
            <Description>5mm Absorbable Strap Fixation Device</Description>
            <Size>5mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Absorbable</Suffix>
            <ARTGs>
                <ARTG>193268</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN175</BillingCode>
            <Name>SECURESTRAP Open</Name>
            <Description>Open Absorbable Strap Fixation Device</Description>
            <Size>Strap length 6.7mm</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Absorbable</Suffix>
            <ARTGs>
                <ARTG>230205</ARTG>
            </ARTGs>
            <MinimumBenefit>473</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS227</BillingCode>
            <Name>ReliaTack Articulating Reloadable Fixation Device</Name>
            <Description>Articulating, reloadable, sterile, single use fixation device prepackaged with 30 standard single use, absorbable reloads</Description>
            <Size>5.1mm, 30 tacks</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Absorbable, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>315822</ARTG>
            </ARTGs>
            <MinimumBenefit>657</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI303</BillingCode>
            <Name>ReliaTack™ Articulating Reloadable Fixation Device with Deep Purchase Tacks</Name>
            <Description>Articulating, reloadable, sterile, single use fixation device pre-packaged with 29 tacks (three eight-tack deep purchase reloads, and one five tack deep purchase reload)</Description>
            <Size>7.0 mm, 29 Tacks</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Absorbable, Articulating/Roticulating</Suffix>
            <ARTGs>
                <ARTG>315822</ARTG>
            </ARTGs>
            <MinimumBenefit>657</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS045</BillingCode>
            <Name>PROTACK*; Endoscopic Tacker Device; ENDO UNIVERSAL*</Name>
            <Description>Endoscopic; Titanium Surgical Tacker</Description>
            <Size>20 tacks; 30 tacks; 5mm; 4mm, 4.8mm (10 staples).</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>181429</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA203</BillingCode>
            <Name>Fixation Anchor Set</Name>
            <Description>Open or Laparoscopic Permanent Fixation System.</Description>
            <Size>15 Fasteners; 30 Fasteners</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <Suffix>Endoscopic</Suffix>
            <ARTGs>
                <ARTG>137898</ARTG>
            </ARTGs>
            <MinimumBenefit>374</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS091</BillingCode>
            <Name>VERSA TACK* stapler</Name>
            <Description>Titanium Surgical Stapler</Description>
            <Size>4, 4.8mm (10 staples)</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <ARTGs>
                <ARTG>181429</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS095</BillingCode>
            <Name>STATTACK </Name>
            <Description>STATTACK  Titanium Helical Tacker</Description>
            <Size>One size only</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>4331</SubGroupID>
            <ARTGs>
                <ARTG>178498</ARTG>
            </ARTGs>
            <MinimumBenefit>234</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE610</BillingCode>
            <Name>Cor-Knot®Quick Load single</Name>
            <Description>The Cor-Knot®Quick Load houses one sterile Cor-Knot®Titanium Fastener for use with the Cor-Knot®device kit</Description>
            <Size>One size</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>5988</SubGroupID>
            <ARTGs>
                <ARTG>219813</ARTG>
            </ARTGs>
            <MinimumBenefit>50</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE611</BillingCode>
            <Name>Cor-Knot®Quick Load 6 Pouch</Name>
            <Description>The Cor-Knot®Quick load 6 contains six single sterile Cor-Knot® Titanium Fasteners for use with the Cor-Knot® device kit</Description>
            <Size>One size</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>5988</SubGroupID>
            <ARTGs>
                <ARTG>219813</ARTG>
            </ARTGs>
            <MinimumBenefit>308</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS229</BillingCode>
            <Name>ReliaTack Articulating Reloadable Fixation Device (Reloads x 10)</Name>
            <Description>10 x absorbable reloads to be used with ReliaTack atriculating tacking device</Description>
            <Size>5.1mm, 10 tacks</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>6003</SubGroupID>
            <Suffix>10 Tacks, Absorbable</Suffix>
            <ARTGs>
                <ARTG>275114</ARTG>
            </ARTGs>
            <MinimumBenefit>323</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>AS228</BillingCode>
            <Name>ReliaTack Articulating Reloadable Fixation Device (Reloads x 5)</Name>
            <Description>5 x absorbable reloads to be used with ReliaTack articulating tacking device</Description>
            <Size>5.1mm, 5 tacks</Size>
            <SupplierCode>AS</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>6003</SubGroupID>
            <Suffix>5 Tacks, Absorbable</Suffix>
            <ARTGs>
                <ARTG>275114</ARTG>
            </ARTGs>
            <MinimumBenefit>162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI304</BillingCode>
            <Name>ReliaTack Articulating Reloadable Fixation Device with Deep Purchase Tacks (Reloads x 5)</Name>
            <Description>5 x absorbable deep purchase reloads to be used with ReliaTack articulating tacking device</Description>
            <Size>7.0 mm  5 Tacks</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>6003</SubGroupID>
            <Suffix>5 Tacks, Absorbable</Suffix>
            <ARTGs>
                <ARTG>315822</ARTG>
            </ARTGs>
            <MinimumBenefit>162</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MI305</BillingCode>
            <Name>ReliaTack Articulating Reloadable Fixation Device with Deep Purchase Tacks (Reloads x 8)</Name>
            <Description>8 x absorbable deep purchase reloads to be used with ReliaTack articulating tacking device</Description>
            <Size>7.0 mm  8 tacks</Size>
            <SupplierCode>MI</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>6003</SubGroupID>
            <Suffix>8 Deep Purchase Tack, absorbable</Suffix>
            <ARTGs>
                <ARTG>315822</ARTG>
            </ARTGs>
            <MinimumBenefit>258</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>DE726</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MG048</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Glutack</Name>
            <Description>Catheter for controlled application of surgical adhesive.</Description>
            <Size>25, 40, 50 drops</Size>
            <SupplierCode>DE</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>6004</SubGroupID>
            <Suffix>Synthetic, Endoscopic</Suffix>
            <ARTGs>
                <ARTG>313580</ARTG>
            </ARTGs>
            <MinimumBenefit>213</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WL001</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>LH528</PriorBillingCode>
            </PriorBillingCodes>
            <Name>LiquiBand Fix8</Name>
            <Description>Hernia Mesh Fixation System, preloaded into applicator</Description>
            <Size>33 tacks</Size>
            <SupplierCode>WL</SupplierCode>
            <CategoryID>21</CategoryID>
            <SubCategoryID>194</SubCategoryID>
            <GroupID>1582</GroupID>
            <SubGroupID>6004</SubGroupID>
            <Suffix>Synthetic, Endoscopic</Suffix>
            <ARTGs>
                <ARTG>233374</ARTG>
                <ARTG>314884</ARTG>
            </ARTGs>
            <MinimumBenefit>467</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG142</BillingCode>
            <Name>DuraSeal Xact Spinal Dural Sealant</Name>
            <Description>Xact Dural Sealant for spine.  Packaged in sterile single use disposable tray.</Description>
            <Size>3ml</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1661</GroupID>
            <ARTGs>
                <ARTG>233759</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN202</BillingCode>
            <Name>Evicel</Name>
            <Description>Dural sealant</Description>
            <Size>0 to 3ml</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1661</GroupID>
            <ARTGs>
                <ARTG>266221</ARTG>
            </ARTGs>
            <MinimumBenefit>666</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW659</BillingCode>
            <Name>ADHERUS Dural Sealant</Name>
            <Description>Dural sealant</Description>
            <Size>6ml</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1662</GroupID>
            <ARTGs>
                <ARTG>202972</ARTG>
            </ARTGs>
            <MinimumBenefit>649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>HW660</BillingCode>
            <Name>Adherus AutoSpray</Name>
            <Description>Hydrogel sealant with automatic applicator.</Description>
            <Size>6mL</Size>
            <SupplierCode>HW</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1662</GroupID>
            <ARTGs>
                <ARTG>202972</ARTG>
            </ARTGs>
            <MinimumBenefit>649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>IG141</BillingCode>
            <Name>Duraseal Dural Sealant</Name>
            <Description>DuraSeal is a Synthetic, absorbable, Polyethylene Glycon, hydrogel sealant used as an adjunct to sutured dural repair to achieve watertight closure.</Description>
            <Size>5ml of hydrogel sealant</Size>
            <SupplierCode>IG</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1662</GroupID>
            <ARTGs>
                <ARTG>233618</ARTG>
            </ARTGs>
            <MinimumBenefit>649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MN203</BillingCode>
            <Name>Evicel</Name>
            <Description>Dural sealant</Description>
            <Size>&gt;3 to 6ml</Size>
            <SupplierCode>MN</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1662</GroupID>
            <ARTGs>
                <ARTG>181318</ARTG>
            </ARTGs>
            <MinimumBenefit>649</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX344</BillingCode>
            <Name>HEMOPATCH SEALING HAEMOSTAT</Name>
            <Description>HEMOPATCH is an absorbable collagen pad intended for sealing and hemostasis.  HEMOPATCH is indicated as a hemostatic device and surgical sealant for procedures in  which control of bleeding or leakage of other body fluids or air by conventional surgical  techniques is either ineffective or impractical. HEMOPATCH may be used to close dural  defects following traumatic injury, excision, retraction or shrinkage of the dura mater.</Description>
            <Size>Small: 2.7CM X 2.7 CM ( 5 pads per box)</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1663</GroupID>
            <ARTGs>
                <ARTG>360130</ARTG>
            </ARTGs>
            <Note>The prosthesis is only to be used in a surgical procedure described in item 39612, 39615, 39641, 39710 and 39712 in Group T8 of the Regulations.</Note>
            <MinimumBenefit>202</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BX343</BillingCode>
            <Name>HEMOPATCH SEALING HAEMOSTAT</Name>
            <Description>HEMOPATCH is an absorbable collagen pad intended for sealing and hemostasis.  HEMOPATCH is indicated as a hemostatic device and surgical sealant for procedures in  which control of bleeding or leakage of other body fluids or air by conventional surgical  techniques is either ineffective or impractical. HEMOPATCH may be used to close dural  defects following traumatic injury, excision, retraction or shrinkage of the dura mater.</Description>
            <Size>Medium 4.5cm X 4.5cm  ( 3 pads per box)  Large 4.5cm X 9cm  (3 pads per box)</Size>
            <SupplierCode>BX</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1664</GroupID>
            <ARTGs>
                <ARTG>360130</ARTG>
            </ARTGs>
            <Note>The prosthesis is only to be used in a surgical procedure described in item 39612, 39615, 39641, 39710 and 39712 in Group T8 of the Regulations.</Note>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH719</BillingCode>
            <Name>TissuePatchDural 50* 25</Name>
            <Description>Self adhesive dural sealant</Description>
            <Size>50*25mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1664</GroupID>
            <ARTGs>
                <ARTG>377573</ARTG>
            </ARTGs>
            <Note>The PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH720</BillingCode>
            <Name>TissuePatchDural 50 * 50</Name>
            <Description>Self adhesive dural sealant</Description>
            <Size>50*50mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1664</GroupID>
            <ARTGs>
                <ARTG>377573</ARTG>
            </ARTGs>
            <Note>The PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH721</BillingCode>
            <Name>TissuePatchDural 50*100</Name>
            <Description>Self adhesive dural sealant</Description>
            <Size>50*100mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1664</GroupID>
            <ARTGs>
                <ARTG>377573</ARTG>
            </ARTGs>
            <Note>The PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>LH723</BillingCode>
            <Name>TissuePatchDural 100*25</Name>
            <Description>Self adhesive dural sealant</Description>
            <Size>100*25mm</Size>
            <SupplierCode>LH</SupplierCode>
            <CategoryID>25</CategoryID>
            <SubCategoryID>219</SubCategoryID>
            <GroupID>1664</GroupID>
            <ARTGs>
                <ARTG>377573</ARTG>
            </ARTGs>
            <Note>The PL benefit is limited to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note>
            <MinimumBenefit>452</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ451</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY034</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Prostar</Name>
            <Description>Suture Mediated Closure Device - Closure of Large holes</Description>
            <Size>Up to 24 French</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <Suffix>L (Large)</Suffix>
            <ARTGs>
                <ARTG>300736</ARTG>
            </ARTGs>
            <MinimumBenefit>608</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW005</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO009</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Mynx Vascular Closure Device</Name>
            <Description>Water-soluble synthetic sealant made of a polyethylene glycol (PEG) The sealant is resorbed by the body within 30 days</Description>
            <Size>5F, 6/7F</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>201265</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW008</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO012</PriorBillingCode>
            </PriorBillingCodes>
            <Name>EXOSEAL (TM) Vascular Closure Device</Name>
            <Description>Vascular Closure Device</Description>
            <Size>5 - 7F</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>176723</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>JW015</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>DO025</PriorBillingCode>
            </PriorBillingCodes>
            <Name>MYNX Control Vascular Closure Device</Name>
            <Description>The MYNX CONTROL Vascular Closure Device is designed to achieve femoral artery hemostasis via delivery of an extravascular, water-soluble synthetic  hydrogel sealant, using a balloon catheter in conjunction with a standard procedural sheath. The sealant is made of a polyethylene glycol (PEG) material which expands upon contact with subcutaneous fluids to seal the  arteriotomy. The sealant is resorbed by the body within 30 days. A 10 ml locking syringe is used for balloon inflation and deflation.</Description>
            <Size>5F, 6/7F</Size>
            <SupplierCode>JW</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>333853</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ452</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY033</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Proglide</Name>
            <Description>Suture Mediated Closure Device</Description>
            <Size>5 - 8 French</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>300736</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ459</BillingCode>
            <Name>Perclose ProStyle Suture Mediated Closure and Repair System </Name>
            <Description>Suture-Mediated Closure and Repair System</Description>
            <Size>One size</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>300736</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>SJ463</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>AY017</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Starclose</Name>
            <Description>6 Fr Exchange Sheath, Dilator, Guidewire, implantable nitinol clip pre-mounted on a Clip Applier</Description>
            <Size>6 Fr</Size>
            <SupplierCode>SJ</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>240055</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU061</BillingCode>
            <Name>FemoSeal Vascular Closure System</Name>
            <Description>Haemostatic Puncture Closure Device</Description>
            <Size>One Size</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>304029</ARTG>
                <ARTG>263892</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TU067</BillingCode>
            <Name>Angio-Seal VAscular Closure Device - VIP</Name>
            <Description>Angio-Seal Haemostatic Puncture Closure Device, Model VIP Platform</Description>
            <Size>6F and 8F</Size>
            <SupplierCode>TU</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>212</SubCategoryID>
            <GroupID>1644</GroupID>
            <ARTGs>
                <ARTG>306829</ARTG>
                <ARTG>128525</ARTG>
            </ARTGs>
            <MinimumBenefit>307</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX030</BillingCode>
            <Name>ARROWg+ard Blue Single Lumen Central Venous Catheters</Name>
            <Description>A polyurethane central venous catheter with Blue FlexTip (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter body.</Description>
            <Size>CS-24301 - 16g x 20cm, Single Lumen, Adult&#xD;
CS-24306E-16g x 16cm, Single Lumen Adult&#xD;
CS-24701 - 14g x 20cm, Single Lumen Adult&#xD;
CS-24706E -14g x 16cm, Single Lumen, Adult</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>156637</ARTG>
            </ARTGs>
            <MinimumBenefit>91</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA049</BillingCode>
            <Name>Hickman/Broviac Catheters</Name>
            <Description>Open-Ended CVC, Single Lumen</Description>
            <Size>2.7Fr - 9.6Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>145466</ARTG>
                <ARTG>145469</ARTG>
            </ARTGs>
            <MinimumBenefit>146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA125</BillingCode>
            <Name>Groshong Central Venous Catheter</Name>
            <Description>Closed-Ended CVC, Single Lumen</Description>
            <Size>5.5Fr - 9.5Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>42589</ARTG>
            </ARTGs>
            <MinimumBenefit>146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA129</BillingCode>
            <Name>Groshong Peripherally Inserted Central Catheter</Name>
            <Description>Closed-Ended PICC, Single Lumen</Description>
            <Size>3Fr - 5Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>42589</ARTG>
            </ARTGs>
            <MinimumBenefit>146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA291</BillingCode>
            <Name>PowerHickman Single Lumen Microinducer with SureCuff (2cm &amp; 5 cm) with AirGuard</Name>
            <Description>PowerHickman, 8 Fr Single Lumen, MicroIntroducer Kit with SureCuff (2 cm &amp; 5 cm)</Description>
            <Size>8 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309584</ARTG>
                <ARTG>309585</ARTG>
            </ARTGs>
            <MinimumBenefit>146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA292</BillingCode>
            <Name>PowerLine Single Lumen MicroIntroducer Kit</Name>
            <Description>PowerLine 5 Fr Single Lumen, Polyurethane Catheter with Surecuff, MicroIntroducer Kit</Description>
            <Size>5 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309588</ARTG>
            </ARTGs>
            <MinimumBenefit>146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA296</BillingCode>
            <Name>PowerHickman, 8 Fr Single Lumen, Intermediate Kit with SureCuff  Airguard(5 cm)</Name>
            <Description>PowerHickman, 8 Fr Single Lumen, Intermediate Kit with SureCuff Airguard(5 cm)</Description>
            <Size>8Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309586</ARTG>
            </ARTGs>
            <MinimumBenefit>146</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA184</BillingCode>
            <Name>Peripherally Inserted Central Catheter</Name>
            <Description>Power Injectable PICC, Single Lumen</Description>
            <Size>3Fr - 6Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>155226</ARTG>
                <ARTG>286034</ARTG>
                <ARTG>286035</ARTG>
                <ARTG>286036</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA212</BillingCode>
            <Name>Peripherally Inserted Central Catheter</Name>
            <Description>Valved, Power Injectable PICC, Single Lumen</Description>
            <Size>4Fr - 6Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>191603</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA220</BillingCode>
            <Name>Groshong Peripherally Inserted Central Catheter</Name>
            <Description>Closed-Ended, Power Injectable PICC, Single Lumen</Description>
            <Size>5Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>198806</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA268</BillingCode>
            <Name>PowerGlide Pro</Name>
            <Description>Single lumen, power injectable percutaneous catheter</Description>
            <Size>18 - 22 Gauge</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>228968</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2016-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA273</BillingCode>
            <Name>PowerMidline</Name>
            <Description>Single lumen, power injectable percutaneous catheter</Description>
            <Size>3Fr-4Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>228968</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA282</BillingCode>
            <Name>PowerHohn 5 Fr Single Lumen, Basic Kit</Name>
            <Description>PowerHohn 5 Fr Single Lumen, Basic Kit</Description>
            <Size>5 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>309587</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA302</BillingCode>
            <Name>Provena™ Midline Catheter</Name>
            <Description>The Provena™ Midline Catheters are intended to be inserted into a patient's vascular system to sample blood, administer fluids and power injection of contrast media. The unique feature of Provena™ Midline Catheters is that they are configured with a smaller outer diameter with minimal reduction to the intraluminal area assisting in providing the optimal catheter to vein ratio, whilst still enabling good flow rates to ensure the therapy delivery is uncompromised.</Description>
            <Size>3Fr single lumen</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>317521</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA308</BillingCode>
            <Name>PowerGlide Pro™ Midline Cannula with Cue™ Needle Tracking</Name>
            <Description>Single lumen, power injectable percutaneous catheter </Description>
            <Size>Basic kits: 22G x 8 cm, 20G x 8 cm, 22G x 10 cm, 18G x 8 cm, 18G x 10 cm   </Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>317521</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS067</BillingCode>
            <Name>POWERWAND</Name>
            <Description>Single Lumen, Percutaneous Catheter, Power Injectable</Description>
            <Size>3Fr - 5Fr&#xD;
6cm - 10cm</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>283998</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2017-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS069</BillingCode>
            <Name>BioFlo Midline</Name>
            <Description>Percutaneous Catheter, Single Lumen, Power Injectable</Description>
            <Size>Length: 20 cm  French Size: 3Fr - 5Fr</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>312726</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS074</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>ER134</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Single Lumen Peripherally Inserted Central Catheter</Name>
            <Description>Power injectable with Pressure Activated Safely Valve (PASV) technology</Description>
            <Size>3F x55cm, 4F x 55cm, 5F x 55cm</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>179150</ARTG>
                <ARTG>203831</ARTG>
                <ARTG>175080</ARTG>
                <ARTG>178780</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS075</BillingCode>
            <Name>Peripherally Inserted Central Catheter (PICC)</Name>
            <Description>Peripherally Inserted Central Catheter, Single Lumen, Power Injectable </Description>
            <Size>4Fr - 5Fr</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>203832</ARTG>
                <ARTG>215418</ARTG>
                <ARTG>215419</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS078</BillingCode>
            <Name>Peripherally Inserted Central Catheter, Single Lumen</Name>
            <Description>Peripherally Inserted Central Catheter, Single Lumen, Anti-Thrombogenic Catheter  Material, Power Injectable</Description>
            <Size>3Fr - 5Fr</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>203831</ARTG>
                <ARTG>203832</ARTG>
                <ARTG>215411</ARTG>
                <ARTG>215412</ARTG>
                <ARTG>215418</ARTG>
                <ARTG>215419</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX036</BillingCode>
            <Name>Arrow single lumen pressure injectable peripherally inserted central catheter (PICC) sets</Name>
            <Description>Single lumen pressure injectable peripherally inserted central catheter (PICC) sets</Description>
            <Size>3, 4, Fr single lumen Pressure Injectable PICCs various Pressure Injection rates, various lengths.</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>148784</ARTG>
                <ARTG>278735</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX061</BillingCode>
            <Name>Arrow Pressure Injectable Midline</Name>
            <Description>The Arrow Pressure Injectable Midline Catheter is a peripherally inserted intravenous catheter manufactured with medical grade, flexible polyurethane. The Arrow Midline is designed with a non-tapered catheter body and softens in-situ to be less traumatic to the vessel.   The Arrow Pressure Injectable Midline Catheter is indicated for peripheral access to the venous system for intravenous therapy, blood sampling, infusion, and pressure injection of contrast media. The maximum pressure of pressure injector equipment used with the Arrow Pressure Injectable Midline Catheter may not exceed 300 psi. The maximum pressure injection flow rate for the specific lumen being used for pressure injection is printed on the extension line hub.  </Description>
            <Size>Single Lumen Pressure Injectable Midline, 4Fr, 20cm</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>371714</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC279</BillingCode>
            <Name>Turbo-Ject Peripherally Inserted Central Catheter Set ( Single Lumen)</Name>
            <Description>3/4/5/6 Fr Single Lumen Polyurethane PICC with Micropuncture Peel-Away Sheath Introducer and Echogenic needle</Description>
            <Size>3, 4, 5, 6 French, 40 and 60 cm catheter length, single lumen catheter</Size>
            <SupplierCode>WA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>161615</ARTG>
                <ARTG>161616</ARTG>
            </ARTGs>
            <MinimumBenefit>131</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX026</BillingCode>
            <Name>Arrow Peripherally Inserted Central Catheterisation Sets</Name>
            <Description>Range of Polyurethane single lumen peripherally inserted central catheters with or without stylet</Description>
            <Size>3 Fr, range of lengths</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <ARTGs>
                <ARTG>148782</ARTG>
                <ARTG>148784</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX027</BillingCode>
            <Name>Arrow Peripherally Inserted Central Catheterisation Sets  </Name>
            <Description>Range of Polyurethane single lumen peripherally inserted central catheters with or without stylet</Description>
            <Size>4 Fr, range of lengths</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1649</GroupID>
            <ARTGs>
                <ARTG>148782</ARTG>
                <ARTG>148784</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX031</BillingCode>
            <Name>ARROWg+ard Four &amp; Five Lumen Central Venous Catheters</Name>
            <Description>A polyurethane central catheter with Blue FlexTip (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter material</Description>
            <Size>CS-22854E - 8.5 Fr x 16cm, Quad Lumen&#xD;
CS-25854E - 8.5Fr x 20cm, Quad Lumen&#xD;
CS-22855 - 8.5 x 16cm, Five Lumen&#xD;
CS-25855 - 8.5Fr x 20cm, Five Lumen</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>156637</ARTG>
            </ARTGs>
            <MinimumBenefit>111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX032</BillingCode>
            <Name>ARROWg+ard Blue Double &amp; Triple Lumen Central Venous Catheters</Name>
            <Description>A polyurethane central venous catheter with Blue FlexTip (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter material</Description>
            <Size>CS-24402 - 4Fr x 13cm, Dual Lumen CS-22502 -5Fr x 5cm, Dual Lumen CS-25402 - 4Fr x 8cm, Dual Lumen CS-25502 - 5Fr x 12cm, Dual Lumen&#xD;
CS-22702E - 7Fr x 16cm, Double Lumen CS-26702 - 7Fr x 20cm, Double Lumen CS-27702E - 7Fr x 20cm, Double Lumen CS-25553 - 5.5Fr x 8cm, Triple Lumen CS-22703E - 7Fr x 16cm, Triple Lumen CS-26553 -5.5Fr x 13cm, Triple Lumen CS-24703E - 7Fr x 30cm, Triple Lumen&#xD;
CS-25703E - 7Fr x 20cm, Triple Lumen</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>156637</ARTG>
            </ARTGs>
            <MinimumBenefit>111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX033</BillingCode>
            <Name>ARROWg+ard Blue Plus QUAD Lumen Central Venous Catheters</Name>
            <Description>Central Venous Catheters (of various lengths, sizes and lumen configurations with antimicrobial impregnation on: 1. The external indwelling surface of catheter material (chorhexidine and silver sulphadiazine) 2. The entire internal fluid pathway including catheter, extension-lines and hubs (chlorhexidine acetate)</Description>
            <Size>CS-42854E - 8.5Fr x 16cm, Quad Lumen CS-45854E - 8.5Fr x 20cm, Quad Lumen</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>157350</ARTG>
            </ARTGs>
            <MinimumBenefit>111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX034</BillingCode>
            <Name>ARROWg+ard Blue Plus Double &amp; Triple Lumen Central Venous Catheters</Name>
            <Description>Double &amp; Triple  Lumen Central Venous Catheters (of various lengths sizes and lumen configurations) with antimicrobial impregnation on: 1. The external indwelling surface of catheter material (chlorhexidine and silver sulphadiazine) 2. The entire internal fluid pathway including catheter, extension-lines and hubs (chlorhexidine acetate)</Description>
            <Size>CS-45802E - 8 Fr x 20cm, Dual Lumen CS-46702E - 7Fr x 20cm, Dual Lumen CS-47702E - 7Fr x 20cm, Dual Lumen CS-42703E - 7Fr x 16cm, Triple Lumen CS-45703E - 7Fr x 20cm, Triple Lumen</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>157350</ARTG>
            </ARTGs>
            <MinimumBenefit>111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC230</BillingCode>
            <Name>Cook Spectrum CVC Catheter 3 Lumen with antibiotic impregnation</Name>
            <Description>Triple lumen CVC line with antibiotic impregnation</Description>
            <Size>5Fr, 7Fr, 9Fr</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>161300</ARTG>
                <ARTG>234273</ARTG>
            </ARTGs>
            <MinimumBenefit>111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC231</BillingCode>
            <Name>Cook Spectrum 5 Lumen CVC Catheter with antibiotic impregnation</Name>
            <Description>5 lumen CVC with antibiotic impregnation</Description>
            <Size>10Fr</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>234273</ARTG>
            </ARTGs>
            <MinimumBenefit>111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2007-06-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC321</BillingCode>
            <Name>Cook Spectrum Central Venous Catheter with antibiotic impregnation - 2 lumen</Name>
            <Description>Double lumen CVC line with antibiotic impregnation</Description>
            <Size>4 Fr, 5 Fr, 8 Fr. Catheter length 5-25cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating)</Suffix>
            <ARTGs>
                <ARTG>161300</ARTG>
                <ARTG>234273</ARTG>
            </ARTGs>
            <MinimumBenefit>111</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2014-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX043</BillingCode>
            <Name>Pressure Injectable ARROWg+ard® Blue Plus Antimicrobial Multi-Lumen Central Venous Catheters</Name>
            <Description>Pressure Injectable Multi Lumen Central Venous Catheters (of various lengths sizes and lumen configurations) with antimicrobial impregnation of the internal and external catheter with Chlorhexidine and Silver Sulphadiazine.</Description>
            <Size>CS42703HP: 16cm x 7Fr Triple Lumen Catheter&#xD;
CS45703HP: 20cm x 7Fr Triple Lumen Catheter&#xD;
CS42854HP: 16cm x 8.5Fr Quad Lumen Catheter&#xD;
CS45854HP: 20cm x 8.5Fr Quad Lumen Catheter</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>A (Anti-infective Agent Coating), pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>177098</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA051</BillingCode>
            <Name>Hickman/Leonard Catheters</Name>
            <Description>Open-Ended CVC, Multiple Lumen</Description>
            <Size>7Fr - 12.5Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>145468</ARTG>
                <ARTG>145469</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA126</BillingCode>
            <Name>Groshong Central Venous Catheter</Name>
            <Description>Closed-Ended CVC, Multiple Lumen</Description>
            <Size>5.5Fr - 9.5 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>42589</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA209</BillingCode>
            <Name>HemoStar Long Term Haemodialysis Catheter</Name>
            <Description>Dialysis Catheter, Multiple Lumen</Description>
            <Size>14.5Fr - 16Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu (cuffed)</Suffix>
            <ARTGs>
                <ARTG>170529</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA289</BillingCode>
            <Name>PowerHickman, 9.5 Fr Dual Lumen, Intermediate Kit with SureCuff (5 cm) &amp; Airguard</Name>
            <Description>PowerHickman, 9.5 Fr Dual Lumen, Intermediate Kit with SureCuff (5 cm) &amp; Airguard</Description>
            <Size>9.5 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309586</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA290</BillingCode>
            <Name>PowerLine Multi Lumen Airguard Intermediate Kit</Name>
            <Description>PowerLine 6 Fr Multi Lumen, Polyurethane Catheter with Surecuff, AirGuard, Intermediate Kit</Description>
            <Size>6 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309590</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA293</BillingCode>
            <Name>PowerLine Multi Lumen MicroIntroducer Kit</Name>
            <Description>PowerLine 5-6 Fr Multi Lumen, Polyurethane Catheter with Surecuff, MicroIntroducer Kit</Description>
            <Size>5-6Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309588</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA294</BillingCode>
            <Name>PowerLine Multi Lumen without Airguard Intermediate Kit</Name>
            <Description>PowerLine 6 Fr Multi Lumen, Polyurethane Catheter with Surecuff, Intermediate Kit</Description>
            <Size>6 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309589</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA295</BillingCode>
            <Name>PowerHickman, 9.5 Fr Multi Lumen, MicroIntroducer Kit with SureCuff (2 &amp;5 cm)</Name>
            <Description>PowerHickman, 9.5 Fr Dual Lumen, MicroIntroducer Kit with SureCuff (2 &amp; 5 cm)</Description>
            <Size>9.5 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>cu, pi</Suffix>
            <ARTGs>
                <ARTG>309585</ARTG>
                <ARTG>309584</ARTG>
            </ARTGs>
            <MinimumBenefit>293</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA183</BillingCode>
            <Name>Peripherally Inserted Central Catheter</Name>
            <Description>Power Injectable PICC, Multiple Lumen</Description>
            <Size>4Fr - 6Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>155226</ARTG>
                <ARTG>286034</ARTG>
                <ARTG>286035</ARTG>
                <ARTG>286036</ARTG>
                <ARTG>286037</ARTG>
                <ARTG>286038</ARTG>
                <ARTG>286039</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA213</BillingCode>
            <Name>Peripherally Inserted Central Catheter</Name>
            <Description>Valved, Power Injectable PICC, Multiple Lumen</Description>
            <Size>4Fr-6Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>191603</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA274</BillingCode>
            <Name>PowerMidline</Name>
            <Description>Multiple lumen, power injectable percutaneous catheter</Description>
            <Size>4Fr - 5Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>228968</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2018-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA283</BillingCode>
            <Name>PowerHohn 6 Fr Multi Lumen, Basic Kit</Name>
            <Description>PowerHohn 6 Fr Dual Lumen, Basic Kit</Description>
            <Size>6 Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>309587</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA298</BillingCode>
            <Name>PowerPICC SOLO²™ HF 5 French Triple Lumen Basic</Name>
            <Description>A peripherally inserted central catheter made from specially formulated and processed medical grade materials. Each PowerPICC SOLO²™ catheter has a kink resistant, reverse tapered design. PowerPICC SOLO²™ is packaged in a tray with accessories for reliable long (greater than 30 days) or short (less than 30 days) term vascular access.    The PowerPICC SOLO²™ catheter valve controls the flow of fluids to provide clamp-free infusion therapy. Positive pressure into the catheter (gravity, pump, syringe) will open the valve, allowing fluid infusion. When negative pressure (aspiration) is applied, the valve opens allowing for the withdrawal of blood into a syringe.</Description>
            <Size>5 French Triple Lumen</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>325434</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA299</BillingCode>
            <Name>PowerPICC SOLO²™ HF 5 French Triple Lumen 3CG</Name>
            <Description>PowerPICC SOLO²™ HF 5-Fr Triple Lumen 3CG comes with a Sherlock 3CG stylet which is made of specifically formulated materials designed to aid in the placement of peripherally inserted central catheters. The stylet material provides internal reinforcement to aid in catheter placement. The Sherlock 3CG stylet may be used with the Sherlock 3CG Tip Confirmation System (TCS) to provide catheter tip placement information during the procedure.    The Sherlock 3CG stylet, Sherlock 3CG TCS system, and the Site~Rite 8 Ultrasound System, include a comprehensive, integrated set of PICC placement tools such as vein location, lumen size visualisation, needle guided vein access, catheter tip orientation, catheter tip depth, catheter tip placement using ECG, and ECG placement documentation. In most instances, this removes the need for confirming PICC tip placement through radiological methods.   </Description>
            <Size>5 French Triple Lumen</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>325434</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA300</BillingCode>
            <Name>PowerPICC SOLO²™ HF 5 French Triple Lumen Radiology</Name>
            <Description>A peripherally inserted central catheter made from specially formulated and processed medical grade materials. Each PowerPICC SOLO²™ catheter has a kink resistant, reverse tapered design. PowerPICC SOLO²™ is packaged in a tray with accessories for reliable long (greater than 30 days) or short (less than 30 days) term vascular access.    The PowerPICC SOLO²™ catheter valve controls the flow of fluids to provide clamp-free infusion therapy. Positive pressure into the catheter (gravity, pump, syringe) will open the valve, allowing fluid infusion. When negative pressure (aspiration) is applied, the valve opens allowing for the withdrawal of blood into a syringe.  </Description>
            <Size>5 French Triple Lumen with 70cm Nitinol Guidewire  5 French Triple Lumen with 135cm Nitinol Guidewire</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>325434</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2020-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA303</BillingCode>
            <Name>Provena™ Midline Catheter</Name>
            <Description>The Provena™ Midline Catheters are intended to be inserted into a patient's vascular system to sample blood, administer fluids and power injection of contrast media. The unique feature of Provena™ Midline Catheters is that they are configured with a smaller outer diameter with minimal reduction to the intraluminal area assisting in providing the optimal catheter to vein ratio, whilst still enabling good flow rates to ensure the therapy delivery is uncompromised.</Description>
            <Size>4Fr dual lumen  </Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>317521</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS071</BillingCode>
            <Name>BioFlo Midline</Name>
            <Description>Percutaneous Catheter, Dual Lumen, Power Injectable</Description>
            <Size>Length: 20 cm  French Size: 5Fr</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>312726</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS076</BillingCode>
            <Name>Peripherally Inserted Central Catheter (PICC)</Name>
            <Description>Peripherally Inserted Central Catheter, Multiple Lumen, Power Injectable</Description>
            <Size>5Fr - 6Fr</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>203832</ARTG>
                <ARTG>215418</ARTG>
                <ARTG>215419</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2021-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS077</BillingCode>
            <Name>Peripherally Inserted Central Catheter, Multiple Lumen</Name>
            <Description>Peripherally Inserted Central Catheter, Single Lumen, Anti-Thrombogenic Catheter Material, Power Injectable</Description>
            <Size>5Fr - 6Fr</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>203831</ARTG>
                <ARTG>203832</ARTG>
                <ARTG>215411</ARTG>
                <ARTG>215412</ARTG>
                <ARTG>215418</ARTG>
                <ARTG>215419</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>MS080</BillingCode>
            <PriorBillingCodes>
                <PriorBillingCode>MS072</PriorBillingCode>
                <PriorBillingCode>MS073</PriorBillingCode>
            </PriorBillingCodes>
            <Name>Peripherally Inserted Central Catheter, Multiple Lumen</Name>
            <Description>Power injectable with Pressure Accivated Safety Valve (PASV) technology</Description>
            <Size>5Fr x 55cm (Dual Lumen), 6Fr x 55cm (Dual Lumen), 6Fr x 55cm (Triple Lumen)</Size>
            <SupplierCode>MS</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>175080</ARTG>
                <ARTG>178780</ARTG>
                <ARTG>179150</ARTG>
                <ARTG>203830</ARTG>
                <ARTG>203831</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX035</BillingCode>
            <Name>Arrow multi lumen pressure injectable peripherally inserted central catheter (PICC) sets</Name>
            <Description>Arrow multi lumen pressure injectable PICC (peripherally inserted central catheter) sets</Description>
            <Size>4, 5, 6Fr multi lumen Pressure Injectable PICCs various Pressure Injection rates, various lengths. Double &amp; triple Lumen configurations.</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>148784</ARTG>
                <ARTG>180279</ARTG>
                <ARTG>278735</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX056</BillingCode>
            <Name>Arrow Pressure Injectable Multi-Lumen Central Venous Catheterisation Kit</Name>
            <Description>7F x 20CM Pressure Injectable Central Venous Catheter with Insertion Kit</Description>
            <Size>7F x 20CM</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>196747</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2019-11-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX062</BillingCode>
            <Name>Arrow Pressure Injectable Midline</Name>
            <Description>The Arrow Pressure Injectable Midline Catheter is a peripherally inserted intravenous catheter manufactured with medical grade, flexible polyurethane. The Arrow Midline is designed with a non-tapered catheter body and softens in-situ to be less traumatic to the vessel.   The Arrow Pressure Injectable Midline Catheter is indicated for peripheral access to the venous system for intravenous therapy, blood sampling, infusion, and pressure injection of contrast media. The maximum pressure of pressure injector equipment used with the Arrow Pressure Injectable Midline Catheter may not exceed 300 psi. The maximum pressure injection flow rate for the specific lumen being used for pressure injection is printed on the extension line hub.  </Description>
            <Size>Double Lumen Pressure Injectable  Midline, 5Fr , 20cm </Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>371714</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2022-03-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC280</BillingCode>
            <Name>Turbo-Ject Peripherally Inserted Central Catheter Set (Double Lumen)</Name>
            <Description>4/5 Fr Double Lumen Polyurethane PICC with Micropuncture Peel-Away Sheath Introducer and Echogenic needle</Description>
            <Size>4 and 5 French, 60 cm Catheter length, double lumen catheter</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>161615</ARTG>
                <ARTG>161616</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2010-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>WC297</BillingCode>
            <Name>Turbo-Ject Peripherally Inserted Central Venous Catheters Set (Triple Lumen)</Name>
            <Description>Turbo-Ject Peripherally Inserted Central Venous Catheters (PICC) Sets are intended for short- or long-term use for venous pressure monitoring, blood sampling, administration of drugs (eg chemotherapy) and fluids (eg TPN), and for use with power injectors for delivery of contrast in CT studies.</Description>
            <Size>6Fr, Catheter length 60cm</Size>
            <SupplierCode>WC</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <Suffix>pi (power injection)</Suffix>
            <ARTGs>
                <ARTG>161616</ARTG>
                <ARTG>161615</ARTG>
            </ARTGs>
            <MinimumBenefit>152</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2012-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>BA130</BillingCode>
            <Name>Groshong Peripherally Inserted Central Catheter</Name>
            <Description>Closed-Ended PICC, Multiple Lumen</Description>
            <Size>3Fr - 5Fr</Size>
            <SupplierCode>BA</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <ARTGs>
                <ARTG>42589</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Prosthesis</ItemType>
            <BillingCode>TX028</BillingCode>
            <Name>Arrow Peripherally Inserted Central Catheterisation Sets</Name>
            <Description>Range of Polyurethane double lumen peripherally inserted central catheters with or without stylet</Description>
            <Size>4 and 5 Fr, range of lengths</Size>
            <SupplierCode>TX</SupplierCode>
            <CategoryID>24</CategoryID>
            <SubCategoryID>214</SubCategoryID>
            <GroupID>1650</GroupID>
            <ARTGs>
                <ARTG>148782</ARTG>
                <ARTG>148784</ARTG>
            </ARTGs>
            <MinimumBenefit>96</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>0</HumanTissueAmount>
            <ActionFlag>No Change</ActionFlag>
            <CycleStartDate>2015-08-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>MAB02</BillingCode>
            <Name>Demineralised Bone Matrix 0.5cc; Freeze Dried</Name>
            <Description>Demineralised Bone Matrix 0.5cc; Freeze Dried</Description>
            <Size>0.5 cc</Size>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1499</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB04</BillingCode>
            <Name>Disc - Freeze Dried</Name>
            <Description>Disc - Freeze Dried</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>858</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB10</BillingCode>
            <Name>Bone - Cancellous Strips (2) Freeze Dried</Name>
            <Description>Bone - Cancellous Strips (2) Freeze Dried</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>912</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB11</BillingCode>
            <Name>Fascia Lata - per sq cm</Name>
            <Description>Fascia Lata - per sq cm</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>8</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB14</BillingCode>
            <Name>Elbow - joint</Name>
            <Description>Elbow - joint</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2961</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB20</BillingCode>
            <Name>Femur - Distal Half</Name>
            <Description>Femur - Distal Half</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>4135</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB30</BillingCode>
            <Name>Femoral Rings</Name>
            <Description>Femoral Rings</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2136</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB31</BillingCode>
            <Name>Femoral Rings - Freeze Dried</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>759</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB39</BillingCode>
            <Name>Humeral Shaft</Name>
            <Description>Humeral Shaft</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2164</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB47</BillingCode>
            <Name>Patella</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>996</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB51</BillingCode>
            <Name>Tibia - Distal</Name>
            <Description>Tibia - Distal</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2795</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB52</BillingCode>
            <Name>Cortical Strut</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>557</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB53</BillingCode>
            <Name>Tibia Shaft</Name>
            <Description>Tibia Shaft</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1331</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB54</BillingCode>
            <Name>Tibia - Proximal</Name>
            <Description>Tibia - Proximal</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3175</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB55</BillingCode>
            <Name>Tibia - Whole</Name>
            <Description>Tibia - Whole</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>5703</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2005-10-31</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB56</BillingCode>
            <Name>Autologous Skull Flap - processed</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2511</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB57</BillingCode>
            <Name>Tendon - Tibialis Posterior</Name>
            <Description>Tendon - Tibialis Posterior</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2838</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB59</BillingCode>
            <Name>Tendon - Gracilis</Name>
            <Description>Tendon - Gracilis</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2838</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB61</BillingCode>
            <Name>Femoral Head - Autologous</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2734</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB63</BillingCode>
            <Name>Tendon - Patellar Hemi</Name>
            <Description>Tendon - Patellar Hemi</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2107</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB65</BillingCode>
            <Name>Tendon - Achilles Hemi</Name>
            <Description>Tendon - Achilles Hemi</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1925</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB67</BillingCode>
            <Name>Bone - Ronguered Chips Freeze Dried</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>3191</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB68</BillingCode>
            <Name>Bone - Ronguered Chips</Name>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2556</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB70</BillingCode>
            <Name>Tendon - Semitendinosus</Name>
            <Description>Tendon - Semi tendinosis</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>2580</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2009-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB78</BillingCode>
            <Name>Demineralised Bone Matrix, 1 cc, Freeze Dried</Name>
            <Description>Demineralised Bone Matrix sourced from Human Tibial and Femoral Diaphysis.  Irradiated at a minimum dose of 11kGy  Clinical uses: revision orthopaedic procedures; Delayed or non-union fractures; Filling osseous cavities and Spinal Fusion</Description>
            <Size>1 cc</Size>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>3</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>1873</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2020-07-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB71</BillingCode>
            <Name>Skin 50cm² - frozen skin graft from human origin</Name>
            <Description>Skin 50cm² - frozen skin graft from human origin</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>28</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>328</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
        <ProsthesisItem>
            <ItemType>Human Tissue</ItemType>
            <BillingCode>QBB72</BillingCode>
            <Name>Skin 100cm² - frozen skin graft from human origin</Name>
            <Description>Skin 100cm² - frozen skin graft from human origin</Description>
            <SupplierCode>MAB</SupplierCode>
            <CategoryID>28</CategoryID>
            <ChangeExplanation>DELETE</ChangeExplanation>
            <MinimumBenefit>0</MinimumBenefit>
            <MaximumBenefit>0</MaximumBenefit>
            <HumanTissueAmount>631</HumanTissueAmount>
            <ActionFlag>Delete</ActionFlag>
            <CycleStartDate>2013-02-01</CycleStartDate>
            <CycleEndDate>2022-12-01</CycleEndDate>
        </ProsthesisItem>
    </ProsthesisItems>
</Prosthesis>
